Articles by Allen

This one is great.

Health “experts” in the United Kingdom are advising a new solution to their nation’s increased incidence of overweight and obesity.

This new solution is one of several included in a new report, “Obesity — Can We Turn The Tide?” which was recently published in the British Medical Journal.

Here’s the new solution these academics are advising:

Include a helpline phone number for weight loss advise in all clothes with a waist of more than 40 inches for men and 35 inches for women. They also recommend this warning label be placed in all women’s clothes with a size of 16 or above.

OK, so lets say you are above these size limits and so you find this warning label attached to all your clothing. Now what?

I guess these academics assume the people would call the phone number and get some weight-loss advice. But, what weight-loss advice are they going to get which has been proven to work? Are they going to recommend starting on one of the popular book-based diets or commercial weight-loss programs that have a 95% failure rate? Or — do they have some other advice in mind?

Is this crazy stuff or what?

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

The American Dietetic Association has come out with a great list of the “Ten Red Flags of Junk Science.”

Science frequently does junk research but there is no area where this practice is more common than with nutrition and weight loss.

We are bombarded with research study after research study which only create confusion because they all seem so contradictory. There are two reasons for this:

* Doing good and valid research in nutrition and weight loss is enormously difficult and it’s this difficulty that leads to contradictory outcomes.

* The results of the research are inappropriately presented to the public.

It is this second reason that the American Dietetic Association is targeting. Here are their ten red flags you should watch out for:

1. Recommendations that promise a quick fix
2. Dire warnings of danger from a single complex study
3. Claims that sound too good to be true
4. Simplistic conclusions drawn from a complex study
5. Recommendations based on a single study
6. Dramatic statements that are refuted by reputable scientific organizations
7. Lists of “good” and “bad” foods
8. Recommendatons made to help sell a product
9. Recommendations based on studies published without peer review
10. Recommendations from studies that ignore differences among individuals or groups.

My advice? Ignore all scientific research reported on by the media. There is no way you can separate the wheat from the chaff.

Yikes! I just read an article about weight loss that actually has some value.

It’s an article about weight-loss myths.

Here is how the article starts out:

“Myths are all over the place without a doubt. Some of these myths are really easy to debunk, but other myths seem so realistic that a lot of the times we take them as reality and sadly this affects our perception of things.”

Here are the myths the article lists:

* “Lose 30 pounds in 30 days”
* Fat is bad for you
* Carbohydrates are bad for you
* Lose weight by not eating
* Don’t eat after 6 p.m.
* Salad bars ahre healthy
* Diet sodas aid in weight loss
* You shouldn’t step on a scale
* You can lose weight with a pill
* You have to join a gym

Great stuff!

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

In 2002, Steve Ballmer — the president of Microsoft — lost 50 pounds. His success prompted the company to offer a weight management benefit to all employees.

Here is what’s included:

* Year’s worth of sessions with a personal trainer

* Behavioral and nutritional counseling

* Support groups

* Medical supervision

The total cost of the program is $6,000 which the employee contributes just 20%.

The result? 61,100 pounds have vanished from 2,152 Microsofties.

So, what do you think? Is this a program which will likely be rolled out to all employees in the United States?

I don’t think so. Microsoft’s experience is like the articles about celebrities losing weight. We read about them losing 50 pounds or whatever but, what we don’t learn, is that they get to work with a personal trainer several hours a day and have a personal chef preparing all the food they eat.

It would be nice — but that’s just not the reality for most Americans.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

This is weird.

Yesterday I posted a blog about a list of 15 weight-loss tips which are worthless.

Well, I just found another list of 15 tips. What is it about 15?

Anyway, out of this list of 15, I could only find three tips that are any good (better than yesterday’s list in which I could only find one good tip).

What’s interesting is that a couple of the bad tips from yesterday also showed up on this list:

* Drink more water
* Eat small meals throughout the day

This is amazing to me. This type of advice — which is based on absolutely no scientific evidence — is almost universally accepted.

For example, I’ve done the research on water. It turns out that NO ONE knows where this idea came from. People have gone back into the medical literature looking for some study which suggested drinking more water was a good idea and nothing could be found. Instead, there have been plenty of studies showing water consumption has no effect on weight.

But, despite the research, drinking more water is on almost everyone’s list of weight loss tips.

But, at least this list had three good ideas — which have some scientific support:
* Avoid the latest weight loss diets
* Take notice of your food
* Drink less soda

However, with these three mixed in with twelve tips which are worthless, the author isn’t doing anyone with weight problems any favors.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

I just read a blog by which summarizes “all the best weight-loss tips in a single post.”

The promise:

“These tips are going to be really big weight loss tips. They will surely help you in getting weight off.”

HOGWASH

There are 15 of these “big weight loss tips” and there is only one which is any good — “shut off TV while eating.”

Now the reason given for why this tip is a good one is all wrong but at least the advice is good.

The other 14 tips are pure nonsense. Here are the worst of the bunch:

* Drink 6 to 8 glasses of water every day
* Eat “negative calories foods”
* Eat small, frequent meals throughout the day
* Take vitamins to increase your metabolism
* Eat green tea via a drink, a pill or a weight-loss patch

No wonder the incidence of overweight and obesity is going up.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

Health ministers from 53 European countries have approved a charter pledging the nations’ commitment to fight obesity on the continent.

The charter is the first ever agreement among nations having to do with obesity, and it focuses on concrete goals like making healthy foods more available and improving roads so more people can bike and walk.

The charter also expects food companies to “self-regulate” in their marketing of fatty and sugar foods to children.

OK, I applaud the effort — but the goals are down right silly.

I’ve said this before but where is there any evidence that this charter’s recommendations are going to have any effect on the “obesity epidemic.”

Here we have 53 countries all agreeing to take action (and probably committing significant resources to the effort) with no data that anything they are doing will make any difference. In fact, if they were to dig into the research like I have, they’d discover their actions are likely to cause more harm than good.

Obesity isn’t caused by the lack of availability of healthy foods, poor roads, or food advertising — so why did they come up with the goals they did?

Pure craziness.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

Have you heard about the Surgeon General’s “Call to Action” to prevent and decrease overweight and obesity?

I hadn’t either.

So the Surgeon General must not have done a lot of “calling.”

Or, more likely, he realized that the “call” was based on such shaky evidence, it didn’t deserve much effort.

Like almost all public health policy related to the increased incidence of overweight and obesity, this “call” tell governments, communities and schools to “take action to assist Americans in balancing healthful eating with regular physical activity.”

So, where is their evidence this will work? Sure, it seems logical but, as I’ve said in previous blogs, the data just isn’t there to support it. But that doesn’t keep the health policy folks from offering up ideas on how to make these things happen — for example:

* Daily gym in school
* Reduce TV time
* Ensure that people get 30 minutes of moderate physical activity most days of the week (have you heard this one before/)
* Create more opportunities for physical activity at worksites
* Make community facilities available for physical activity
* Promote healthier food choices — including 5 servings of fruits and vegetables each day
* Ensure schools provide healthful foods

Don’t get me wrong, these are all great ideas — but for reasons other than addressing the “obesity epidemic.”

Doing things to help American increase their physical activity is a wonderful idea — if the goal is to improve American’s fitness.

And, doing things to help Americans eat healthier food is a wonderful idea — if the goal is to improve American’s nutrition.

However, these two objectives are the WRONG place to focus if the goal is to prevent overweight and obesity.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

Finally, someone has written an article that makes some sense.

The title: “Some food dos and don’t are best ignored, experts say:

Yep, this article points out some of the dozens of silly food ‘rules’ that are plain not true.

Here are a few of the ‘rules’ listed in the article:

* Don’t eat before bedtime or you’ll gain weight (never mind that folks in Spain almost eat their family meal just before bed).

* It’s best to eat at the same times every day (but, what if you aren’t hungry?)

* Refusing food at a party or when visiting is rude (no, what’s rude is not being able to tell your host you are totally satisfied with their wonderful food because you ate something you didn’t like or ate more than you wanted to).

* Bread is fattening, nuts are fattening, pasta is fattening (actually, there are no fattening foods).

Why do people continue to believe these silly ideas — when there is no absolutely no evidence they are true? — and a lot of evidence they are false.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

Have you heard of the “national weight control registry?”

It is a database of more than 4,800 adults who report being successful at maintaining a weight loss of at least 30 pounds for a minimum of one year.

Once someone registers by meeting these basic criteria, they are sent annual surveys to collect information about how they remain successful at preserving their weight loss.

The results from these surveys are then consolidated into a summary which is often published by the media.

Here is one such summary.

Methods used to lose weight by registrants:
* 55% use a formal program or professional assistance
* Most use both diet (low calorie and fat) and physical activity
* Majority report limiting the types of foods eaten (e.g., avoid fatty foods)
* Less than half report limiting the quantity of food eaten
* About half counted calories

So, what do you think? Is this list worth paying attention to?

First of all, who do you think registers? Did you know about this registry? Do you know anyone who knows about it? If you lost a bunch of weight, would you register?

Here is my guess. If someone loses a bunch of weight using a “formal program” or “professional assistance,” he or she is told about the registry and encouraged to register. In fact, I bet they are almost forced to register.

And what do these programs recommend? — dieting, limiting foods, counting calories. So, if 55% use a “formal program” or “professional assistance,” it’s no surprise that about half of the registrants diet, limit foods and count calories.

But, here is what is suprising to me. Given the number of people involved with Weight Watchers, Nutrisystems, and all the rest — and the number of people who see a weight-loss expert of some type, wouldn’t you think more than 4,800 people in the entire United States would have registered by now?

With those results, it seems like the National Weight Control Registry is the wrong place to look for weight-loss advice.

Allen Oelschlaeger

It seems like the media is constantly reporting on obese people dieing who are in their 20s, 30s, or 40s.

The assumption is that obesity is a killer disease.

Despite what the media says, the truth is that there’s a huge controversy about obesity’s real impact on people’s health.

I’m not going to go into all the research here. Just understand that the evidence related to obesity’s impact on health is VERY INCONSISTENT.

However, I found an obituary back in December pretty interesting.

Do you know the name Rosalie Bradford?

I didn’t until I read this obituary.

It turns out she holds the Guinness Book of Records for being the world’s heaviest person. In 1987, she weighed 1,050 pounds. At that weight, she was 8 feet wide and took 90 minutes to bathe.

Then she discovered Richard Simmons, the television fitness character — and by 1992 she held a second Guinness world record.

Yep, she lost 736 pounds, dropping to a weight of 314 pounds at the age of 49 (about 3 pounds lost per week).

Sadly, she died when she was 63 — but she lived a whole lot longer than most people would probably have predicted.

Here’s the reality — a lot of extra weight probably isn’t good for your health, but it probably isn’t the killer it’s often made out to be.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

Since 1999, the International Food Information Council Foundation has tracked the media coverage of the obesity issue.

Last month, I read an article with the quarterly tracking chart included.

Yikes!

The chart only went back to the year 2000 — in which there were about 4,000 articles published (annual rate of 16,000 per year!).

I would assume the numbers prior to 2000 are far lower — and, if you went back far enough in time, probably nonexistant.

Well, the number of articles has gone up each year since 2000.

Not a big surprise — but would you have quessed a THREE TIMES increase to about 12,000 articles (48,000 per year) in just four years!!

Is this crazy or what?

No wonder we have an obesity problem.

You may have seen the new movie called the “Secret.” It’s message — you attract what you think about. In other words, if you think good things are going to happen, they’ll likely happen (e.g., power of positive thinking). However, the opposite will likely occur also.

Maybe if we all thought a lot less about the “obesity epidemic” because we didn’t have to read as much about it, we would all lose weight.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

I found this pretty darn interesting.

The MTA (responsible for New York subways) keeps track of the causes for train delays.

Track work and signal troubles are the top two causes.

Guess what is #3 — sick customers.

Asim Nelson, a MTA emergency medical technician, was quoted in AM New York as saying, “While flu-symptoms, anxiety attacks, hangovers, and heat exhaustion also strike passengers, they pale in comparison to fainting caused by missed meals.”

He went on to say, “You have women trying to get their boides tight for the summer and they won’t eat. Not eating for three for four days, you are going to go down. If you don’t eat for 12 hours you are going to get weak.”

This is so disappointing.

First of all, there’s no reason to skip meals in order to management your weight. In fact, doing this probably harms weight loss efforts rather than helps — for a whole bunch of reasons.

Second, it’s crazy our society so demands thinness that people will risk their health and well being by doing what they think is necessary to keep their weight down.

People need to know the straight scoop about weight loss so they can do it correctly while protecting their health.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

Most doctors and nutritionists say that the increased incidence of overweight and obesity has a simple explanation — we eat too much and exercise too little.

But, as a UK article recently pointed out,

“The current wave of obesity in the US began in about 1980. Back then, only about 5 percent of the population was obese. Now, the figure is six times greater. But the Western diet hasn’t become noticeably more calorific in the past 26 years. Nor do people exercise markedly less or drive more.”

The article asks the question “could something else be contributing to the epidemic?”

I can tell you the answer has to be YES. There’s just too much evidence that our dietary habits and physical activity levels haven’t changed enough to explain the population’s increase in weight.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

A common assumption is that exercise is a key positive contributor to any weight-loss effort.

Well, it turns out this assumption hasn’t been consistently demonstrated by research studies.

In fact, many studies don’t show exercise making ANY contribution. In other words, people who exercise as part of a weight-loss program don’t lose any more weight than people who don’t exercise.

That’s probably why the US Dietary Guidelines emphasize the value of exercise in maintaining weight loss (there is more research evidence this is true) but doesn’t say much about exercise contributing to weight loss.

So, why is the belief that exercise is important to losing weight so prevalent?I think it’s because studies are done demonstrating a minimal positive impact but the authors conclude something much different.

A recent study from Australia is an example of this. The authors did an extensive literature search and found 43 studies of good enough quality to be included in their review. When they dug into the data, here is what they found:

* Excercise by itself compared with no treatment resulted in only small weight losses across the studies.
* Exercise combined with diet resulted in a 2.4 pound greater weight loss than diet alone.
* More intense exercise combined with diet resulted in a 3.7 pound greater weight loss than diet alone.

I don’t know about you but these results don’t seem very signficant to me. If someone lost 20 pounds using ONLY dietary measures, this data suggests they would have lost 22.4 to 23.7 pounds if they would have added moderate to intense exercise to their regimen.

However, given these results, the authors conclude the following:

“The results of this review support the use of exercise as a weight loss intervention, particularly when combined with dietary change.”

Do you see the problem? The impact of exercise on weight loss was minimal in this study but the conclusion suggests it was signficant.

Exercise is great for your health (in fact, this study concluded that “exercise is associated with improved cardiovascular disease risk factors even if no weight is lost”) but the evidence suggests it contributes very little to weight loss.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

An 8-year study on 600 Americans by MPH researchers showed that the more diet sodas a person drinks the more weight they were likely to gain.

The study started with normal weight Americans and eight years later about a third were overweight or obese.

Suprisingly, those who gained the most weight drank at least two cans of diet soda a day.

The researchers didn’t know why this relationship occurred.

Also, given the study only showed a correlation and not a cause-and-effect relationship, the researchers couldn’t say if:
* Drinking diet soda caused obesity
* Obesity caused people to drink diet soda
* Some other factor — not identified in the study — caused people to both drink diet soda and gain weight.

However, this same correlation has shown up in other studies so there probably is something real going on here.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

A recent study lists the United States as having the 9th highest percentage of people who are overweight or obese.

Yep, according to the authors of this study, 74.1% of the U.S. population is overweight or obese.

Here are the countries who were listed higher: Nauru (94.5%), Federated States of Micronesia (91.1%), Cook Islands (90.9%), Tonga (90.8%), Niue (81.7%), Samoa (80.4%), Palau (78.4%), Kuwait (74.2%).

When I first heard we were 9th, I didn’t think that sounded so bad. But, then I saw this list. Niue, Palau, Nauru — I didn’t even know these countries existed!

But what about our peer countries?
* Japan — 22.6%
* China — 28.9%
* France — 40.1%
* Germany — 60.1%
* Canada — 61.1%
* United Kingdom — 63.8%

Once I saw this list, being 9th doesn’t look so good — does it?

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

A new book published by the University of Toronto Press promotes the idea of taxing junk food.

This book, “The Health Impact of Smoking and Obesity and What To Do About It,” suggests that the lessons learned from tobacco can be applied to obesity.

One of these lessons is that economic levers can have an impact. Research has shown that taxing tobacco decreased its use. Therefore, the book states — “One option, then, is to use special taxation on unhealthy, energy-dense foods and/or subsidies for healthy food.”

This idea has a number of very serious problems:

1. As the authors point out, “one of the obvious differences between tobacco and obesity is that people still need to eat.”

Yep, that’s a major problem. With tobacco, the goal is to stop smoking all together. With eating, the goal is for people to eat the correct types and amounts of food for their unique physiology. These goals are so different I would doubt a strategy that worked for one would work for the other.

2. There’s absolutely no evidence that eating “unhealthy” food leads to weight gain. Almost everyone assumes this is true but there’s no data which supports this assumption.

In fact, given the way the body works, there is no reason to even imagine this assumption is true. What matters is HOW MUCH food is eaten — not WHAT TYPE of food. The body doesn’t care if it is being fed refined white bread or whole wheat bread. If the number of calories is the same, that’s how much energy the body has to deal with — either burning it for energy or storing it away as fat.

Therefore, banning “unhealthy” food to address the “obesity epidemic” makes no sense.

3. Who is going to decide what foods are “healthy” and what foods are “unhealthy?” Again, everyone assumes that high fat foods are unhealthy — but then data comes out indicating that pregnant women who don’t eat enough fat have problems and that kids who don’t eat enough fat have nutrient deficiencies.

The truth is that no one knows enough about all the intricacies of nutrition to accurately decide what’s good and bad for each one of us — given that we are all unique in the way our body’s work.

4. Actually, I could go on and on about the problems with the idea of taxing junk food but I’m going to stop here.

I’ll come back to this topic in a later blog.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

France is experiencing an increased incidence of overweight and obesity just like almost every other country in the world.

Although no one knows the true cause of this increase, the working assumption is that everyone in the world is eating less healthy food and getting less physical activity.

This assumption is almost universally accepted even though there is almost no evidence to suggest it is true.

Sure, it makes some logical sense, but there is no data to support this contention.

However, that doesn’t prevent governments, communities and schools from implementing programs (often at great expense) to try to get people to eat healthier and be more physically active — with the single goal of weight loss.

I’m very supportive of eating healthier food due to all the health benefits of improved nutrition — and being more physically active due to all the physical and mental benefits of doing so. However, these behaviors should not be encouraged as a way to lose weight.

Why? Because these behaviors rarely lead to weight loss and, as a result, people often return to their unhealthy eating and sedentary lifestyle when they don’t lose any weight.

But, in desperation and due to the enormous pressures to do something about this “epidemic,” governments, communities and schools are adopting unproven strategies to get people to eat healthier and be more physically active.

France has done this recently by requiring these messages to be included in food advertising:
* “For your health, eat at least five fruits and vegetables per day”
* “For your health, undertake regular physical activity”
* “For your health, avoid eating too much fat, to much sugar, and too much salt”
* “For your health, avoid snacking between meals”

This might be OK advice (yet, not necessarily the BEST advice) but the real problem is that these messages are tied to weight management — a goal for which they will likely have little impact.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

Yesterday I listed some reasons obesity researchers are putting forth for why there is a higher incidence of obesity.

One of their explanations is that people are getting too little sleep.

There have been a number of studies demonstrating a link between less sleep and increased weight over the last few years. The most recent was published in the American Journal of Epidemiology.

In this study researchers followed 68,000 women over a period of 16 years — tracking weight and sleep patterns.

Here is what they found.

Women averaging less than five hours sleep per night were 32 percent more likely to have a 7 pound weight gain over the 16 year period than women sleeping seven hours or more.

No one knows why this association occurs but some guess that sleep deprivation somehow alters the hormones that affect appetite and metabolism.

So, there you have it — a very good reason to sleep in a bit.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

With the increased incidence of obesity worldwide there is an enormous effort to try to figure out the cause.

The reality is that no one really knows — but a lot of people are certainly making guesses.

Here’s a list from the International Journal of Obesity of what 20 obesity experts believe are the 10 most plausible explanations of this epidemic.

1. Better indoor climate control (so we sweat and shiver less)
2. Less people are smoking (nicotine is an appetite suppressant)
3. Overweight people have more kids (who are genetically programmed with the tendency to gain weight)
4. Higher percentage of the population are older people (who are generally heavier than younger folks)
5. People are taking more prescription drugs which can lead to weight gain
6. Increased pollution which ends up disrupting the hormones that control weight
7. Women are giving birth at a higher age (which seems to be an independent risk factor for obesity)
8. Overweight people marry each other and then have kids who are genetically prone to be overweight

The evidence supporting any of these reasons is pretty flimsy.

But, here’s the bigger problem — we can’t or, in some cases shouldn’t, do anything about these explanations. We aren’t going to stop heating and cooling our homes, ban overweight people from having kids, stop people from taking needed prescription drugs, keep older women from having children, or require overweight people to not marry each other. And we certainly aren’t going to suggest that people should continue to smoke so as to keep their weight down. And there’s nothing we can do about the national demographic trends of our population getting older. And, sure, we should be trying to reduce pollution levels for many reasons beyond its possible impact on obesity incidence — but that’s a very long process.

But, wait a minute — there are only 8 reasons listed above. What about the other two?

Yep, I left two out because, if they prove to be valid, we might actually be able to do something about them.

The first one is there’s evidence that what women eat during pregnancy can contribute to an increased incidence of obesity. High fat diets, diets that cause high-blood sugar levels, and starvation have all been implicated. Women are already told to not drink alcohol, not smoke, take a multivitamin with folic acid, and avoid certain drugs during pregnancy. Maybe it also makes sense to educate women on the best diet practices during pregnancy. Right now, no one knows exactly what the best advice would be — but, if this was ever determined, we could certainly put such an educational program in place.

The second explanation is that people are getting too little sleep. This reason is the first one listed by the obesity researchers and is the most intriguing.

Over the last few years several well-executed studies have shown a link between less sleep and an increased incidence of obesity — and separate research has demonstrated that most people are sleeping less than they used to. In a future blog I’ll review some of this research.

So, ten explanations for the increased incidence of obesity, but only one we can do something about in the short term — get a good night’s sleep.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

As I’ve discussed in the past, glycemic index (GI) is a measure of how fast food is absorbed into the blood stream. Foods that are absorbed slowly have a low GI and foods that are absorbed fast have a high GI.

But, here’s the kicker — GI measurement is based on foods being eaten by themselves, which almost never happens. Once you mix foods and end up eating a combination of protein, carbohydrate and fat, the individual GIs of each food no longer applies to how fast the entire meal is absorbed.

But, that doesn’t stop researchers from doing studies on GI.

Here is the conclusion from a GI study published in the October issue of the American Journal of Clinical Nutrition:

*** A high glycemic index diet correlates with greater waist circumference, body weight, and percentage of body fat in women — but these correlations are not seen in men. ***

So what the heck are we supposed to learn from this???

Isn’t it obvious? If you’re a man, you can live primarily on donuts and juice (foods classified as having a high GI) and never have any problems with your weight. But, if you’re a woman, you better not get near these foods.

I’m clearly being sarcastic. You can’t come to this conclusion from this study. In fact, you can’t come to any conclusion.

Why? Here are just some of the reasons:

1. The study implies that the GI of the women’s diet CAUSED the higher weight and fat levels. That’s just not true. Correlations (which is what they found in this study) don’t say anything about cause and effect.

2. Glycemic index of individual foods is an interesting concept but is almost impossible to apply in daily life. GI has only been measured on a few foods; GI is not listed on a product’s food label so memorization or carrying a reference text with you is the only way to know the GI of each food; the measured GI of a food changes with how it is cooked, prepared and chewed; the GI of individual foods does not apply when foods are combined.

3. Even thought the different results between men and women has no explanation, the study implies that women need to be concerned about GI and men don’t.

Bottom line — this study is just another example of the information presented by the media about weight-loss and nutrition that creates more confusion than help — and that actually contributes to the world’s “obesity crisis.”

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

Are you familiar with Google AdSense — those little text ads that seem to show up on almost every web page on the Internet?

Here is how AdSense works.

Advertisers bid on words that people might enter into a search engine. Then, if you enter that word or phrase into Google, the highest bidder’s ad show up on the right side of the Google results page.

These same ads can also appear on other web pages (with permission of the web page owner) if the words being bid on are included in the page text. For example, if a web page is about dogs, then ads from advertisers who bid on dog-related words would display on that page — and the page owner would get paid by Google if someone clicked on that ad.

Relative to my area of research, I find this practice quite humorous at times and a good screen for the validity of the information I find.

For example, I might read a review of some legitimate weight-loss study that says to not pay attention to fad diets and diet pills, and on the same page find ads like this:

Lose 20 Pounds in 3 Weeks
Amazing Chinese fat-loss secret. As seen on Oprah and 60 minutes

or

Oprah’s Diet Review
Oprah and NBC report: Hoodia works for dieters. Try free sample here.

When I see this, I have two reactions:

1. Laughter — talk about contradictory messages!!!

2. Questioning of the validity of the article. I wonder if the author is more interested in getting AdSense revenue or in offering valuable information.

The reality is #2 is a big problem. People are now putting up web pages and writing articles with nonsensical information just as a backdrop for displaying AdSense advertisements.

Bottom line — if you see these AdSense ads on a web page, you should seriously question the validity of what you are reading.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

Check out this headline from an article I read over the weekend:

“A new study suggests that middle aged adults looking for effective methods of losing weight should take into account the fact that regular physical exercise is more effective than a strict diet.”

There you have it — proof that exercise is better than dieting for losing weight.

But wait a minute!

What about the vast number of studies that demonstrate just the opposite? Did the US government guidelines (based on a thorough review of all the available research) get it wrong in saying that exercise has NOT shown to be effective in helping people lose weight?

This happens all the time. The only published studies that get any media attention are the ones the contradict the general conclusions from available research.

In this case, the study referenced was based on data from 34 adults between 50 and 60 years of age collected over a relatively short period of time. Never mind that the conflicting research is based on studies with thousands of participants extending over multiple years.

In my course I call this the “one study problem” — where a single study is assumed to be true where, in fact, no single study in the health-care field has ever proven anything.

Did you notice the above headline described the study’s results as “the fact?” I’m sorry, but there were no “facts” that came out of this study. In reality, on the topics of weight, nutrition, and fitness, there are no “facts” that come out of any single study.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

If you are a regular reader of this blog, you know I rarely read weight-loss tips with which I agree. That’s the reason I wrote my course on weight, nutrition, and fitness. I’ve been shaking my head for over 35 years about the myths, misconceptions, and misdirection in the area of weight-loss and I felt an obligation to share the truths.

I keep hoping I’ll read something in the lay press that gets the facts mostly right but, so far, that hasn’t happened.

Today, I saw another article with weight-loss tips that’s more than half wrong. But here’s what’s crazy — the misconceptions about weight loss are so widespread, most people reading this article would think the advice given sounds pretty reasonable.

Here are just a few examples of wieght-loss tips from this article that are out-and-out not true:
* Never skip a meal and always eat breakfast
* Cut out white foods (flour, bread, crackers) because they increase insulin levels which prevents fat from getting burned off
* Drink lots of water to flush harmful toxins from your body and speed up metabolism
* Eat slowly and put down your fork/spoon after every bite
* Do not eat after 7:00 PM
* Exercise every day, without exception

Haven’t you heard all of these tips so often that you just assume they are true?

See, that’s the problem. The falsehoods have been so widely promoted that most of us don’t question their validity. So we end up trying to adhere to all this silly advice and cause ourselves more problems than help.

I’ll keep reading and let you know if I find an article that gets the advice mostly right.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

Since 2004 Virginia has been working on the CHAMPION program — Commonwealth’s Healthy Approach and Mobilization Plan for Inactivity, Obesity, and Nutrition.

Well, last week they released their 300+ page preliminary report based on input from 900 people on behalf of 250 organizations. The results were in the form of a ranking of 4,500 factors that may cause obesity, and a separate ranking of possible solutions.

Here are some of the high-ranking solutions that were identified:
* Provide food label and grocery shopping education
* Educate on ways to cook meals in a short amount of time
* Increase safety of the outdoor environment
* Conduct media/public service announcement campaigns about increasing level of activity
* Offer community based after-school activities
* Provide nutrition education and counseling

So, what do you think? Will these solutions solve our obesity problem?

Personally, I don’t think so.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

I just read an article titled “Go for Scientific Weight Loss.”

I was intrigued because I find that almost all weight-loss advice is based on myths and misinformation rather than the truths.

Well, once again, I was disappointed with what I read. The title was right on, but the content was a bunch of hogwash.

Here are just some of the “scientific” (but completely wrong) concepts presented:

* Obesity is a disease which can “sneak right up on you like a homicidal lunatic.”
* You shouldn’t drink tap water that’s loaded with minerals that aren’t good for you.
* The more water you drink, the less hungry you feel.
* Water will flush toxins from your body when you lose weight
* Supplements that improve metabolic control should be part of any weight-loss program
* Avoid drinking soda pop in aluminum cans because it’s bad for your brain
* Eat your “bad” foods but only once per week
* Fat is “contagious”

Honestly, I’ve rarely seen so much misinformation in one article.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

I just learned about the “Smell and Taste Treatment and Research Foundation” which is promoting the use of “flavor crystals” to help people lose weight.

The idea is to sprinkle these non-caloric scented crystals on your food to intensify its smell and taste.

Normally, you would think that smelling something delicious would actually stimulate your hunger. Well, it turns out that’s true for many smells. However, according to Dr. Alan Hirsch, the founder of this foundation, neutral sweet smells like green apple, banana, vanilla and peppermint will curb a person’s appetite.

This type of thing bothers me a lot.

It seems to me that the last thing you want to do is artificially block or modify your hunger. Hunger is a natural regulatory signal — just like thirst and the desire to breathe. You’d never consider doing anything to block or modify these other two regulatory signals, so why would you ever want to do anything to block or modify hunger?

This is the same problem I have with diet pills or special diets that promise to reduce a person’s hunger. That’s probably the worst thing you can do if you want to lose weight.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

I’m sure you are familiar with “direct-to-consumer” advertising — or DTC. That’s what the prescription medical products industry calls the practice of advertising directly to consumers.

The goal of this practice is to get consumers to request a prescription from their physician.

This type of advertising — which has only been going on since the early 1990s — now dominates the airwaves. The most common ads are for drugs that treat “ED,” insomnia, high cholesterol, and allergies. I’m sure you’ve seen them.

Well, I just learned that this same type of advertising is now being used to promote bariatric (weight-loss) surgery. Allergan (a pharmaceutical company) purchased the Lap-Band System from Inamed Health earlier this year and now wants to get the word out.

This type of weight-loss surgery ties a band around the stomach rather than using staples to make the stomach smaller.

This advertising campaign is one of the medical industry’s first TV campaigns for a surgical procedure. It’s a 60 second testimonial spot that will air on both the national networks and national cable stations between now and the end of the year. The ads give a toll-free number to call and a website to visit. A spokesperson for the company said the responses have exceeded expectations.

To be blunt, I don’t agree with this type of advertising. The medical treatment world is hugely complex, so to expect consumers to evaluate and then request a prescription based on a 60 second advertisement is fraught with problems. I’ll discuss these problems in future blogs.

Bariatric surgery is very serious stuff. In fact, in my course on weight loss, I suggest it as the very last thing to consider — and only after exhausting the primary recommendations I offer.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

This might be the worst idea yet for losing weight.

It’s called the “Bodybugg” and here is how it works.

You strap it to your arm and it measures and records your temperature, galvanic-skin-response, and movement. It’s kind of like a pedometer but it measures more parameters than just steps.

You upload the recorded data to a website and enter what you’ve eaten during the day and the online system calculates if you ate more or less calories than your body used. Or you can just enter your weight and the system will calculate — on a weekly basis — what your average calorie consumption was. If you gained weight, the system will assume you ate more calories than your body used and vice versa.

The BodyBugg costs about $400 plus a monthly fee to access the online system.

I’m sorry, but the concept behind this contraption is hugely flawed. It’s very possible people lose some weight using this device (just as they do using almost any weight-loss method, whether it’s a diet, a pill, or some contraption). The challenge isn’t losing weight — that’s the easy part. The difficulty comes in maintaining a healthy weight while living a normal life.

What do you think? Would anyone wear a contraption like this for the rest of their life and enter everything they ate into a computer on a daily basis? Absolutely not!

The only approach to weight loss that makes any sense is one where you end up living a life where eating plays the normal, healthy role it’s meant to play.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

The US Agency for Healthcare Research and Quality reviewed the discharge records on 86,520 patients who underwent bariatric (weight-loss) surgery during 2002 to 2004 in 17 states.

Here’s what they found out.

The overall mortality (death) rate was 0.19% or about 2 out of every 1000 cases and about 40% experienced various levels of complications once they returned home.

However, the risk of complications, such as bleeding and infection, varied drastically between hospitals. Complications were 66% less likely in highly-rated hospitals than in poorly-rated ones.

These results are obviously a concern to patients, but they also impact the folks paying for these procedures. The average bariatric surgery, with no complications, costs about $25,000. However, this cost jumps to $36,000 if there is a complication while the patient is in the hospital, and to $65,000 if the complication requires the patient to return to the hospital after going home.

What these statistics say to me is that morbidly obese patients should exhaust all other opportunities to lose weight before considering weight-loss surgery. Then, if all other methods fail and weight-loss surgery is a possibility, they should do some serious research before taking this drastic step.

Basically I don’t agree with this quote that was included in the article I read about this study — “Bariatric surgery is the only currently effective treatment we have for the morbidly obese.” (by Samantha Collier, senior vice president of medical affairs at Health Grades, Inc.). This just isn’t true.

Sure, the goofy approaches to losing weight (e.g., any diet, diet pills, hypnosis) don’t work. But there are definitely approaches that do.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

Obesity has been implicated as a contributor to almost every disease known (not always correctly).

Now, one blogger is suggesting that obesity actually contributes to global warming.

Here’s the logic:

* People eat in excess and get bigger
* Overweight people ride instead of walk and, thus, contribute to the greenhouse effect
* The greenhouse effect leads to more rain which causes more grass to grow
* Cows eat the grass and increase in size and number which results in lower beef prices
* Lower beef prices result in people eating more — and the cycle starts again

Obviously, this is a joke. But the logic isn’t too much worse than the explanation of how obesity contributes to 400,000 deaths per year in the US.

Recently, a researcher reviewed the rationale for this huge number and concluded that actual number is more like 26,000 deaths.

Now, don’t get me wrong. Obesity is a real problem and we should be trying to lower its incidence. I just don’t think we need to overstate the statistics in order to get obesity classified as a disease.

Yep, I’m pretty sure that’s what is happening here. See, pharmaceutical and weight-loss companies don’t get reimbursed for drugs/procedures which change appearance. Health insurance companies only want to pay for the treatment of a real disease.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

In an earlier blog I referenced an article I was surprised to find.

Why? — because it actually included some information that I partially agreed with. But, more importantly, it didn’t list a bunch of ideas that are out-and-out wrong — like so much of the stuff about weight loss that’s available on the Internet.

Now, that same author has published another article and I’m disappointed to say that I can’t make the same statement.

In fact of the “six dieting tips” listed, I only agree with one (#4). The rest are pure hogwash.

Some of the other tips are so familiar you might assume they’re valid. THEY ARE NOT!

Trust me. I’ve researched every one of this person’s tips and discovered NONE of them are based on any data. And, worse, some of these tips, if acted upon, actually cause more problems than they solve.

As I’ve said in previous blogs, we need to get real about weight loss — and the only way to do this is to start with the truths, rather than the misconceptions and bad advice that are so prevalent.

Allen Oelschlaeger
Auhor of Finally, the Straight Scoop About Weight, Nutrition, and Fitness

For years I’ve considered Peter Herman and Janet Polivy as two of the few people who have an accurate understanding of the causes of obesity.

They wrote “Breaking the Diet Habit” back in 1983, which I think is one of the best books ever written about gaining and losing weight. In fact, in my course on weight, nutrition, and fitness I heavily quote from their work.

I haven’t heard about them for a while, so I was pleased to see an announcement that they were the keynote speakers at a recent conference titled, “The Clinicians Challenge in Treating Obesity.” This is the inaugural symposium of the newly-formed Obesity Prevention and Treatment Society (OPTS).

Herman and Polivy, professors in psychology at the University Toronto, Canada, are best known for their research on “restraint theory,” which holds that, if you deny yourself of food, you’ll ultimately overeat (also nicknamed the “What the Hell Effect”).

My copy of their book is badly dog-eared and underlined. It is out of print but many libraries have a copy, as do some of the online used book sellers.

Here is more information about the OPTS.

The Obesity Prevention and Treatment Society (OPATS) was formed in early 2006 by clinicians working with obese people who recognized that traditional approaches to weight loss were having very limited success. Traditional, non-surgical weight loss strategies have 5 year success rates of typically less than 20%. More concerningly, research shows that after people lose weight, on average, they regain all that they lose plus another 15%. With over 50% of the population obese or overweight, the Society operates from the imperative of improving treatment outcomes. Of particular concern is the need to apply recent research to understanding the complexities of managing weight in families with young children.

This organization’s website is at http://www.opats.org

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition and Fitness

Here’s an indication of what’s going to happen to the bariatric (weight-loss) surgery market over the next few years.

NewHope Bariatrics just landed $18.5 million in financing to expand their operations by opening surgical centers throughout the country.

This means that some financial folks did some serious research and concluded that bariatric surgery was a huge and growing market.

It certainly has been in recent years (175,000 procedures in 2005 which is 8 times the number in 1999).

Why is this happening?

Two reasons:

* The potential market is growing with more people becoming morbidly obese.
* Weight-loss diets and prescription weight-loss drugs have such a poor track record that physicians are seeking new therapies — and bariatric surgery is the only other option they believe is available.

Not true. For over 100 years people have used another weight-loss method with great results. But, its not supported by millions of dollars of investment so few people know about it.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition and Fitness

I’m not kidding — people are getting their ears stapled with the goal of losing weight.

The theory is that the ear has a pressure point related to the stomach and appetite. And, if you drive a staple through that point, it will reduce hunger and increase thirst for water.

The problem is that ear stapling for weight loss is illegal in some states due to the threat of infections and other health problems.

Florida is one of those states with a fine of up to $1,000 for practicing ear stapling. But, despite it being illegal, ear-stapling companies (Staple Me Thin LLC, Staple Lean, Staple Image LLC) are setting up branches in Florida to take advantage of the growing demand.

I need to quit getting surprised by such foolishness.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition and Fitness

Here are some interesting statistics about how dieters diet from a recent phone survey of 3,500 adults:

* 70% are following their own diet plans and have no interest in seeks a doctor’s help.
* One-third have tried dietary weight-loss supplements — those over-the-counter pills and powders that promise to burn fat, boost metabolism, or melt away pounds.
* 15% of US households bought a dietary weight-loss supplement at least once last year.

This study has been widely reported as evidence that people are making poor (maybe even dangerous) choices in trying to lose weight.

But, here’s what’s interesting.

The study was funded by GlaxoSmithKline, a large pharmaceutical company which makes a prescription weight-loss pill called orlistat (tradename: Xenical).

The implication of this study is that people should see their doctor and use more “legitimate” products like a prescription diet pill instead of the poorly-regulated over-the-counter pills.

Or, they can just wait a bit since Xenical will soon be available over-the-counter and without a prescription.

Do you think GlaxoSmithKline had some marketing goals in funding this study?

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition and Fitness

It seems like once a week I read that the cause of our obesity epidemic is the presence of too much food in our environment.

The assumption is that human beings have been programmed to eat whatever is readily available. Therefore, if more food is available, the more we all are going to eat.

Now a book titled “Mindless Eating: Why We Eat More Than We Think” reports on a variety of experiments which demonstrates that this does happen (at least for some people).

I haven’t read the book yet (I’m on a waiting list at our local library) but I have read a few reviews. Here are the some of the food-eating behaviors reviewers have reported on:

* People eat more if the evidence of how much you have eaten is removed (e.g., candy wrappers).
* People eat more if the food is served in a larger bowl.
* People will eat more of a “low-fat” food than if the same food is not labeled as such.
* People eat more if the portion size is greater.

OK, I believe all these things happen (with some people). But, I don’t agree that we are genetically programmed to eat this way.

Instead, it’s my contention that many people are overly influenced by external cues (e.g., size of bowls, food portion sizes) because they’ve never learned how to pay attention to their internal cues.

Once I read this book, I’ll report on it further in this blog.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition and Fitness

One of the most controversial areas of nutrition research is related to salt intake.

Some researchers think that consuming too much salt creates all sorts of problems, while others think the concern about salt is overstated.

However, in general, most agree that a comprehensive reduction in salt consumption would not produce significant health benefits for a population.

Now a recent study suggests otherwise. Two Finland professors reported recently that a 30-35% reduction in salt intake over the last 30 years in Finland was associated with a 75-80% decrease in stroke and heart disease mortality in the population under 65 years.

The key word here is “associated.” These professors don’t have any data demonstrating that reducing salt intake causes these health benefits. Instead, they just discovered a relationship between salt intake and stroke/heart disease. It could be that the salt intake reduction had nothing to do with the improved health of the population in Finland.

However, they also discovered that the salt intake in the US increased 50% between the mid-1980s and the late-1990s — during which time the prevalence of high blood pressure increased. Doesn’t that prove that increased salt intake is a bad thing?

Well, in fact, no it doesn’t.

But, we hear this kind of misleading stuff all the time. Goofy associations are discovered by researchers and it gets presented by the media as cause and affect.

In fact, what was the headline for the article about this study? “Salt intake strongly associated with obesity.”

Yep, it turns out this same study found a link between salt intake and obesity in Finland. How do the researchers explain this finding? Their hypothesis is that increased salt intake causes increased thirst — and that this results in people drinking more sugary beverages, causing a marked net increase in calorie consumption.

And guess what? Until 1983, salt consumption in the US was pretty stable. But, since then, salt intake has increased and so has the prevalence of obesity.

So, there you have it — the answer to our obesity epidemic. All we need to do is cut back on using the salt shaker and we’ll all get skinny.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition and Fitness

It turns out that 60% of Americans believe that over-the-counter dietary supplements for weight loss are required to have been tested and proven safe and effective.

Not true.

In fact, since the 1994 passage of the Dietary Supplement Health and Education Act, dietary supplements require no pre-market safety evaluations.

Now a group of obesity experts have banned together in a consortium called the Reality Council to tell people that these products raise false hopes. One member of the consortium said that “people buy these products rather than go into programs that work.”

I wonder what programs this guy is talking about? The last time I checked, over 95% of medically-prescribed weight-loss diets fail to cause people to lose weight and keep it off. In fact, a survey performed by the consortium found that those surveyed had made an average of 15 serious attempts to lose weight — even if they consulted with a doctor.

So, I whole-heartedly agree that the false advertising claims by weight-loss products should stop. But, so should the promotion of traditional weight-loss programs and prescription weight-loss medications that have an equally poor success rate.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition and Fitness

The World Health Organization announced this month that one billion people in the world are overweight, while only 800 million are malnourished.

Even in China, over 20% of the people in certain cities are seriously overweight.

The WHO believes this problem constitutes a global epidemic which could, one day, cripple economies.

Yikes! This sounds like a problem we should be trying to solve.

Well, that was the purpose of a four day conference on the treatment and prevention of obesity which was organized by the North American Society of the Study of Obesity.

I haven’t seen any reports as to what they came up with. However, with over 2000 “experts” attending, I’d expect it’s something pretty good.

I’ll keep my eyes open and report their findings when they’re ultimately released to the public.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition and Fitness

Recently a researcher from Providence, RI said they found the “secret weapon” against yo-yo dieting.

In a study reported in the New England Journal of Medicine, people who had previously lost more than 10% of their weight were split into three groups:

* Group 1 received a quarterly newsletter about eating and exercise in the mail.

* Group 2 attended monthly face-to-face meetings.

* Group 3 participated in monthly Internet chat meetings.

Groups 2 and 3 were told to eat breakfast, get an hour of physical activity each day, and weigh themselves daily. They also were required to report their weight each week to the researchers. Then, if they were within three pounds of their starting weight, they received encouraging phone calls and small “green rewards” such as green mints or a dollar bill.

However, if they gained between three and four pounds, they were considered to be in the “yellow” zone and were advised to tweak their eating habits or exercise routine.

I hesitate to even tell you what happened if they fell into the “red” zone by gaining more than five pounds. But, for completeness, here you go.

They were urged to open a “red toolbox” they had been given at the start of the program that included a meal-replacement shake, a pedometer, a diet diary, and a printed copy of their own weight-loss success story. The were also given a chance to get a one-on-one counseling session with one of the researchers.

So here are the dramatic results. After 18 months:
* 72% of Group 1 gained more than five pounds
* 46% of Group 2 gained more than five pounds
* 55% of Group 3 gained more than five pounds

Boy, that sounds like a “secret weapon” to me. I’m sorry, but the results of this study are not good news. With each group, about half or more gained back a bunch of the weight they lost!

I can’t tell you how disappointed I am when I read studies like this one. These researchers shouldn’t be rewarded by getting their study published in a prestigious medical journal. Instead, they should be ridiculed for wasting their time on such a project.

Allen Oelschlaeger
Author of Finally, the Straight Scoop About Weight, Nutrition and Fitness

I just saw a press release from March, 2005 that announced the release of a 307-page study on the weight-loss and diet-control market.

Here’s the major segments of the US diet industry included in the study:
* Diet soft drinks
* Commercial weight-loss programs
* Medical programs/diet drugs
* Retail non-prescription meal replacements and diet pills
* Health clubs
* Artificial sweeteners
* Weight-loss surgeries
* Low-cal entries

When the market researchers added it all up the total expenditures came to $46 billion in 2004