Monday, March 11, 2019

Activity tracker may not be the key to weight loss

My Shih Tzu, Latte, is like a therapist, personal trainer, and primary care physician all wrapped up into 10 pounds of white fluffiness. When you are bedridden with a cold, she never leaves your side until you are well. When you have a bad day, she is there with a comforting look that says, “Everything is going to be okay.” At 5 p.m., she reminds you that you’ve sat for too long and need to take her for a walk.

It turns out that Latte is doing what most animals naturally do with humans: provide comfort and support.

This type of therapeutic interaction even has a scientific name — animal-assisted therapy (AAT) — and research has shown it helps with a variety of emotional issues like depression, anxiety, and grief.

“The great thing about animals is they don’t have a preconceived notion of people,” says Dr. Henry Feldman, of the Division of General Internal Medicine at Harvard-affiliated Beth Israel Deaconess Medical Center. “They provide unconditional love, which encourages interaction and helps people feel more confident.”
Animal-assisted therapy in action

Animal-assisted therapy involves interacting regularly with animals for a set time over weeks or months. The get-togethers usually involve dogs and cats in either individual or group settings, and consist of everything from petting to giving treats to just sitting together.

What happens when you interact with animals? Researchers speculate that levels of oxytocin, the “love hormone” that encourages bonding, often increase, as does the production of serotonin, the feel-good brain chemical.

Animal-assisted therapy is often used in retirement centers to help people with depression. A study in the June 2013 Anthrozoos found that patients with dementia living in residential care who received 11 weeks of dog-assisted therapy improved their depression scores compared with those who had human-only therapy.

Hospitals also use animal-assisted therapy for patients coping with stressful treatment and recovery. A study in the January 2015 Journal of Community and Supportive Oncology explored how AAT — in this case therapy dogs — affected the well-being of cancer patients who underwent radiation therapy and chemotherapy. The patients received daily 15- to 20-minute animal visits for six weeks, and afterward reported a noticeable increase in their emotional well-being.

AAT is especially helpful for people healing after traumatic events like an accident, the death of a loved one, or catastrophes like the recent Pulse club shootings in Orlando. In fact, Orlando’s Trinity Lutheran Church coordinated with Chicago-based Lutheran Church Charities’ K-9 Comfort Dogs program to bring in golden retrievers to help with grief counseling for survivors, first responders, and volunteers.
Find your animal therapy

Physicians usually “prescribe” animal-assisted therapy, but you may need to be proactive and inquire about AAT and how it may complement your treatment and needs. But you don’t need a prescription to tap into AAT’s feel-good effects. Pet ownership is one way, but if you are not ready for that responsibility, check with your local senior center about public animal therapy programs, or volunteer with community partners of animal therapy organizations like Pet Partners, Therapy Dogs International, and the Good Dog Foundation.

Another option: advertise your services as a local pet sitter or dog walker, or lend a hand to a pet-owning neighbor, friend, or family member. Or you could hang out with Latte for awhile. She would love it. As mindfulness meditation and yoga have become mainstream and more extensively studied, growing evidence suggests multiple psychological and physical benefits of these mindfulness exercises, as well as for similar practices like tai chi and qi gong.

Systematic reviews and meta-analyses analyzing hundreds of research studies suggest that mindfulness-based interventions help decrease anxiety, depression, stress, and pain, and help improve general health, mental health, and quality of life. These practices also appear to reduce inflammation and increase immune response.
You say vacation, I say meditation…

As much as this intuitively makes sense, I’ve often wondered if simple rest and relaxation could be just as good for you. The few studies conducted suggest that vacation does result in real, albeit temporary, positive effects on health and well-being.

So when the editors at Harvard Health Publishing suggested I take a look at a recent study comparing a mindfulness meditation and yoga retreat to regular vacation in terms of mental health as well as physical health outcomes, I agreed. This is interesting stuff.

The study was conducted at a resort in Southern California with 91 female volunteers who had no major health problems, were not pregnant, nor taking hormones or antidepressants. The mindfulness intervention was an established meditation and yoga retreat consisting of 12 hours of meditation, nine hours of yoga, and self-reflective exercises over a week. The participants were divided into three groups of about 30 each: experienced meditators, women who had never meditated, and a group who simply “went on vacation.” The 30 “vacation participants” listened to health lectures and then did fun outdoor things for a week.

At the end, all three groups (vacation, novice, and regular meditators) showed statistically significant improvements in scores of stress and depression, which were measured using well-established and commonly used questionnaires. If we stop there, it seems that vacation is just as good as mindfulness exercises for stress reduction and mood lifting.

But what’s really striking are the result from 10 months later: the regular meditators still showed significant improvements on these scores, the novice meditators even more so. However, the vacationers were back to baseline. The researchers had ensured that all three groups were equal in average age, education level, employment status, and body mass index. This finding is in keeping with prior research showing that vacation has beneficial but very temporary effects, and that mindfulness therapies have sustained beneficial effects.
What about long-term physical benefits of meditation?

These researchers also took blood samples just before and after the weeklong study period. All three groups showed significant positive changes in the markers of immune function. However, regular meditators also showed additional, more interesting changes. I got in touch with study author Eric Schadt, Ph.D., director of the Icahn Institute at Mount Sinai, who offered this interpretation of the data:

“Regular meditators showed both the same types of ‘improvements’ at the molecular level as the others, but on top of that exhibited changes that were also associated with some aging/disease processes that also correlated with biomarkers of aging in a favorable direction. I think there is some suggestion there of improved healthy aging, so hopefully that motivates further study in this direction.”

He went on to explain that other factors that often go hand in hand with meditation (for example, exercise, diet, even exposure to incense) could help explain these improvements. “So that as well remains to be more fully resolved in future studies.”

The vacation study was fairly small and included only women, and the authors point out that more research in this area is needed. But the evidence that mindfulness exercises can result in long-lasting positive psychological effects, especially for people new to these experiences, is compelling. In addition, meditation and yoga can boost immunity, and regular practice seems to promote more complex genetic effects related to healthier aging. A delightful and dangerous season approaches. While fall brings bright colors and refreshingly cooler weather, it also brings Halloween candy, Thanksgiving pies, and other holiday treats. Around this time of year, weight loss is always on my mind.

In wanting to lose weight, I am definitely not alone. Traditionally, about half of the U.S. population is trying to lose weight at any given time. And it seems intuitive that it would be easier to do battle with a tempting candy bar when armed with a sleek, attractive activity tracker on my wrist.
Do activity trackers help you lose weight…

Just in time to curtail my spending, a recent study looking at the effects of wearable technology on long-term weight loss has arrived. In this work, published in JAMA in September, the authors sought to learn whether activity trackers helped people to lose more weight than a more traditional diet and exercise program.

Researchers at the University of Pittsburgh randomized 471 people aged 18 to 35 into two groups. The participants in each group were mostly women who ranged from overweight to obese, but none were morbidly obese (doctors consider morbid obesity to be a BMI > 40). To ensure a level playing field, both groups were prescribed a low-calorie diet, more exercise, and group counseling sessions for the first six months of participation. At the six-month mark, one group started to monitor their diet and activity the old-fashioned way — by adding up the number of calories they ate and the minutes of exercise completed, and recording the information in a web-based “journal.” The other group was given an activity tracker to wear on the upper arm. The tracker collected exercise information and uploaded it to a website, where study participants could enter information on what they were eating. Remember, both groups received the same diet and exercise education and the same support from the research team. The only essential difference between the groups was whose responsibility it was to tabulate and record exercise.

Investigators followed the participants for two years. Both groups lost weight, and those wearing the trackers were on average eight pounds lighter at the two-year mark. But those who did not wear the trackers lost more — on average, 13 pounds.
…and keep it off?

Many of us want to lose more than eight or 13 pounds, but in the medical world, keeping off 13 pounds versus eight pounds is a big deal. This study, like many others, showed that people can lose weight in the short term. About six months after the study began, both groups had lost roughly the same amount of weight. But over the next 18 months, the group wearing the activity trackers gained more of it back than the group that did not wear trackers. This is the real heart of the issue with weight loss — keeping it off. The group that did not use the activity tracker seemed better able to do that in this study.

After reading this study, I wondered why the group that used the activity trackers did not lose more weight. It could be that the trackers provided a false sense of security regarding exercise. Perhaps they don’t record calories burned accurately. Maybe participants did not use them to their full potential. This study was able to tell us that there was a difference between how these two groups lost weight — further studies will be needed to figure out why the activity trackers helped less than expected.

This study has two powerful messages for us. First, both groups were taught how much to eat and how much to exercise, and both were lighter in two years. That means that if we make real, sustainable lifestyle changes regarding diet and exercise, we can all be slimmer in 2017. But it takes ongoing perseverance. Swearing off chocolate for a few weeks and then returning to our old habits later Will. Not. Work. Secondly, the authors could not make a compelling argument that activity trackers will make it any easier for us to lose weight or keep it off. Here, we are provided with scientific information that can both help us lose weight, and make us better informed consumers.

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