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U.S. Activity Levels Stagnant

Most U.S. adults did not engage in the minimum recommended level of physical activity in 2003, according to the Centers for Disease Control and Prevention.

Results from the nationwide Behavioral Risk Factor Surveillance System (BRFSS) suggest that between 2001 and 2003 there were no significant changes in the proportion of U.S. adults who engage in the recommended amount of physical activity or in the proportion who don't exercise at all, the CDC said (MMWR 2005;54:1208–12).

Responses from 214,500 participants in the 2001 BRFSS were compared with those of 264,684 in the 2003 survey. To meet the minimum recommended activity level, an individual had to engage in moderate activity for at least 30 minutes per day, 5 or more days a week, or vigorous activity at least 20 minutes per day, 3 or more days per week. Inactivity was defined as no moderate or vigorous activity of at least 10 minutes.

In 2003, the age-adjusted proportion of adults engaging in the minimum recommended activity level was 45.9%, up only slightly from the 45.3% reported in 2001. Increases occurred in 41 states and territories, while levels decreased in 12 states and territories. There was also no major change in lifestyle inactivity between 2001 (16.0%) and 2003 (15.6%), although there were decreases in 32 states and territories.

Bariatric Surgery Rates Balloon

The recent growth of bariatric surgery in the United States appears highly correlated with the development of laparoscopic bariatric surgery, reported Dr. Ninh T. Nguyen and colleagues at the University of California, Irvine.

From 1998 through 2002, a total of 188,599 morbidly obese patients underwent bariatric surgery in the United States. The number of procedures rose from 12,775 in 1998 to 70,256 in 2002, according to the investigators. During the same period, the rate of bariatric procedures rose from 6.3 per 100,000 adults in 1998 to 32.7 per 100,000 adults in 2002 (Arch. Surg. 2005;140:1198–202).

“The increased enthusiasm for bariatric surgery coincides with the development and dissemination of the laparoscopic approach,” the investigators wrote.

The overall annual rate of laparoscopic procedures increased exponentially, from 0.1 procedures per 100,000 adults in 1998 to 5.9 procedures in 2002. This compares with the smaller linear rise of open procedures, from 6.2 procedures per 100,000 adults in 1998 to 26.8 procedures per 100,000 adults in 2002. The percentage of laparoscopic procedures increased from 2.1% of the total in 1998 to nearly 18% in 2002.

The percentage of laparoscopic procedures increased from 2.1% of the total in 1998 to nearly 18% in 2002.

A previous study reported that bariatric procedures increased from 9,189 in 1993 to 12,541 in 1997, while the American Society for Bariatric Surgery (ASBS) has estimated that there were around 140,000 bariatric procedures in 2004, Dr. Nguyen and colleagues said.

The ASBS reported that their membership has risen from 258 in 1998 to 631 in 2002, a 144% increase in membership over 5 years.

Same Old, Same Old Aids Weight Loss

Limiting the variety of snack foods consumed to a subject's favorite snack may decrease the craving for that food, according to Hollie A. Raynor, Ph.D., and her colleagues at Brown University, Providence, R.I.

Thirty overweight and obese adults were randomized to one of two 8-week behavioral weight-loss interventions. The subjects, 27 of whom were female, were assigned a daily caloric goal of 1,200–1,500 kcal, with 20% of the calories coming from fat.

Half the subjects were randomized to an intervention that limited variety to one chosen snack food. They were told to eat this favorite snack at least four times a week in any amount, as long as their overall calorie restrictions were met. The 15 control subjects were told to keep their snack food servings to less than one per day, but they had no restriction on variety (Eat. Behav. 2006;7:1–14).

Both groups lost nearly 8 pounds, as was expected based on the calorie prescription. But the subjects in the reduced-variety group showed a decreased sense of pleasantness in response to their chosen snack food over time, compared with other snack foods given to them by researchers at the end of the study (−17.9 vs. −3.4 on a 100-mm visual analog scale, respectively). The pleasantness of the chosen snack food increased in the first 3 weeks but decreased steadily as the study went on, the investigators said.

In contrast, the controls showed no long-term sensory-specific satiety or feelings of monotony in response to the snack foods they ate.

By the end of the study, the reduced-variety group decreased energy consumption from snack food by 1,732 calories/week, while controls had a reduction of 1,448 calories/week, they said.

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