Weight Loss report # 5 181 pounds.
This doesn't seem like good news since it's a gain of two pounds instead of a loss.
I'm suffering from two weekends of backsliding. But the important thing is not to focus on the bad but to figure out what has to be done to get back to a positive outcome.
I'm still down four pounds from the start and I'm not going to try to starve those extra two pounds off. That would only lead to another relapse. I'm pretty sure that returning to my diet schedule instead of trying to make up for the lapse will be the most effective in the long run.
So today's watchword/slogan is - GET BACK ON THE HORSE (your regular schedule of dieting. You know what they say if you fall off a horse? Get back on the horse - and keep riding. That's what I'm going to do.
If you'd like to tell me how you're doing with your diet program write me, Erwin Posner at BrownBagDiet@gmail.com.
Senin, 23 Maret 2009
Nonselective and Cyclooxygenase-2-Selective NSAIDs and Acute Kidney Injury
Approximately 1 in 200 patients over age 65 will develop acute kidney injury within 45 days of newly initiated non-steroidal anti-inflamatory drug therapy. Patients initiating treatment with indomethacin, ibuprofen, and rofecoxib had higher rates of acute kidney injury than did individuals who received celecoxib. Clinicians need to be aware of the heterogeneity in acute kidney injury risk among cyclooxygenase (COX)-2 inhibitors.
Abstract
Objective
The association between nonsteroidal anti-inflammatory drugs (NSAIDs) and acute kidney injury is well established, but it is less clear whether this risk is focused with specific agents. We undertook a large pharmacoepidemiologic analysis of the risk of acute kidney injury among older adults using nonselective NSAIDs or cyclooxygenase (COX)-2 inhibitors.
Methods
Medicare beneficiaries from 2 large states with drug benefit were eligible for study. Patients were included if they filled a prescription for a nonselective NSAID or COX-2 inhibitor after more than 6 months without any such prescriptions and without a previous diagnosis of acute kidney injury. Incident acute kidney injury was ascertained from hospitalization claims within 45 days of initiating nonselective NSAID or COX-2 inhibitor therapy. Adjusted proportional hazards models estimated the relative risk of acute kidney injury associated with each agent compared with celecoxib.
Results
We included 183,446 patients whose mean age was 78 years; 80% were women. Acute kidney injury was identified in 870 (0.47%) of nonselective NSAID or COX-2 inhibitor users. The agents with significantly elevated risk compared with celecoxib were indomethacin (rate ratio [RR] = 2.23; 95% confidence interval [CI], 1.70-2.93), ibuprofen (RR = 1.73; 95% CI, 1.36-2.19), and rofecoxib (RR = 1.52; 95% CI, 1.26-1.83). These findings were robust in several subgroups.
Conclusion
Acute kidney injury requiring hospitalization is a relatively rare adverse event among older adults after initiation of nonselective NSAIDs or COX-2 inhibitor treatment, observed in approximately 1 in 200 new users within 45 days. There seems to be a marked gradient of risk for acute kidney injury across agents, specifically for indomethacin, ibuprofen, and rofecoxib.
To read this article in its entirety, please visit our website.
-- Wolfgang C. Winkelmayer, MD, ScD, MPH, Sushrut S. Waikar, MD, MPH, Helen Mogun, MS, Daniel H. Solomon, MD, MPH
This article was originally published in the December 2008 issue of The American Journal of Medicine.
Abstract
Objective
The association between nonsteroidal anti-inflammatory drugs (NSAIDs) and acute kidney injury is well established, but it is less clear whether this risk is focused with specific agents. We undertook a large pharmacoepidemiologic analysis of the risk of acute kidney injury among older adults using nonselective NSAIDs or cyclooxygenase (COX)-2 inhibitors.
Methods
Medicare beneficiaries from 2 large states with drug benefit were eligible for study. Patients were included if they filled a prescription for a nonselective NSAID or COX-2 inhibitor after more than 6 months without any such prescriptions and without a previous diagnosis of acute kidney injury. Incident acute kidney injury was ascertained from hospitalization claims within 45 days of initiating nonselective NSAID or COX-2 inhibitor therapy. Adjusted proportional hazards models estimated the relative risk of acute kidney injury associated with each agent compared with celecoxib.
Results
We included 183,446 patients whose mean age was 78 years; 80% were women. Acute kidney injury was identified in 870 (0.47%) of nonselective NSAID or COX-2 inhibitor users. The agents with significantly elevated risk compared with celecoxib were indomethacin (rate ratio [RR] = 2.23; 95% confidence interval [CI], 1.70-2.93), ibuprofen (RR = 1.73; 95% CI, 1.36-2.19), and rofecoxib (RR = 1.52; 95% CI, 1.26-1.83). These findings were robust in several subgroups.
Conclusion
Acute kidney injury requiring hospitalization is a relatively rare adverse event among older adults after initiation of nonselective NSAIDs or COX-2 inhibitor treatment, observed in approximately 1 in 200 new users within 45 days. There seems to be a marked gradient of risk for acute kidney injury across agents, specifically for indomethacin, ibuprofen, and rofecoxib.
To read this article in its entirety, please visit our website.
-- Wolfgang C. Winkelmayer, MD, ScD, MPH, Sushrut S. Waikar, MD, MPH, Helen Mogun, MS, Daniel H. Solomon, MD, MPH
This article was originally published in the December 2008 issue of The American Journal of Medicine.
Jumat, 20 Maret 2009
Incidence and Mortality Rates of Syncope in the United States
Syncope remains a common cause of hospital admission. The hospital mortality rate for syncope is low, but the risk of death increases with age, male gender, and severe comorbidity index. A better definition and a nationally implemented care path for syncope diagnosis could provide a substantial cost savings.
Abstract
Purpose
Syncope is a common cause of hospitalization in the US. The main objective of this study is to determine the incidence and mortality rates when patients are admitted with a principle diagnosis of syncope.
Methods
An observational cross-sectional study included patients with the principle diagnosis of syncope identified from the National Inpatient Sample database for the years 2000-2005. Incidence rate of syncope was adjusted according to the US Census data. In-hospital mortality and its predictors were identified by a logistic regression analysis, and Cochran-Armitage test was used for trend analysis.
Results
After data cleansing, 305,932 patients were included in the analysis. Adjusted incidence rate of syncope varied between 0.80 and 0.93 per 1000 person-years and was unchanged over the years included in the analysis. Overall mortality rate is 0.28%, a trend that has not changed over the years (P = 0.07). The odds ratio (OR) of death increased with age, becoming more prominent after age 40 years. Hospital mortality is higher in men (OR 1.49; 95% confidence interval [CI], 1.30-1.71) and in patients with higher comorbidity index (OR 1.39; 95% CI, 1.20-1.62) for moderate, and (OR 4.14; 95% CI, 3.05-5.61) for severe comorbidity index. The median cost of hospitalization is $8579, which increased by 3- to 11-fold if patients had a cardiac pacemaker or implantable cardioverter-defibrillator.
Conclusions
Syncope remains a common cause of hospital admission. The hospital mortality rate for syncope is low. A better definition and a nationally implemented care path for syncope diagnosis could provide a substantial cost savings.
To read this article in its entirety, please visit our website.
-- Amer Alshekhlee, MD, MSc, Win-Kuang Shen, MD, Judith Mackall, MD, Thomas C. Chelimsky, MD
This article was originally published in the February 2009 issue of The American Journal of Medicine.
Abstract
Purpose
Syncope is a common cause of hospitalization in the US. The main objective of this study is to determine the incidence and mortality rates when patients are admitted with a principle diagnosis of syncope.
Methods
An observational cross-sectional study included patients with the principle diagnosis of syncope identified from the National Inpatient Sample database for the years 2000-2005. Incidence rate of syncope was adjusted according to the US Census data. In-hospital mortality and its predictors were identified by a logistic regression analysis, and Cochran-Armitage test was used for trend analysis.
Results
After data cleansing, 305,932 patients were included in the analysis. Adjusted incidence rate of syncope varied between 0.80 and 0.93 per 1000 person-years and was unchanged over the years included in the analysis. Overall mortality rate is 0.28%, a trend that has not changed over the years (P = 0.07). The odds ratio (OR) of death increased with age, becoming more prominent after age 40 years. Hospital mortality is higher in men (OR 1.49; 95% confidence interval [CI], 1.30-1.71) and in patients with higher comorbidity index (OR 1.39; 95% CI, 1.20-1.62) for moderate, and (OR 4.14; 95% CI, 3.05-5.61) for severe comorbidity index. The median cost of hospitalization is $8579, which increased by 3- to 11-fold if patients had a cardiac pacemaker or implantable cardioverter-defibrillator.
Conclusions
Syncope remains a common cause of hospital admission. The hospital mortality rate for syncope is low. A better definition and a nationally implemented care path for syncope diagnosis could provide a substantial cost savings.
To read this article in its entirety, please visit our website.
-- Amer Alshekhlee, MD, MSc, Win-Kuang Shen, MD, Judith Mackall, MD, Thomas C. Chelimsky, MD
This article was originally published in the February 2009 issue of The American Journal of Medicine.
Kamis, 19 Maret 2009
Angiotensin Receptor Blockers: Current Status and Future Prospects
Angiotensin receptor blockers (ARBs), through their physiological blockade of the renin-angiotensin system, reduce morbidity and mortality associated with hypertension, heart failure, myocardial infarction, stroke, diabetic nephropathy, and chronic kidney disease. The author reviews results from multiple clinical trials of ARBs.
Abstract
Angiotensin receptor blockers (ARBs), through their physiological blockade of the renin-angiotensin system, reduce morbidity and mortality associated with hypertension, heart failure, myocardial infarction, stroke, diabetic nephropathy, and chronic kidney disease. Among many attributes, excellent tolerability, and their ability to control hypertension for 24 hours with a positive effect on renal function position them as a useful choice for hypertension and related conditions. Because of the widespread actions of the renin-angiotensin system on critical tissues, treatment with ARBs may be beneficial in special populations. Ongoing and future studies will be needed to conclusively determine if ARBs also improve outcomes in patients with heart failure and preserved systolic function, atrial fibrillation, cognitive dysfunction, and kidney transplant recipients. Preliminary clinical data also suggest that combining ARBs and angiotensin-converting enzyme inhibitors may provide a more optimal blockade of the renin-angiotensin system and, therefore, may offer greater cardio- and nephroprotection. Future data will help delineate which ARBs and angiotensin-converting enzyme inhibitors are best combined and which patient populations might benefit from the dual blockade of the renin-angiotensin system.
To read this article in its entirety, please visit our website.
-- C. Venkata S. Ram, MD
This article was originally published in the August 2008 issue of The American Journal of Medicine.
Abstract
Angiotensin receptor blockers (ARBs), through their physiological blockade of the renin-angiotensin system, reduce morbidity and mortality associated with hypertension, heart failure, myocardial infarction, stroke, diabetic nephropathy, and chronic kidney disease. Among many attributes, excellent tolerability, and their ability to control hypertension for 24 hours with a positive effect on renal function position them as a useful choice for hypertension and related conditions. Because of the widespread actions of the renin-angiotensin system on critical tissues, treatment with ARBs may be beneficial in special populations. Ongoing and future studies will be needed to conclusively determine if ARBs also improve outcomes in patients with heart failure and preserved systolic function, atrial fibrillation, cognitive dysfunction, and kidney transplant recipients. Preliminary clinical data also suggest that combining ARBs and angiotensin-converting enzyme inhibitors may provide a more optimal blockade of the renin-angiotensin system and, therefore, may offer greater cardio- and nephroprotection. Future data will help delineate which ARBs and angiotensin-converting enzyme inhibitors are best combined and which patient populations might benefit from the dual blockade of the renin-angiotensin system.
To read this article in its entirety, please visit our website.
-- C. Venkata S. Ram, MD
This article was originally published in the August 2008 issue of The American Journal of Medicine.
Obesity Surgery and Diabetes: Does a Chance to Cut Mean a Chance to Cure?
When insulin was initially discovered by Banting and Best in 1922, it was hailed as a cure for type 1 diabetes. Given the ability of insulin to reverse ketoacidosis and severe hyperglycemia, who could doubt that the ravages of type 1 diabetes would be relegated to the archives of medical history? However, within a few short decades of insulin's discovery, it became apparent that the short-term mortality associated with type 1 diabetes was being replaced by longer term morbidities related to renal failure, blindness, nerve damage and vascular disease. The “cure” had treated the short-term sequelae related to the metabolic derangements of insulin deficiency but unfortunately had not (in its initial use) affected the longer-term consequences of hyperglycemia.
To read this article in its entirety, please visit our website.
-- Stuart R. Chipkin, MD, Robert J. Goldberg, PhD
This article was originally published in the March 2009 issue of The American Journal of Medicine.
To read this article in its entirety, please visit our website.
-- Stuart R. Chipkin, MD, Robert J. Goldberg, PhD
This article was originally published in the March 2009 issue of The American Journal of Medicine.
Rabu, 18 Maret 2009
The Management of Hyperkalemia in Patients with Cardiovascular Disease
The development of hyperkalemia is common in patients who have cardiac and kidney disease and take drugs that antagonize the renin-angiotensin-aldosterone system. Management of hyperkalemia may be improved by identifying the levels of potassium that potentially could induce harm and using strategies to avoid dangerous or life-threatening levels.
Abstract
The development of hyperkalemia is common in patients with cardiac and kidney disease who are administered drugs that antagonize the renin-angiotensin-aldosterone system (RAAS). As the results of large-scale clinical trials in hypertension, chronic kidney disease, and congestive heart failure demonstrate benefits of RAAS blockade alone or, in some cases, in combination therapies, the incidence of hyperkalemia has increased in clinical practice. Although there is potential for adverse events in the presence of hyperkalemia, there also are potential benefits of RAAS blockers that support their use in high-risk patient populations. Management of hyperkalemia may be improved by identifying the levels of potassium that may potentially induce harm and using appropriate strategies to avert the levels that may be dangerous or life threatening.
To read this article in its entirety, please visit our website.
-- Apurv Khanna, MD, William B. White, MD
This article was originally published in the March 2009 issue of The American Journal of Medicine.
Abstract
The development of hyperkalemia is common in patients with cardiac and kidney disease who are administered drugs that antagonize the renin-angiotensin-aldosterone system (RAAS). As the results of large-scale clinical trials in hypertension, chronic kidney disease, and congestive heart failure demonstrate benefits of RAAS blockade alone or, in some cases, in combination therapies, the incidence of hyperkalemia has increased in clinical practice. Although there is potential for adverse events in the presence of hyperkalemia, there also are potential benefits of RAAS blockers that support their use in high-risk patient populations. Management of hyperkalemia may be improved by identifying the levels of potassium that may potentially induce harm and using appropriate strategies to avert the levels that may be dangerous or life threatening.
To read this article in its entirety, please visit our website.
-- Apurv Khanna, MD, William B. White, MD
This article was originally published in the March 2009 issue of The American Journal of Medicine.
AJM Letters to the Editor on the Blog
Beginning today, The American Journal of Medicine will start publishing many letters to the editor and related research articles on the AJM blog, instead of in the print Journal or the Web-based Journal.
Often AJM readers are inspired to write letters to the editor soon after a new issue has been released. Unfortunately, due to production schedules, these letters and related replies often are printed four to six months later. Putting letters on the blog will allow for immediate publication of not only the letters themselves but also of comments by the author(s) of the original article and comments by blog readers. Letters and comments originally published on the blog will not receive an AJM citation and will not be listed in PubMed.
AJM's editors believe that the immediacy of blog publication will open up a new world of lively scientific debate on this blog and on the Internet.
Often AJM readers are inspired to write letters to the editor soon after a new issue has been released. Unfortunately, due to production schedules, these letters and related replies often are printed four to six months later. Putting letters on the blog will allow for immediate publication of not only the letters themselves but also of comments by the author(s) of the original article and comments by blog readers. Letters and comments originally published on the blog will not receive an AJM citation and will not be listed in PubMed.
AJM's editors believe that the immediacy of blog publication will open up a new world of lively scientific debate on this blog and on the Internet.
Rabu, 11 Maret 2009
Weight and Type 2 Diabetes after Bariatric Surgery: Systematic Review and Meta-analysis
As the incidence of obesity-induced type 2 diabetes mellitus continues to increase worldwide, medical research indicates that surgery to reduce obesity can completely eliminate all manifestations of diabetes.
Abstract
Background
The prevalence of obesity-induced type 2 diabetes mellitus is increasing worldwide. The objective of this review and meta-analysis is to determine the impact of bariatric surgery on type 2 diabetes in association with the procedure performed and the weight reduction achieved.
Methods
The review includes all articles published in English from January 1, 1990, to April 30, 2006.
Results
The dataset includes 621 studies with 888 treatment arms and 135,246 patients; 103 treatment arms with 3188 patients reported on resolution of diabetes, that is, the resolution of the clinical and laboratory manifestations of type 2 diabetes. Nineteen studies with 43 treatment arms and 11,175 patients reported both weight loss and diabetes resolution separately for the 4070 diabetic patients in these studies. At baseline, the mean age was 40.2 years, body mass index was 47.9 kg/m2, 80% were female, and 10.5% had previous bariatric procedures. Meta-analysis of weight loss overall was 38.5 kg or 55.9% excess body weight loss. Overall, 78.1% of diabetic patients had complete resolution, and diabetes was improved or resolved in 86.6% of patients. Weight loss and diabetes resolution were greatest for patients undergoing biliopancreatic diversion/duodenal switch, followed by gastric bypass, and least for banding procedures. Insulin levels declined significantly postoperatively, as did hemoglobin A1c and fasting glucose values. Weight and diabetes parameters showed little difference at less than 2 years and at 2 years or more.
Conclusion
The clinical and laboratory manifestations of type 2 diabetes are resolved or improved in the greater majority of patients after bariatric surgery; these responses are more pronounced in procedures associated with a greater percentage of excess body weight loss and is maintained for 2 years or more.
To read this article in its entirety, please visit our website.
-- Henry Buchwald, MD, PhD, Rhonda Estok, RN, BSN, Kyle Fahrbach, PhD, Deirdre Banel, BA, Michael D. Jensen, MD, Walter J. Pories, MD, John P. Bantle, MD, Isabella Sledge, MD, MPH
This article was originally published in the March 2009 issue of The American Journal of Medicine.
Abstract
Background
The prevalence of obesity-induced type 2 diabetes mellitus is increasing worldwide. The objective of this review and meta-analysis is to determine the impact of bariatric surgery on type 2 diabetes in association with the procedure performed and the weight reduction achieved.
Methods
The review includes all articles published in English from January 1, 1990, to April 30, 2006.
Results
The dataset includes 621 studies with 888 treatment arms and 135,246 patients; 103 treatment arms with 3188 patients reported on resolution of diabetes, that is, the resolution of the clinical and laboratory manifestations of type 2 diabetes. Nineteen studies with 43 treatment arms and 11,175 patients reported both weight loss and diabetes resolution separately for the 4070 diabetic patients in these studies. At baseline, the mean age was 40.2 years, body mass index was 47.9 kg/m2, 80% were female, and 10.5% had previous bariatric procedures. Meta-analysis of weight loss overall was 38.5 kg or 55.9% excess body weight loss. Overall, 78.1% of diabetic patients had complete resolution, and diabetes was improved or resolved in 86.6% of patients. Weight loss and diabetes resolution were greatest for patients undergoing biliopancreatic diversion/duodenal switch, followed by gastric bypass, and least for banding procedures. Insulin levels declined significantly postoperatively, as did hemoglobin A1c and fasting glucose values. Weight and diabetes parameters showed little difference at less than 2 years and at 2 years or more.
Conclusion
The clinical and laboratory manifestations of type 2 diabetes are resolved or improved in the greater majority of patients after bariatric surgery; these responses are more pronounced in procedures associated with a greater percentage of excess body weight loss and is maintained for 2 years or more.
To read this article in its entirety, please visit our website.
-- Henry Buchwald, MD, PhD, Rhonda Estok, RN, BSN, Kyle Fahrbach, PhD, Deirdre Banel, BA, Michael D. Jensen, MD, Walter J. Pories, MD, John P. Bantle, MD, Isabella Sledge, MD, MPH
This article was originally published in the March 2009 issue of The American Journal of Medicine.
Some Thoughts on Bedside Teaching
There is general agreement throughout academic medicine that bedside teaching and its concomitant honing of clinical skills have been eroded significantly by changes in the financial environment of academic medical centers, as well as by changes in residency work hours. The large-volume clinical care system that is currently in place in academic hospitals occurs at the expense of time for teaching medical students and residents. Medical education in the third year of medical school has become much more classroom/seminar oriented rather than hands-on bedside teaching. A variety of surveys involving medical students demonstrate that students still perceive hands-on bedside teaching as one of the most valuable components of their medical education. Patients also view bedside teaching in a positive manner.
To read this article in its entirety, please visit our website.
-- Joseph S. Alpert, MD
This article was originally published in the March 2009 issue of The American Journal of Medicine.
To read this article in its entirety, please visit our website.
-- Joseph S. Alpert, MD
This article was originally published in the March 2009 issue of The American Journal of Medicine.
Risk Factors for Type 2 Diabetes Among Women with Gestational Diabetes: A Systematic Review
Obesity, gestational age at gestational diabetes diagnosis, and method of glucose control are risk factors for the subsequent development of type 2 diabetes among women with previous gestational diabetes, according to the authors of this review.
Abstract
We conducted a systematic review of studies examining risk factors for the development of type 2 diabetes among women with previous gestational diabetes. Our search strategy yielded 14 articles that evaluated 9 categories of risk factors of type 2 diabetes in women with gestational diabetes: anthropometry, pregnancy-related factors, postpartum factors, parity, family history of type 2 diabetes, maternal lifestyle factors, sociodemographics, oral contraceptive use, and physiologic factors. The studies provided evidence that the risk of type 2 diabetes was significantly higher in women having increased anthropometric characteristics with relative measures of association ranging from 0.8 to 8.7 and women who used insulin during pregnancy with relative measures of association ranging between 2.8 and 4.7. A later gestational age at diagnosis of gestational diabetes, >24 weeks gestation on average, was associated with a reduction in risk of development of type 2 diabetes with relative measures of association ranging between 0.35 and 0.99. We concluded that there is substantial evidence for 3 risk factors associated with the risk of type 2 diabetes in women having gestational diabetes.
To read this article in its entirety, please visit our website.
-- Kesha Baptiste-Roberts, PhD, MPH, Bethany B. Barone, ScM, Tiffany L. Gary, PhD, MHS, Sherita H. Golden, MD, MHS, Lisa M. Wilson, ScM, Eric B. Bass, MD, MPH, Wanda K. Nicholson, MD, MPH
This article was originally published in the March 2009 issue of The American Journal of Medicine.
Abstract
We conducted a systematic review of studies examining risk factors for the development of type 2 diabetes among women with previous gestational diabetes. Our search strategy yielded 14 articles that evaluated 9 categories of risk factors of type 2 diabetes in women with gestational diabetes: anthropometry, pregnancy-related factors, postpartum factors, parity, family history of type 2 diabetes, maternal lifestyle factors, sociodemographics, oral contraceptive use, and physiologic factors. The studies provided evidence that the risk of type 2 diabetes was significantly higher in women having increased anthropometric characteristics with relative measures of association ranging from 0.8 to 8.7 and women who used insulin during pregnancy with relative measures of association ranging between 2.8 and 4.7. A later gestational age at diagnosis of gestational diabetes, >24 weeks gestation on average, was associated with a reduction in risk of development of type 2 diabetes with relative measures of association ranging between 0.35 and 0.99. We concluded that there is substantial evidence for 3 risk factors associated with the risk of type 2 diabetes in women having gestational diabetes.
To read this article in its entirety, please visit our website.
-- Kesha Baptiste-Roberts, PhD, MPH, Bethany B. Barone, ScM, Tiffany L. Gary, PhD, MHS, Sherita H. Golden, MD, MHS, Lisa M. Wilson, ScM, Eric B. Bass, MD, MPH, Wanda K. Nicholson, MD, MPH
This article was originally published in the March 2009 issue of The American Journal of Medicine.
Weight Loss Report - 4 - the Brown Bag Diet - 179 pounds
Weight Loss Report - 4 - the Brown Bag Diet - 179 pounds
The weight is still coming off - but slowly. I'm pleased that I've lost 6 pounds but it seems painfully slow. But then again it is 6 real pounds that have stayed off since Feb. 4th. That's not a weekend of crash dieting only to return to the original weight or more.
So what is the lesson here? I think the lesson is a well used adage that, "Slow and steady wins the race" or "The slower it comes off the longer it stays off".
So let's remember that this lesson's wathchword is, Slow & Steady.
Remember to send your comments and suggestions to me at:
Brownbagdiet@gmail.com
The weight is still coming off - but slowly. I'm pleased that I've lost 6 pounds but it seems painfully slow. But then again it is 6 real pounds that have stayed off since Feb. 4th. That's not a weekend of crash dieting only to return to the original weight or more.
So what is the lesson here? I think the lesson is a well used adage that, "Slow and steady wins the race" or "The slower it comes off the longer it stays off".
So let's remember that this lesson's wathchword is, Slow & Steady.
Remember to send your comments and suggestions to me at:
Brownbagdiet@gmail.com
Selasa, 03 Maret 2009
Weight Loss Report -3- the Brown Bag Diet
Weight Loss Report - 3 - the Brown Bag Diet - 180 pounds
Things are slowing down a bit. I had a two pound loss from Feb. 12Th but considering I began at 185 pounds I'm satisfied with my 5 pound loss to date.
Our last watchword was "PORTION CONTROL". That is so important. And so is the next. Remember we started with "PLAN AHEAD". Now we add the watchword, "Eat by the Clock".
When you plan your eating for the day decide when you will eat each meal. If you decide that 12:30 to 1:00 PM is lunchtime don't start cheating by snacking at 12:15. It's a lot easier to refrain from silly eating habits when you know exactly what time your next meal is scheduled.
So keep this watchword handy. It will help you get through the day without breaking down and spoiling your diet plans.
Any questions? Write me, Erwin Posner, at BrownBagDiet@gmail .com
Things are slowing down a bit. I had a two pound loss from Feb. 12Th but considering I began at 185 pounds I'm satisfied with my 5 pound loss to date.
Our last watchword was "PORTION CONTROL". That is so important. And so is the next. Remember we started with "PLAN AHEAD". Now we add the watchword, "Eat by the Clock".
When you plan your eating for the day decide when you will eat each meal. If you decide that 12:30 to 1:00 PM is lunchtime don't start cheating by snacking at 12:15. It's a lot easier to refrain from silly eating habits when you know exactly what time your next meal is scheduled.
So keep this watchword handy. It will help you get through the day without breaking down and spoiling your diet plans.
Any questions? Write me, Erwin Posner, at BrownBagDiet@gmail .com
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