Sipping diet colas and counting calories are well-known weight-reduction tricks.
But reducing fat intake is a surer route to permanent weight control than either filling up with artificially sweetened drinks or restricting overall calorie intake. That's the consensus of East Coast researchers who tested the effects of low-, medium- and high-fat diets in 24 women and reported the results last month in the American Journal of Clinical Nutrition.
On the average, the women in the study lost weight on the low-fat and medium-fat diets, but gained on the high-fat diet. During a two-week period, they consumed only the foods and beverages supplied by the researchers, but had no caloric restrictions. On the low-fat diet, fat contributed 15%-20% of calories; on the medium, 30%-35%; on the high, 45%-50%. Many nutritionists recommend keeping total daily fat intake to 30% of calories.
Researchers aren't sure why the lower-fat diets without caloric restriction caused weight loss, but offer a hypothesis. "The body doesn't recognize fat in the same way as it recognizes (complex) carbohydrates and sugars," said David A. Levitsky, a professor of nutrition and psychology at Cornell University, Ithaca, N.Y., who authored the report with Lauren Lissner, now a postdoctoral fellow at the University of Pennsylvania, and others.
"When you pull fat (out of the diet) the body doesn't notice. But by reducing fat, you can reduce your weight--and we think chronically."
Reducing overall caloric intake seems to be a natural consequence of reducing fat intake, he added, observing that the women consumed the least number of calories while on the lowest-fat diet. (Consuming less fat can automatically
reduce overall caloric intake, nutritionists say, since a gram of fat has nine calories while each gram of carbohydrate or protein has four calories.)
The bottom line, in Levitsky's view: "Pay less attention to calories and more to fat intake."
Icy Headache Relief
To the nation's 45-million chronic headache sufferers, ice isn't a new treatment suggestion. But the Suboccipital Ice Pillow, developed by an Encino physician, is a new twist.
Available at selected Los Angeles-area pharmacies, the $39.95 pillow is designed for at-home, do-it-yourself treatment, said Dr. Lee Kudrow, a headache specialist who directs the California Medical Clinic for Headache in Encino. When headache strikes, sufferers insert a frozen gel pack into the pillow's insulated pocket and place the pillow around the neck so it's in contact with "critical muscle groups and arteries at the juncture of the head and neck," according to product literature. The cooling of involved muscle groups and blood vessels provides relief, Kudrow said.
In an unpublished test of the pillow in nearly 200 headache sufferers at Kudrow's center and the New England Center for Headache in Connecticut, Kudrow and his colleagues found that it works best in the early stages of headaches. "Eighty percent of the attacks, when treated in a dull (early) state improved 50% or more," Kudrow said. Only 30% of moderate headaches and 10% of severe headaches got better with the ice pillow, he added.
But another headache specialist isn't sold on the pillow. "Certainly there's nothing harmful about putting ice at the back of your neck," said Dr. Joel R. Saper, director of the Michigan Headache and Neurological Institute in Ann Arbor, and author of "Help for Headaches" (New York, Warner Books: $4.50). "But I think to portray it as something most people will benefit from is unreasonable."
Saper advised trying to prevent headaches by learning your personal "triggers." Those might include sleeping too late, eating certain foods and ingesting monosodium glutamate, say Saper and other specialists.
Young, well-educated urbanites who were previously healthy tend to be the most forgetful about following their doctors' medication advice, a recent survey conducted by Schering Laboratories, a New Jersey-based pharmaceutical manufacturer, shows.
Ninety-three percent of the 2,000 patients interviewed got their prescriptions filled. Patients under age 30 and college graduates proved less compliant than older patients and high school graduates. Patient noncompliance with medications is a serious nationwide problem, the report noted, resulting in 125,000 deaths a year, hundreds of thousands of hospitalizations, an estimated 20 million lost workdays and $1.5 billion in lost earnings.
How can you remember to pop the proper pills? "Use your habits to your advantage, and tie your drug-taking to them," suggested Maude Babington, a pharmacist and spokeswoman for the American Pharmaceutical Assn. in Washington. "One woman, for example, put her medicine by her slippers. A man on once-a-day medication always had cereal for breakfast, so he put his prescription inside his cereal box."
Special compartmentalized containers can help, she added, as can encouraging "somebody who cares to check up on you."