ROCHESTER, Minn. — Turning the calendar to a new year often finds people working on their commitment to a healthy lifestyle.

When it comes to losing weight, experts advise taking a longer view, beyond a New Year’s resolution.

“Achieving and maintaining a healthy weight is best accomplished through a lifestyle approach,” says Donald Hensrud, M.D., M.P.H., medical director of the Mayo Clinic Healthy Living Program and medical editor-in-chief of the Mayo Clinic Diet. “You should follow a dietary pattern that is practical. If it’s too restrictive, it’s impossible to sustain.”

Media contact: Susan Barber Lindquist, Mayo Clinic Public Affairs, 507-284-5005 or newsbureau@mayo.edu

Today, the Mayo Clinic Diet was named No. 1 in the Commercial Diet category by U.S. News & World Report. The Mayo Clinic Diet offers a weight-loss and lifestyle program that’s based on research and clinical experience. Learn more about the diet in The Mayo Clinic Diet book. An online program also gives access to meal plans, recipes, interactive tools like an iOS app for Apple operating systems, and fitness plans and exercises.

The two-phase program offers a two-week jump-start to weight loss and a lifelong approach to diet and health. The dietary plan is built around health-supporting vegetables and fruits, lean proteins, whole grains and healthy fats, such as nuts and olive oil. There’s no calorie counting. Instead, the diet focuses on generous amounts of vegetables and fruits, and healthy choices in other food groups. No foods are excluded. Portions of higher-calorie foods are limited. Physical activity of at least 30 minutes most days also is emphasized to highlight overall health — not just weight.

People with health conditions are encouraged to talk with their doctor before starting any diet or exercise plan.

“When you make even small changes in your diet and exercise habits, you decrease your health risks from many conditions, including diabetes, heart disease, high blood pressure and sleep apnea,” Dr. Hensrud says. “That’s a gift to you and your family all year-round.”

For an interview with Dr. Hensrud, contact Susan Barber Lindquist, Mayo Clinic Public Affairs, at 507-284-5005 or newsbureau@mayo.edu.

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DEAR MAYO CLINIC: What exactly is the MIND diet, and can it really help prevent dementia? Is it a healthy diet for everyone?

ANSWER: The MIND diet is a combination of two other healthy diets, so it is a healthy option. Results from a recent study show that, over time, older adults who followed the MIND diet appeared to have less cognitive decline, such as memory problems. The effect of food on cognitive health has been the subject of research for quite some time. The research has shown that certain foods — particularly plant foods, such as green leafy vegetables, nuts and berries — can help preserve brain function.

The MIND diet includes a variety of brain-friendly foods. MIND stands for Mediterranean-DASH Intervention for Neurodegenerative Delay. It includes aspects of a Mediterranean diet, as well as the Dietary Approaches to Stop Hypertension, or DASH, diet. A Mediterranean diet is rich in fruits, vegetables, olive oil, legumes, whole grains and fish. The DASH diet, often recommended for people who need to lower their blood pressure, emphasizes vegetables, fruit and low-fat dairy foods, along with moderate amounts of whole grains, fish, poultry and nuts.

To evaluate the benefits of the MIND diet, researchers monitored the eating habits of 900 older adults for several years. Specifically, they assessed a pattern of eating that emphasizes foods associated with cognitive benefit and limits foods associated with cognitive decline. This pattern of eating includes relatively high amounts of green leafy vegetables, as well as other vegetables, berries, fish, olive oil, whole grains, beans, nuts and poultry, along with moderate amounts of wine. It also includes low amounts of red meat, cheese, butter, margarine, fried foods, pastries and sweets.

Researchers found that people who regularly followed this pattern of eating showed less cognitive decline over time than people who did not. Based on previous studies, the results of this study are not surprising. But they extend the previous research by looking at an entire pattern of eating, not just specific foods. The results also are consistent with many studies that show benefits from this pattern of eating on other health conditions. It helps lower blood pressure and serum cholesterol, and it follows guidelines to lower the risk of heart disease and cancer.

Following the Mediterranean diet, upon which the MIND diet is partially based, can be a very tasty way of eating that incorporates different types of salads with olive oil, whole-grain pasta or rice with vegetables, and fish, poultry or beans. But making beneficial dietary changes and transitioning to a diet that relies more heavily on plants may seem challenging. There are strategies you can use to make it easier.

For example, plan ahead before you shop or make meals. Try new recipes that incorporate MIND diet foods. Keep different types of berries and mixed nuts on hand to snack on, rather than potato chips or processed crackers. When you eat at a restaurant, try grilled fish or chicken rather than fried. Start off with a salad and include generous amounts of vegetables. Stick to whole-grain bread with a little olive oil rather than white bread with butter. Opt for berries for dessert instead of pastries or other sweets. Eating in this way can be enjoyable, and the benefits on your mind, your overall health and your quality of life can be tremendous.

Because the MIND diet incorporates a wide variety of healthy food choices, it is safe for most people. If you have a chronic medical condition that requires you to eat or avoid certain foods, however, it would be a good idea to talk with your health care provider before you make significant changes to your diet. — Donald Hensrud, M.D., Preventive Medicine, Mayo Clinic, Rochester, Minn.

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For more information about the Healthy Living Program click for the link or call (507) 293-2933.

Miss the program?  Here's the podcast: MayoClinicRadio-FullShow-3-22-2014

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Eat less, move more, quit smoking and get more sleep! These are just some of the common sense solutions we often hear that would help us live a healthier lifestyle. So, WHY does it seem so difficult to put it all together? Join us for our next program Saturday, March 22, at 9 a.m. CDT, when we speak with Donald Hensrud, M.D., medical director for the new Healthy Living Program at Mayo Clinic. The Healthy Living Program focuses on the pillars of wellness: physical activity, nutrition and resiliency. We'll take a peek inside what makes this program work and how you can put it to use for a healthier you! Join us.

Myth or Matter of Fact: When it comes to losing weight, what you think is more important than what you eat.

To hear the program LIVE on Saturday, click here.
Follow #MayoClinicRadio and tweet your questions.
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Listen to this week’s Medical News Headlines: News Segment March 22, 2014 (right click MP3) 

Mayo Clinic Radio is a weekly one-hour radio program highlighting health and medical information from Mayo Clinic. The show is taped for rebroadcast by some affiliates.

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For more information about the Healthy Living Program click for the link or call (507) 293-2933.

Miss the program?  Here's the podcast: MayoClinicRadio-FullShow-3-22-2014

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DEAR MAYO CLINIC: 

ANSWER: Vitamin B-12 deficiency is more common with increasing age and affects 5 to 15 percent of adults. Some of this is early deficiency and not associated with symptoms. Once symptoms develop, they are sometimes overlooked because they develop slowly and are similar to many other problems related to growing older. It pays to be alert to symptoms and consider taking a vitamin B-12 supplement or eating food fortified with vitamin B-12. Vitamin B-12 is one of the few vitamins Mayo Clinic experts routinely recommend for older adults.

Vitamin B-12 plays a role in red blood cell formation, cell metabolism, nerve function and bone health. The primary natural sources of vitamin B-12 are meats, fish, shellfish, eggs and milk; it is not found naturally in plant products. Some foods such as breakfast cereals are fortified with vitamin B-12. It is stored in large quantities in the liver and recirculated in the body, so even if you suddenly stopped getting vitamin B-12, it would likely take years for deficiency to develop.

Deficiency can occasionally occur due to a diet that contains very little vitamin B-12, such as with strict, long-term vegans (vegetarians who consume no animal products at all) and people who are malnourished, such as some who abuse alcohol. However, it most commonly develops because the body isn’t properly digesting and absorbing vitamin B-12 due to causes that include:

Aging — With age, the ability to absorb vitamin B-12 often diminishes. Inadequate nutrition and higher risk of digestive diseases also may be an issue.

Diseases that affect digestion — The most common of these is pernicious anemia, in which your own immune system destroys a protein that enables you to absorb B-12. Celiac disease and Crohn’s disease also can interfere with proper vitamin B-12 absorption, as can gastric bypass surgery.

Prolonged use of certain medications — Proton pump inhibitors, such as omeprazole and H-2 blockers, which reduce stomach acid to treat gastroesophageal reflux disease (GERD) and stomach problems, can interfere with vitamin B-12 absorption. The diabetes drug metformin also is associated with lower vitamin B-12 levels. 

Symptoms of B-12 deficiency can be subtle at first. Early symptoms may include a persistent tingling or prickly feeling in your feet or hands, weakness, numbness, imbalance, and mental problems such as confusion, depression, irritability and forgetfulness. Rarely, vitamin B-12 deficiency is a cause of dementia.

As vitamin B-12 deficiency becomes more advanced, a shortage of red blood cells (anemia) or even white blood cells and platelets may develop. Deficiency often is caught before it reaches this level.

Diagnosis of vitamin B-12 deficiency typically involves blood tests. Testing for anemia may be one of them, but just because you’re not anemic doesn’t mean you’re not vitamin B-12 deficient. If vitamin B-12 deficiency is diagnosed, additional testing is sometimes performed to look for an underlying cause. 

For those who are deficient, raising vitamin B-12 to adequate levels may first involve correcting or treating an underlying problem, if possible. People with severe deficiency or who have an underlying problem in which the body poorly absorbs vitamin B-12 may need injections of high-dose vitamin B-12. These injections may be given several times a week at first, reduced to weekly injections, and then monthly injections if the underlying cause can’t be corrected.

Taking high-dose oral vitamin B-12 may sometimes be an alternative to injections; however, it may be better used as long-term maintenance therapy after vitamin B-12 levels have been stabilized.

The body responds rapidly to high-dose vitamin B-12, with nerve symptoms subsiding over weeks to months. However, the degree of improvement of nerve problems is typically influenced by how severe and long lasting the nerve problems were before treatment. In advanced cases, nerve problems can be irreversible.  

If you eat meat or eat breakfast cereal fortified with vitamin B-12, you’re likely getting the recommended daily intake of 2.4 micrograms (mcg). However, older adults may not be absorbing this B-12 efficiently and may want to take a daily supplement to prevent deficiency. You can’t overdose on vitamin B-12, as it’s not toxic. If you have a disease or take a drug that increases risk of vitamin B-12 deficiency or eat a strict vegan diet, talk to your doctor about appropriate supplementation levels or screening for deficiency. — Donald Hensrud, M.D., Preventive Medicine, Mayo Clinic, Rochester, Minn.

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People participating in a weight loss study who received financial incentives were more likely to stick with the program and lose more weight than study participants who received no incentives. Mayo Clinic internal medicine resident and lead author Steven Driver, M.D., says, “The take-home message is that sustained weight loss can be achieved by financial incentives. The financial incentives can improve results, compliance and adherence.”
Findings will be presented Saturday, March 9 at the American College of Cardiology’s 62nd Annual Scientific Session. Click here for news release.

Sound bites with Dr. Steven Driver are available in the downloads below.

Expert title for broadcast cg:
Dr. Steven Driver, Mayo Clinic Internal Medicine

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ANSWER: Advice on vitamin and mineral supplementation is constantly changing. Over the past few years, well-conducted research has found that some supplements previously thought to be beneficial for disease prevention may not be helping — and some may actually be causing harm. 

This research includes the Iowa Women’s Health Study, which tracked the supplementation habits of more than 38,000 women 55 and older for nearly 20 years. Among the findings, taking a multivitamin appeared to increase risk of premature death. Interestingly, the people who took multivitamins actually had better overall health habits than those that didn’t. With this study and others, there is increasing evidence against taking most supplements for general health or disease prevention. There are exceptions — such as calcium and vitamin D for bone health — but even the exceptions should be approached with caution. 

Many people take supplements as an “insurance policy” against inadequate nutrition. However, in developed countries, deficiencies in most vitamins and minerals are uncommon, unless there is a predisposing condition. Taking supplements provides these nutrients far in excess of what’s necessary for good health.  

Another reason people take supplements is to help prevent serious diseases. Studies have consistently shown that diets high in antioxidant-rich fruits, vegetables and other plant foods are associated with lower rates of cancer and heart disease. However, studies looking at supplements, including antioxidants such as beta carotene and vitamins A and E, haven’t shown much benefit, and there is some evidence they may actually cause harm.  

Plant foods contain hundreds of beneficial compounds termed phytonutrients. Singling out a few specific vitamins as being beneficial appears to be too simplistic. Also, some vitamins occur in many forms — and supplements may not provide the right forms in the right amounts.  

Potentially risky vitamin and mineral supplements include:   

Vitamin E — A 2012 review of research published in the Cochrane Database found that taking daily vitamin E supplements may increase the risk of dying prematurely.   

Vitamin A — The same review found large doses of vitamin A supplements were also associated with an increased risk of dying prematurely. Supplementation with beta-carotene, a compound that’s converted to vitamin A by the body, was also shown to increase risk of death, especially for smokers or former smokers. Since vitamin A deficiency is rare in the U.S., it’s probably not worth the potential risk to take this supplement.   

Folic acid (vitamin B-9) — Most older adults consume adequate folate. Supplementation helps prevent birth defects, but evidence of other benefits has been elusive.   

Vitamin B-6 — Large daily doses of vitamin B-6 — more than 100 milligrams (mg) — can over time cause nerve damage.   

Vitamin B-3 (niacin) — High doses can help lower high cholesterol levels, but this should be done only under the supervision of a doctor. Side effects, including severe liver disease, can occur.   

Iron — In healthy men and postmenopausal women, iron deficiency is rare. If you’re in one of these categories and iron deficient, further evaluation may be considered. There is some evidence that too much iron is associated with adverse effects, including possibly increased mortality.   

Trace minerals — Copper, chromium, magnesium, selenium and zinc are among the essential trace minerals. However, there isn’t any solid evidence that trace mineral supplementation has any benefit in the absence of deficiency — which is rare.   

Supplements that older adults may consider taking include:   

Calcium — The recommended intake is 1,200 mg daily for women over the age of 50 and men over the age of 70. A meta-analysis found that calcium supplementation increased the risk of cardiovascular disease. However, not all studies have supported this conclusion. Mayo Clinic experts support meeting — but not exceeding — your daily calcium requirements, primarily through food, as there was no evidence of increased risk with dietary sources of calcium.   

Vitamin D — In support of bone health and prevention of falls, 600 to 800 IU daily from diet and supplements combined is recommended for older adults. Some doctors and organizations believe that higher doses may be appropriate. Vitamin D enhances calcium absorption.  

Vitamin B-12 — It’s estimated that up to 15 percent of older adults are deficient in vitamin B-12. Since vitamin B-12 has not been shown to cause harm, even in large doses, it may be beneficial for older adults to take a B-12 supplement containing at least 2.4 mcg — the Recommended Dietary Allowance — to help prevent deficiency.  

Although many of the reported risks are small, any increase in risk is troublesome since people take supplements to improve their health. Because a large number of people take supplements, a correspondingly large number may experience adverse effects. Talk to your doctor before taking any supplements or making any changes to your current regimen, and ask for his or her recommendations for your specific needs. — Donald Hensrud, M.D., Preventive, Occupational and Aerospace Medicine, Mayo Clinic, Rochester, Minn.  

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