Das ist ein Vortrag, den Dr. Clarence P. Davis im Jahre 2007 im Rahmen eines Anti-Aging Kongresses in Paris gehalten hat. Er beinhaltet theoretisches Basis- und Hintergrundswissen zu den verschiedenen Diaettypen, sowie einige praktische Beispiele aus dem aerztlichen Alltag. Der Vortrag ist auf einem hohen Niveau und richtet sich ausschliesslich an professionelle Leser mit fundierten Vorkenntnissen.

2. Great Diets for Weight Reduction Dr. Clarence P. Davis Bergstrasse 8 CH-8702 Zollikon

3. Diet and/or behavior modification: Long-term results -5 0 -5 WEight change (kg) VLCD Modified diet + behavior modification VLCD + behavior modification -10 -15 -20 1 2 3 4 5 Years after intervention Intervention (adapdet from Wadden TA. Ann Intern Med 1993; 119:688-93)

4. Behavior modification 2 [months] 0 6 18 0 Standard behavioral -2 Treatment (SBT) SBT + structered -4 meal plans -6 SBT + fat reduction SBT + caloric -8 restriction -10 SBT + walking program 3d/week -12 -14 [weight loss % of initial weight] -16 [Sherwood et al. Int J Obes 1999;23:485-93

5. Focus of every overweight therapy should lie on a LIVELONG continuing weight reduction

6. activity milleniumscenturies decades energy density

7. Cause: Genetics versus Environment OBESITY Catherine Christie, PhD, RD, LD/N, 2003

8. Population percentage with BMI > 30kg/m2 Prof. P James, et al., IOTF Unpublished Data. Obesity Rates Could Double in 25 Years

9. BIG EATER

10. Definition: BIG EATER Has no or only short lasting feeling of satiety Eats at least once a day more than a normal restaurant size serving Usually not more than 4 meals per day No feelings of discomfort even after very opulent meals.

11. BBC 2003 'Big portions' health warning http://news.bbc.co.uk/1/hi/health/3112718.stm Hamburgers are 112% bigger than they were 20 years ago BBC 2003: Fast food 'as addictive as heroin' http://news.bbc.co.uk/1/hi/health/2707143.stm BBC 2002 Snack food sales rocket http://news.bbc.co.uk/1/hi/uk/2262816.stm BBC 2003 Court dismisses McDonald's obesity case http://news.bbc.co.uk/1/hi/world/americas/2685707.stm BB2 2002 Junk food battle hits US schools http://news.bbc.co.uk/1/hi/world/americas/2016819.stm NEWS Tbo 2004: Fast Food As Health Food? http://news.tbo.com/news/MGALX4Y1WPD.html

12. Increased Portion Sizes Catherine Christie, PhD, RD, LD/N, 2003

13. Comparison of Energy Densities Nielsen SJ et al JAMA. 2003 Jan 22-29;289(4):450-3

14. Comparison of Energy Densities Prentice AM et al Obes Rev. 2003 Nov;4(4):187-94

15. Changes in body weight, fat mass and fat-free mass in overweight people during intervention with sucrose vs. artificial sweeteners. 10 week-followup ● sucrose; mean BMI 28.0; n=21 ∆ artificial sweetners; mean BMI 27.6; n=20 Over study period, significant differences between changes in: body weight- P < 0.001 fat mass- P < 0.05 At different time points: * P < 0.05 ** P < 0.001 *** P < 0.0001 Mean±SEM Raben A, et al. Am J Clin Nutr 2002;76:721-9.

16. „Energy-density“of typical fast-food 145% more energy per meal compared with a traditional African diet A.M. Prentice et al. Obes Rev. 2003;4:187-194

17. Summary:Energy density Energy content of fast food is +145% higher of Gambian traditional food Energy density correlates best with fat content No adaptation process  PASSIVE over-consumption Results in: Higher fat intake Weight gain

19. Glucophage 1000 (Metformin): 1-0-0

21. WM male 56 years

24. hyperuricemia

25. gout

27. age < 60 y

29. Absolute:

30. Low serum potassium

31. Hyperuricemia

32. Any form of renal dysfunction

33. Nephrolithiasis

34. Instable angina

35. Myocardial infarction within the last 6 months

36. Epilepsy

37. Pregnancy and lactation

38. Malignancies

39. Relative

40. certain professions

41. Drivers

42. Pilots

43. etc.

45. Permitted and not permitted food

46. Preparation techniques (fat- and CHO-restricted cooking)

47. Possibly self control with ketone sticks

48. Slow resumption of CHO after dietRegular weight control in your office Transition phase

50. Dairy products

51. 300 ml: skim milk, buttermilk, whey protein drinks

52. 2 x 180 yogurt (preferentially skim milk yogurt)

53. 100 g cottage cheese, tofu

54. 50 g of 50% fat cheese

55. Eggs

56. 1 egg

57. Fish

58. 60 g of fish (any kind, preferentially lean types) or canned fish in water

59. Meat

60. 50 g of lean meat (pork, beef, veal, horse, poultry, venison)

62. Eggplant, artichoke, broccoli, cauliflower, cucumber, salt cucumber, pepperoni, cabbage (all types), mushrooms, radish, spinach, asparagus, tomato, chicory, onions, zucchini, celery, fennel

63. Vegetable group 2 (1 serving = 150 g)

64. Green beans, green lattice, dandelion, carrots, pumpkinOne green salad per main course is extra

65. Herniated disc impedes physical activity Severe illness of close family member WM male 56 years

66. FAT EATER

67. Nutritional Fat Typical nutrition composition Recommended nutrition composition Protein Protein 15-20% 15-20% CHO CHO 40-50% Fat 40% Fat 30% 45-55%

72. Blood lipids

74. Distribution of fat-types: SFA:MUFA:PUFA=<1:1-1.5:<1

75. Cholesterol < 300 mg/d

76. Avoid/reduce trans fatty acids

77. Increase of fibers to ≥ 30 g/d

78. Diet should be high in CHO (~ 55-60% of total energy intake)

79. Avoid alcohol or strict alcohol reductionRegular weight control in your office Well suited as lifelong diet

81. 9 g of fat 0,7 g of fat

82. 1 handful = 50 g 1 handful = 40 g 12 g of fat 1,3 g of fat

83. 1 handful = 20 g 1 handful = 40 g 2 g of fat 7 g of fat

84. 1 plate 1 Pizza 10 g of fat 32 g of fat

85. 1 serving = 180 g 1 seving (side dish) = 60 g 0,4 g of fat 32 g of fat

86. 1 sausage = 110 g 1 chicken breast = 150 g 26 g of fat 2,4 g of fat

87. Active center lipase CHONH OH Xenical® H2NCO OH Stable Xenical-complex blocks fat digestion Low-fat Diet: medical treatment

88. 42 Xenical prevents the absorption of up to 30% of dietary fat...

89. 30% of triglycerides pass undigested and are excreted. …which pass through the body undigested and are excreted.

90. Placebo + diet Xenical + diet Weight loss (%) p&lt;0.001 12 p&lt;0.001 p&lt;0.001 10.2% 9.7% 10 8.8% 8 6.6% 6.1% 5.8% 6 4 2 0 Sjöström Rössner Davidson Consistent weight loss in clinical trials Sjöström L et al Lancet. 1998 Jul 18;352(9123):167-72Rössner S et al Obes Res. 2000 Jan;8(1):49-61 Davidson MH et al JAMA. 1999 Jan 20;281(3):235-42

91. 0 Placebo Xenical® 60mg Xenical® 120mg -2 *p&lt;0.01 -4 Veränderung Körpergewicht (%) -6 -8 -10 60 70 80 90 104 -4 0 10 20 30 40 52 Xenical: Long-term weight reduction Sjöström L et al Lancet. 1998 Jul 18;352(9123):167-72

92. Placebo + lifestyle modification Xenical + lifestyle modification (kg) 0 –3 –4,1 kg –6 –6,9 kg –9 p&lt;0.001 vs. Placebo –12 0 52 104 156 208 Woche Xenical: XENDOS-results Torgerson JS et al Diabetes Care. 2004 Jan;27(1):155-61

93. Low-fat Diet