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A Clinical Observation
Part 2

Page 2

A High-Protein Regimen and Auriculomedicine for the Treatment of Obesity: A Clinical Observation - Part 2

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METHOD

Subjects

We enrolled 42 patients with clinical obesity.  Each patient underwent a history and physical examination.  All patients had lipid panels, fasting blood sugars (FBS), creatinines (Cr), and blood urea nitrogen (BUN) studies.  We excluded electrocardiography, thyroid, and urine studies, unless the history and/or clinical examination justified further evaluation.  Patients having elevated TC, TG, LDL, and low HDL were not excluded, but further work-up was performed to determine suitability for our program.  Patients with elevated FBS levels were excluded.

High-Protein Regimen

1. Meat

  • Red (cooked) meat: unlimited
  • Chicken:  unlimited
  • Low-fat fish: unlimited

2. Vegetables

Green vegetables only. Small portions (slightly less than half-a-cup) with at least 2 meals. Example: greens, spinach, peas, asparagus, green beans, broccoli, lettuce, and cucumbers.

3. Fruit, Juice, or Bread

2 (8-oz.) glasses of fruit juice, or 2 pieces of fruit, or 6 slices of low-calorie bread per day (40 calories per slice). They may be mixed, e.g. 3 pieces of bread and 1 fruit, or 3 breads and 1 juice, or 1 juice and 1 fruit. Meat must be eaten with all meals, i.e. apple and meat.

4. Salad Dressing

1 tablespoon of salad dressing a day of any variety is acceptable.

5. Beverages

6 (8-oz.) glasses of water a day must be consumed, with an optional twist of lemon, lime, or orange.

Unlimited diet caffeine-and sodium-free drinks are permissible. Caffeine-free coffee and tea are permitted.

6. Excluded

  • No sugar products: cakes, cookies, candy, or soda.
  • No starch products
  • No potatoes, rice, noodles, or cereals,
  • No sauces, gravies, mustard, or ketchup
  • No tomatoes, onions, or any vegetables that are not green.
  • No dairy products:  eggs, cheese, or butter.
  • No alcoholic beverages.
  • No yellow vegetables.
  • No ice cream.

We adhered to and recognized the need to meet the minimum nutritional requirements of the American Dietetic Association Food Guide Pyramid as found on the Internet at Http://www.eatright.org and the United States Recommended Dietary Allowances (7).  As a consequence, we modified our regimen by increasing the amount of low-calorie bread (40 calories per slice) from 4 to 6 slices a day.  In addition, we added calcium 500 mg, and a multi-vitamin tablet daily (7).

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Auriculomedicine

Auriculomedicine served the purpose of suppressing bingeing.  The therapy was started one week after initiation of the high-protein regimen.  The auriculomedicine procedure is very simple, consisting of 3 or 4 points:  Appetite Control Point, Shen Men, and Point Zero.  Tranquilizer Point may be added or substituted for Point Zero (8).  The treatment should have a duration of 15 minutes.  We have found in some instances, a mild suppression of appetite with therapy over 15 to 20 minutes; this should be avoided.  One wants the patient to indulge in eating meat to prompt a weight loss.  Seirin blue-topped needles were employed:  No. 3 (0.20) x 30mm J type with tube.

Statistical Analysis

Both the pre-treatment and post-treatment samples of the five groups (weight, TG, TC, LDL, And HDL) were first tested for normality using a one-sample Kolmogorov_Smirnov test. Based upon the results of this test, differences between pre-treatment and post-treatment means of the five groups were then compared using either one of two tests.  If both the pre- and post-treatment samples of a given group were normal, then a two-tailed paired-differences t-test was used for that group.  If either the pre- or post-treatment sample of a given group was nor normal, then a two-tailed Wilcoxen signed ranks test was used for that group (Table A).  Table B depicts follow-up data on patients that were contacted by telephone.  We were interested in determining a relapse rate based on weight gain over time, and other parameters such as no change in weight or weight loss.

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Statistical Results

Weight decreased in a statistically significant manner an average of 19.2 lbs over a 12-week period starting at week 0, going from an average value of 206.2 lbs at week 0 to an average value of 186.9 lbs at week 12 (Figure 1).

TG levels decreased in a statistically significant manner an average of 89.0 mg/L over a 12-wek period starting at week 0, going from an average value of 175.1 mg/L at week 0 to an average value of 86.1 mg/L at week 12 (Figure 2).

TC levels decreased in a statistically significant manner an average of 14.7 mg/L over a 6-week period starting at week 0 to an average value of 191.4 mg/L at week 6.  Changes thereafter were not statistically significant (Figure 3).

LDL levels did not change in any direction in a statistically significant manner during the 12-week period (Figure 4).

HDL levels decreased in a statistically significant manner an average of 3.8 mg/L over a 3-week period starting at week 0 to an average value of 42.6 mg/L at week 3.  Changes thereafter were not statistically significant (Figure 5).

The number of patients participating in the study steadily decreased over the 12-week period.  If the number of patients had remained steady, then it is possible that the increasing changes observed in some of the measures toward the end of the study, which were not statistically significant, would have been significant.  It is also possible that these increasing changes would have disappeared.

Table B and Figure 6 show that 50% of the patients did not gain weight, while 38.9% did;  11.1% desired to lose more weight, for whatever reasons.  The data goes out to over 91 days and thus, no final conclusions should be made.

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RESULTS

Forty-two patients successfully completed a clinical program incorporating a high-protein regimen and auriculomedicine.  Each patient reached his or her desired weight goal.  The average weight loss was 1.61lbs. per week.  There were no clinical complications.  Compliance was excellent throughout the course.  It was the unanimous opinion of the patient group that the auriculomedicine greatly decreased an urge to binge.  There was a significant decrease in weight, TG, TC (up to week 6), and HDL levels (up to week 3).  No clinically significant changes occurred in LDL, FBS, Cr, or BUN levels.  There were no adverse effects reported by patients from the high-protein regimen or auriculomedicine.

The number of patients participating in the study steadily decreased over a 12-week period as individual goals were met.  We telephoned our patients and fond a long-term relapse rate of 38.9%; 50% were still maintaining their weight, and 11.1% decided to lose more weight by employing the high-protein regimen alone (Figure 6).  Table B only represents 18 patients.  Our military patient population is geographically unstable.

Several patients stated that the protein diet was expensive and increased their weekly grocery bill by $45.  Others stated that the diet did not add to their food expenditures.

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DISCUSSION

This paper is not a research endeavor nor was it designed as such.  Instead, we are reporting on a very efficient clinical treatment for simple obesity that combined a high-protein diet and auriculomedicine.

There are many popular "crash" diets:  The One-Week Cabbage/Chicken Soup Diet Plan, the Cambridge Diet, the Doctor Kretnzman No-Diet Diet Program and others, which can be easily found in various references, including the Internet.  Although it is not the purpose of this paper to compare and contrast other programs, we state our observation and make no claims other than the data presented.  The true test of obesity is the relapse rate.

The high-versus-low-protein diet controversy is more an issue of fear and confusion than fact.  From the above data, it appears that the high-protein meat regimen does not produce an acute elevation of lipids; the fact is that there is a significant drop in TG levels.  None of the patients complained of fatigue.  There was no negative impact on kidney function.

It is believed that a high-protein and low-carbohydrate regimen apparently causes the body to burn its stored body fat to meet energy needs throughout the day.  Large amounts of meat must be digested and this, in turn, requires energy.  The amount of energy to digest large amounts of protein in the presence of low and simple carbohydrates may lend itself to the rapid metabolism of adipose tissue.  It is also well-known that a high-protein diet suppresses insulin peaks and false hunger pains.

One patient, who was no part of this group, requested only suriculomedicine.  He was not able to eat a high-protein regimen because of possible kidney disease, and was being treated medically for hyperlipidemia.  It is challenging to understand why he also lost weight, and his triglycerides an dcholesterol values normalized for the first time since the onset of his condition.

Auriculomedicine and the choice of the Appetite Control Point, Shen Men, Point Zero, and the Tranquility Point attenuate cravings more so for carbohydrates.  The role of auriculomedicine as reported by patients allows them to comfortably pass up the need to return to their previous dietary carbohydrates errors.  It was noticed that sessions over 20 minutes seemed to mildly suppress the appetite for a few days.

Omura reported that acupuncture can induce decreases in TG, TC, and phospholipids.  It may also provide a regulatory mechanism towards homeostasis, which depends on pre-treatment levels.  The significant changes for TG and TC that we noted may be due to this homeostatic effect (9,10).

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CONCLUSION

In conclusion, this paper demonstrates a practical high-protein diet that is very successful for the treatment of obesity caused by poor carbohydrate management.  When coupled with auriculomedicine, patients report a very subjective but definite increase in the quality of the program and prevention of bingeing.  The homeostatic effect of auriculomedicine on serum lipids needs to be further investigated.  An effort to obtain an increased patient population size and data points would be of significant interest in determining the long-term effects of our program on weight, TG, TC, LDL, and HDL levels.

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REFERENCES

  1. Shapiro L. "Is fat that bad," Newsweek. April 21, 1997; 58-64.
  2. Shute N.  "The joy of fat," U.S. News. January 12, 1998; 55-58.
  3. Galuska DA, Sedula M, Pamuk E, Siegel PZ, Byers T. Trends in overweight among US adults from 1987 to 1993: a multi-state telephone survey. Am J Public Health. 1996; Vol. 86/No.12, 1729.
  4. Jowers K. Air Force Times. Times publishing Company. November 23, 1998; 6.
  5. Tierney JR, Lawerence M, Mcphee SJ, Papadakis MA. Current medical diagnosis & treatment. Appleton and Lange, Connecticut, 1999; 1185.
  6. Niemtzow RC. A high-protein regimen and auriculomedicine for treatment of obesity: a clinical observation. Medical acupuncture, Fall/Winter 1997/98; Vol.9/No.2, 15-21.
  7. National Research Council, Recommended dietary allowances. National Research Academy Press 10th Edition, Washington, DC 1989; 41,45,125,262,284.
  8. Oleson T. Auriculothereapy manual:  Chinese and Western systems of ear acupuncture. Health Care Alternatives 2nd Edition, Los Angeles, 1996; 135, 56-57, 58.
  9. Omura Y. Pathophysiology of acupuncture treatment: effects of acupuncture on cardiovascular and nervous systems I.
  10. Helms JM. Acupuncture energetics: a clinical approach for physicians. Berkeley: Medical Acupuncture Publishers, 1995; 1.

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