From: Ms. Santa Henriquez [office@am-coll-nutr.org]
Sent: Tuesday, November 18, 2003 2:54 PM
To: FDADockets@oc.fda.gov
Subject: FDA Obesity Statement

To: Ms. Jeanie Butler

Via e-mail: FDADockets@oc.fda.gov

From: The International College for the Advancement of Nutrition, 300
South Duncan Avenue, Suite 225, Clearwater, FL 33755' Tel. 727/446-6086;
Fax 727/446-6202. Web site: www.am-coll-nutr.org, E-mail:
office@am-coll-nutr.org
Betty Wedman-St. Louis, Ph.D., FACN, CNS, RD, Executive Director

The International College for the Advancement of Nutrition (ICAN)
acknowledges the World Health Organization's assessment that obesity is
a global epidemic and recognizes that obesity is associate with a number
of chronic illnesses including cardiovascular disorders, diabetes and
arthritis.  ICAN asserts that obesity is overtaking cigarette smoking as
the leading cause of preventable death throughout the world.

Many nutrition experts are acknowledging that over-eating and obesity
are most likely a result of two concomitant factors not directly
associated with psychological abnormalities:  1/ a calorie-dense
environment that results in over consumption of calories and refined
carbohydrates with poor fiber intake, and 2/ sedentary lifestyles
emanating from television and computers producing unfavorable
modifications in physical activity patterns.

Dieting has become an obsession.  In the US, it has been estimated that
more than $30 billion is spent on diet programs annually.  But ICAN
emphasizes that dieting alone may not achieve significant benefits
because simple calorie restriction often leads to muscle loss along with
body fat loss and, long-term, weight is regained, often at a higher
level than pre-diet, the so called "Yo-Yo Syndrome" in most of the
initially "successful" dieters.

While diet modification can reduce calorie intake, exercise can promote
calorie expenditure.  ICAN recognizes that different types of exercise
needs to be considered in a weight reduction program.  ICAN recommends
both aerobic exercise and resistance training are important to burn
calories, enhance insulin utilization and prevent loss of lean body
mass.

ICAN further acknowledges that better weight loss studies are needed to
provide scientifically based protocols.  Many weight loss studies focus
on placebo protocols which may alter compliance and enhances the
artificial environment of the study. Achieving long term studies is
difficult due to human factors but, nonetheless, are absolutely
essential to properly evaluate the multiple of claims which currently
derive from short-term (less than five year) weight loss studies.

ICAN also is a strong advocate for increasing the teaching of nutrition
in medical school curricula, including that addressing overweight and
obesity.

The International College for the Advancement of Nutrition believes that
obesity management programs should include measures to decrease calorie
intake and lose fat while maintaining or building up muscle.