Page 37 - Retail Pharmacy Assistants September 2020

WEIGHT LOSS 35
likely to be short term because if you’re skipping meals ... you’re less likely to be able to get in the nutrients that you need,” she said.
She adds that for an older person, fasting may “not necessarily [be] a useful thing”.
“I think for people over 70 compromising nutrition by fasting or avoiding food groups is not going to
be the best way to ensure adequate nutrition, either. I would think an accredited practising dietitian is someone to get on your healthcare team, if you’re struggling with body weight.”
Accredited Practising Dietitian Dr Tim Crowe (thinkingnutrition.com.au) adds that diets such as “intermittent fasting fare no better than any other diet, such as traditional calorie restriction when it comes to weight loss”.
“Some people do well on it, but it is not for everyone,” he said. “There’s no evidence, so far, that intermittent fasting would work better or worse in someone who is older.”
Regarding other potential health benefits of intermittent fasting, Dr Crowe says that while “claims have been made about intermittent fasting as a way to reducing inflammation, cutting the risk of diabetes and heart disease, improving the brain and neural systems, few of these claims have much evidence to support them over and beyond what is linked to losing weight in the first place”.
“Metabolism falls with age and this is primarily from a decline in muscle mass, which happens because of hormonal factors and because of overall lower levels of physical activity,” he said. “There’s very little that can be done to boost metabolism outside of being as active as you can.”
However, Dr Sostaric believes intermittent fasting has its benefits, particularly when it comes to glucose control.
“It appears that the most sustainable intermittent fasting method is time restriction – eating within a six or eight- hour window,” he said. “The obvious benefit there is less opportunity to consume excessive calories.”
Dr Sostaric adds that fasting
also promotes or stimulates fat metabolism due to blood glucose levels being lower.
“You also have glycogen being metabolised [during the fast], out of
the muscles and the liver to be made available for the quick, important energy source,” he said. “When that’s lower, you get this immediate shift to increasing fat metabolism. So, the immediate effect
of a prolonged period of time without calories is an ideal environment to stimulate fat metabolism.”
The role of pharmacy
While a plethora of supplements available in retail pharmacy are marketed as
being effective for weight loss (Optifast, according to Mr Quigley, has the most “clinical evidence” behind it), the role
of pharmacy staff goes beyond simply selling a product. Mr Quigley suggests pharmacy staff have the potential to play a “health coaching” role in this space.
“In a pharmacy world, you can make a big difference there by perhaps encouraging a person to understand that replacing a meal every now and then with, say, a meal replacement option like Optifast ... or if they’ve
got nutritional deficiencies, looking
at a multivitamin ... or if they don’t understand how much water to drink – just talking them through these things can often make a difference,” he said. “And that classic invitation, which you hear me say all the time: ‘Let me know in a week, how you’re getting on’.”
Mr Quigley continued: “The first
thing to do is to become engaged.
We constantly get asked for the golden bullet that’s going to ‘make me have the body of Elle Macpherson’. And there’s no such thing.
“Being able to engage with a person and find out what they feel are the reasons behind their weight gain, rather than just selling them something, which they’ll add to the other 25 products they’ve got at home, all of which have been unsuccessful – that’s no way to help a person lose weight.
“And be non-judgemental.”
RETAIL PHARMACY ASSISTANTS • SEP 2020