THE FACTS ABOUT WEIGHT LOSS AND FITNESS

NOTE:  You can almost pretty much ignore everything that I've written in the section  that follows this book review. I will be rewriting this piece in the near future.  Instead, read my review of the book Good Calories, Bad Calories by Gary Taubes here:

This week, Good Calories, Bad Calories will be released in paperback form. Note that this is NOT a nutrition or diet book - it's a science book that everyone with an interest in nutrition, weight problems, health should take a look at. Author Gary Taubes is not trying to sell a diet program. Rather, this book stemmed from research that he was engaged in while looking at "bad science" for an article that he was writing for the journal, Science.

"Good science" occurs when an individual comes up with a theory and then tests it to make sure that the results are accurate and reproducible. The individual then publishes his/her findings in a manner that correctly summarizes the experiments' conclusions.  When experiments are conducted and the published results are not what the tests demonstrated, that would be considered "bad science" (think propaganda).

During the course of his research into instances of "bad science," Taubes was startled to find that many nutritional/diet studies were just that - bad science.  He then went back and examined studies of diet/nutrition, exercise, diabetes, lipids (cholesterol), etc and learned that almost everything we've been taught about obesity and diet is not supported by the evidence.  For example, some people have been promoting low fat diets and increased exercise as what's best for humans to live long and healthy lives. It turns out that this is pretty much the opposite according to the legit scientific studies.  Fat is not the evil that it's been made out to be. Instead, the culprit is sugars (and refined carbohydrates such as white flour) and their inherent ability to stimulate insulin production.

Insulin, as most are aware, lowers blood sugar. Most people are not aware, however, that insulin also deposits fat in the body (including inside of the blood vessels). This is an evolutionary thing.  If you're, let's say, a saber tooth tiger that is eating it's fresh kill. It will gorge and the excess calories must be stored for another day because - after all - who knows just how long it will take before it can make another kill (days or weeks)? Insulin does this.

On a practical basis, many people snack on sweets (soda, cakes, candy) and eat meals that contain starches e.g. potatoes.  This results in nearly elevated insulin levels throughout the day doing what it does best - deposit fat on the body. This is just one reason for why it's so hard for many people to lose weight.  The excellent movie, Supersize Me, demonstrated this nicely.  Most of Spurlock's McDonald's meals included large sodas and French fries. However, the guy who ate only the Big Mac's every day (Big Mac Man) did not gain weight!

High fructose corn syrup is another culprit in our lives.  While it may not stimulate as much insulin as sucrose, it directly stimulates the liver to put out triglycerides which screws up the good cholesterol (HDL).  This leads to heart ailments and strokes.

Taubes also discusses the impact that sugars (et al) have on common disease states.  Just a few hundred years ago, missionaries and doctors studied native tribes in Africa, South Pacific Islanders, and Eskimos (among many others around the world). All consumed diets relatively high in fats and protein (and low in carbs). Think coconuts and ocean fish, for example. None of these groups suffered from heart disease, diabetes or any other chronic diseases.  Even cancer rates were very low.  Enter their exposure to western diet through trading: "Here. Try some of this sugar stuff. Let us show you how to make bread from this white flour." You get the idea.  Soon after, all of these populations started to develop problems with obesity, heart disease and diabetes. The evidence is very compelling.

Be aware that I just over-simplified these concepts, but Taubes does a great job of laying out what the science really says about what really works for losing weight (cutting down sugars, refined carbs, etc) and what doesn't (dieting, exercise).  Check out the Borzoi Reader's review of the book here.  They summarize Taube's findings and even list what the science bears out.  Better yet, if you have a difficult time controlling weight, diabetes, heart disease, etc, then pick up a copy and read/study it. I strongly recommend it.

jpearson

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Start ignoring here:

There is no question that how we feel about ourselves influences our behavior in everyday life and no one is more pleased to remind us of this fact than the companies who promote all sorts of weight loss programs on the air waves or in the print media (But looks aren't everything - maintaining one's appropriate weight is necessary for the maintenance of good health. Obesity is steadily making it's move to overtake tobacco as the #1 cause of medical problems in the U.S.). To the tune of about $40 billion a year, weight loss is a national obsession and has become a field of rapid growth within the health industry.

But who should one believe? Given the multitude of choices that include everything from "heart healthy" diets to "A Twinkie a day keeps the doctor away," is it any wonder that the American public remains confused?

Let's begin with some simple facts: After heredity (genes), an individual's weight is largely determined by their balance of energy (calories). In other words, weight gain or loss depends upon the quantity of calories consumed, in comparison to the number of calories used ("burned up"). Specifically, an individual can gain weight by eating more or exercising less (the "couch potato" syndrome). Sound simple enough? [Actually, it can get a bit more complicated - we’re skipping all of the stuff about hormones (insulin) and chemicals in the brain (serotonin) for now.]

One pound of fat is equal to approximately 3500 calories. In order to lose this amount over the course of a week, one would have to create a negative balance of 500 calories per day. Rather than starve ourselves, the healthier way to achieve this goal is to increase the level of your activity through that "dirty" word called exercise.

Why? Because our bodies are finely-tuned machines with the ability to monitor and regulate our metabolism (use of energy). Here's an oversimplification: Imagine a sensor in our brains, much like a thermostat. Our bodies are constantly burning up calories for things that we don't even think about - our heart beating, lungs breathing, occasional walking, etc.. Let's say that a body uses up to 1500 calories/day essentially doing nothing more than basic life functions. If this individual takes in only 1000 calories/day, he or she would lose 500 calories/day because of this "negative" energy balance.

Unfortunately, this lasts only for the first two or three weeks because the "sensor" realizes "Hey, this jerk is trying to starve me - I'd better conserve energy!" The thermostat-like mechanism then resets itself to a lower number (for example 1000 calories expended per day for those same basic functions). The 1000 calories/day coming in now balances the 1000 calories/day being burned up, therefore, the weight loss slows down or stops. Therefore, you have a better chance of losing weight if you eat throughout the day, rather than dieting, if you eat correctly.

Also, exercise works by helping to reset that thermostat - usually to even higher than the 1500 calories/day at baseline, let's say to 2000 calories/day. It is through this mechanism that weight loss can then be achieved.

Incidentally, the Wall Street Journal recently published an excellent article, "The Diet that Works - what science tells us about successful weight loss" by Tara Parker-Pope (April 22, 2003). I recommend that everybody read this piece. (If the link doesn't work, I've scanned the article here.)

If you do nothing else, simply reducing your daily fat intake will result in weight loss. Learn how to read food packaging labels. Try substituting lower fat foods for those that you normally consume. For example, drink 2% milk instead of whole milk; frozen yogurt instead of ice cream; eat leaner meats; use low-calorie mayonnaise and salad dressings. These relatively easy substitutions alone can result in a 7-15 pound weight loss over the course of a year.

Suggestion: try to think of food only in terms as a source of fuel for your body, rather than as a source of recreation. Eat only when you sense your body is hungry in response to low energy stores and not just because you’re going to a movie or to "kill time."

[Stephen Furst is an actor best known for his obese roles in Animal House, St. Elsewhere, and Babylon 5. He went from 320 lbs down to 170 lbs and now looks great - I listened to him speak at the 2001 AOA (American Osteopathic Association) meeting.  Steve participated in a discussion for the American Diabetes Association which can be found at http://www.diabetesforecastlive.com/edition1/index.html.  If you have a weight problem and about an hour of free time, I recommend listening to this often humorous discussion on losing weight.]

A Crash Course in Nutrition

[FYI: For an excellent and very readable book on nutrition, I recommend checking out Nancy Clark's Sports Nutrition Guidebook.] I also highly recommend 30 Secrets of the World's Healthiest Cuisines by Steven Jonas M.D. and Sandra Gordon.

Carbohydrates (carbs) represent an immediate source of energy for your body; they provide the fuel for your muscles and other organs such as your brain. Deprivation of carbohydrates, such as seen in persons who fast, results in easy fatigue, possibly interfering with activities of daily living. Carbs are your body's first choice for fuel i.e. if given a choice of several types of foods simultaneously, your body will use the energy from carbohydrates first.

Protein is necessary for building new tissues such as muscle fibers, after they are damaged from routine everyday use. [note: get your protein from natural sources such as fish and poultry, rather than those very expensive supplements sold in the health food store; the quality of protein is usually much better and at a significantly cheaper price!] 

Fat is not used immediately by your body , but rather is stored for future energy reserves. In other words, fat goes right to fat. (Actually, some is used to create needed hormones such as estrogen and testosterone. Also, endurance athletes do use fat as fuel.)

Not all nutrients are created equal in terms of energy value. One gram (approximately 28 grams = one ounce) of carbohydrates is equal to 4 calories. Protein has the same 4 calories of energy value. Fats, on the other hand, have 9 calories for every gram - more than twice the amount of either carbohydrates or protein.

What this means is that if you eat equal amounts of carbohydrates and fats, for example 20 grams of each, you will gain substantially more calories from the fat (180) than from the carbohydrates (80). [Remember this at snack time when you're trying to decide between potato chips (high fat) and pretzels or Graham crackers (high carbs).]

Incidentally, each gram of alcohol yields 7 calories that your body is unable to use directly and is thus stored as fat (hence the origin of the "beer belly").

Opinions vary. For example, the American Heart Association (AHA) recommends that no more than 30% of our total daily calories be derived from fat. Even this is probably too high for most people. The Pritikin diet, on the other hand, recommends a 10% limit. This is difficult for many to achieve (as fat is what makes food taste so gosh darn good!).

They work - plain and simple, although not everyone agrees as to the reason why. They gained much recognition in the press following the introduction of Dr. Atkin's Diet Revolution and Sugar Busters! books. Insulin, a hormone secreted by the pancreas, is the touted culprit behind weight gain from carbohydrates.

In addition to it’s role in reducing blood sugar after a meal, insulin helps to deposit fat! Simple carbohydrates (e.g. sugars) stimulate the quickest/greatest insulin release, whereas complex carbohydrates (e.g. grain breads, yams, etc.) induce a slower, more measured insulin response. The rating of a carbohydrate's ability to stimulate insulin production has been termed the glycemic index. Foods with a high glycemic index release more insulin than those with a lower index.  For example, according to Sugar Busters!, baked potatoes have a very high glycemic index (yet many people consume these as part of their diets), whereas sweet potatoes (yams) have a very low glycemic index. Hence, for weight loss purposes, it makes more sense to consume yams over regular plain potatoes. (By the way, the healthiest part of a baked potato is the skin which contains the most important nutrients.)

Personally, my beliefs are along the lines as touted by the Lean For Life program, which was developed by doctors at UCLA more than 30 years ago and is the mainstay of the Lindora Weight Loss Clinics.  As noted earlier, our body's preference for fuel is carbs, which is fine when I was a toothpick in high school. However, when I wanted to lose weight, I had to find a way to force my body to utilize my stored fat as fuel, instead. Therefore, by reducing my dietary intake of carbohydrates, I was hoping to  do this.  This is termed "ketosis." Incidentally, one of the side benefits of maintaining your body in slight ketosis is that appetite is dampened, making it less likely that we'll overeat.

In this program, individuals are encouraged to eat throughout the day, generally three main meals consisting mainly of protein with some carbs, and supplementing with protein-based snacks whenever one is hungry. My personal favorite are the Premier Protein 8 Bars which contain 30 grams of protein and anywhere from 1-6 grams of sugar, depending upon the flavor. I've tried a lot of different products and, in my opinion, these taste the best. [They can be found at many stores, but the best value is to find them at Costco during a road show; note that Costco normally carries the regular Premier meal supplement bars with higher amounts of sugar, not the Protein 8 Bars.)] Beef/turkey jerky, sunflower seeds, etc also work for snacks. Also, be sure to drink lots of water throughout the day to keep your kidneys well-hydrated. Protein contains nitrogen, like fertilizer for your lawn. If you fail to water your lawn adequately following application of fertilizer, you may "burn" it!

Be aware that fruits and vegetables contain many necessary vitamins and minerals. If an individual cuts down too much on their carb selections, they will be at risk nutritionally. While multivitamins can provide these lost vitamins, they do not furnish fiber and other phytonutrients (derived from plants) that are also necessary for our health. Getting back to the subject of glycemic indices, complex carbohydrate containing foods tend to help out with this regard. This is the logic behind selecting 100% whole grain bread and cereal products over plain ol' white bread, or wild rice over white rice. So be sure to incorporate these into your meal plan. (Click the following link to read the Patient Care magazine education handout "Advice from your Doctor": A Healthy Low Carbohydrate Diet.")

The jury is still out on why people lose weight on these plans. Is there something really special about the carb/insulin relationship? Is it ketosis? Or do these patients simply end up eating consuming less calories overall? I suspect the latter, but patients often require specific instructions for whatever ailment they are treating and weight loss is no different. Asking patients to reduce the serving sizes of the white breads, white rice, etc. seems to make it much easier for them to make decisions about what goes into their mouth. [My own personal addiction is sushi. We have an all-you-can eat sushi restaurant near our office, that I hit several times a week for lunch. I pick the fish off off the rice, allowing me to boost the percentage of protein in my diet. When I'm finished, my plate is covered with mounds of rice that I would have otherwise consumed. Forget the fact that there might be something special about carbs, I take in a lot less calories at each visit by not eating the rice.] While I'm on the subject of excess calories, don't ever supersize anything - Lots of calories in those sodas and French fries! [If you haven't already seen it, rent the highly entertaining and informative DVD of the documentary "SuperSize Me." Then, pick up a copy of Eric Schlosser's excellent book, Fast Food Nation, and learn what really makes those  fries and burgers taste so great...]

Is Santa obese or merely overweight? (and what’s the difference?)

Obese = plain and simply means too much fat! (e.g. 20% above ideal body weight)

Overweight = weighs more than would be expected for height. Fails to consider muscle mass. e.g. Arnold Schwarzeneggar weighs more than the typical male, but mostly due to muscle!

 Fat content of common foods and snacks

How to read a food label

The Mediterranean Food Pyramid [http://www.oldwayspt.org/html/p_med.htm]

Burning up the fat!

Exercise, for our purposes, refers to anything that you enjoy doing, that makes your heart go fast (i.e. aerobics). These activities can include running, swimming, cycling, racquet sports, etc. for those so inclined, or fast (race) walking for persons concerned about trauma to their joints. If running/jogging, be sure to wear good shock absorbing shoes!

The good news is that it doesn’t require much intensity for your body to burn fat as fuel. While sprinting (and other activities that encourage short bursts of energy) use stored glycogen/sugar for fuel, slower endurance activities, such as jogging, burn free fatty acids as fuel. Therefore, you don't have to "kill yourself" in order to lose or maintain a healthy weight.

Low to moderate intensity exercise is all that's required. The simplified formula for calculating your target heart rate is as follows:

HRmax = 220 - age                  [HRmax refers to your maximum heart rate.]

HRmax × 0.60 = target heart rate for low intensity exercise

HRmax × 0.80 = target heart rate for moderate intensity exercise

e.g. 50 year old starting a low intensity program would aim to maintain a target heart rate (pulse) of 102 beats per minute.

That being said, I dislike formulas. Instead, aim to exercise with enough intensity so that you can talk, but not sing.

The American College of Sports Medicine guidelines state that the minimum amount of time required to achieve fitness benefits per week is about 90 minutes. For most people, 30 minutes 3 times a week or 20 minutes daily should be relatively easy to accommodate. Start out easy and, ideally, try to work up to 30 - 45 minutes of low-moderate intensity exercise, 5 times a week. Varying the types of exercise activity can help maintain interest, as can setting up your exercycle/stairmaster/treadmill in front of your TV during the evening news broadcast, Wheel of Fortune, or other favorite show. 

Exercise has other benefits, as well. Primary among them is a positive effect on mood. Studies show that individuals who engage in low to moderate intensity aerobic activity for 35-45 minutes/ 5 times per week improve their mood/attitude. Besides generating those endorphins (runners high), the improved endurance that develops from training probably makes it less likely for someone to become fatigued towards the end of the day and improves one's tolerance for things that would otherwise "tick" us off! Endurance  activity is also excellent for improving one's lipid (cholesterol) profile.

A modest loss of only 1-2 pounds per week at the most should be expected on average; any more is usually a result of water loss and not fat. This may not seem like a lot, but remember that this can represent 8-16 pounds over a 2 month period (and even more if the program is continued!). Be aware that it may take up to two years for your brain’s "thermostat" to finally reset itself to a leaner weight, so don’t give up the effort - it’s worth it.

In short, the secrets of a healthy weight loss program should not be a mystery to anyone. As The Nike advertisement so eloquently states: "JUST DO IT!"

Frequency: 5 times/week or more

Intensity: low-moderate

Timing (duration): 30 - 45 minutes/day

Fat is comprised of small units called fatty acids. Each fatty acid molecule consists of carbon (C), hydrogen (H⁺), and oxygen (O), arranged in a special pattern. When there is a H⁺ at every available spot in the molecule, the fat is saturated. When one H⁺ is missing, the fat is mono-unsaturated. if more than one H⁺ is missing, it is considered poly-unsaturated.

Coconut oil

Palm oil

Butter, shortening

Beef

Chicken

[Saturated fats are used by the liver to make cholesterol, hence this is considered to be the most dangerous type of fat. Both total and LDL ("Bad" cholesterol) are raised. These should not exceed greater than 10% of your daily caloric intake.]

Olive

Canola

Peanut

[Mono-unsaturated fats do not appear to have any effect on cholesterol levels. The problem with these oils is that they do not have a long shelf life. ]

Safflower

Sunflower

Corn

Cottonseed

[Polynsaturated fats do not appear to raise blood cholesterol levels, either.]

A word about Trans fats

Trans fats were developed in order to increase the shelf life of certain food products. These fats are the by-product of hydrogenation - the chemical process used to change liquid unsaturated fat to a more solid fat. As a result, these are structurally similar to saturated fat and they can elevate both total and LDL cholesterol levels,  too. They have been linked to a greater risk of heart disease. Stay away from these!

Trans fats may be found in stick margarine as well as most commercially prepared cookies/cakes and snack foods.

You can learn more about trans fats at: http://fpc.unl.edu/ProductCategories/TransFat.htm

For those of you who watch what you eat, here's the final word on nutrition and health. It's a relief to know the truth after all those conflicting medical studies.

1. Japanese eat very little fat and suffer fewer heart attacks than Americans.

2. Mexicans eat a lot of fat and suffer fewer heart attacks than Americans.

3. Africans drink very little red wine and suffer fewer heart attacks than Americans.

4. Italians drink excessive amounts of red wine and suffer fewer heart attacks than Americans.

5. Germans drink a lot of beer and eat lots of sausages and fats and suffer fewer heart attacks than the Americans.

CONCLUSION: Eat and drink what you like. Speaking English is apparently what kills you!