Tag Archives: diet

Postpartum Weight Loss

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One of the most common inquires I get is from new moms looking to lose that postpartum belly. How is it possible that celebrities like Heidi Klum can drop 30-40 pounds in just 4 months?  Anna Paquin goes from twins to 6-pack abs in 5 months. For new moms, that is frustrating, when you work so hard to lose stubborn body weight. What do they do that you don’t? Trust me, there is no super-secret information or magic formula that only they are privy to. You have the same physiology and weight loss capabilities as Hollywood superstars.

Normal weight gain during pregnancy is 30-35 pounds. Roughly 10 pounds is lost immediately after birth – seven pounds for the baby, plus two-three for blood, amniotic fluid and other. Through the first week your body will flush another 5 pounds of reserved water weight.  Optimal weight loss should be 1-2 pounds per week. If you do the math, you will find that Anna Paquin and Heidi Klum lost about 2 pounds per week.  Suddenly, Heidi and Anna’s weight loss isn’t so dramatic, does it? A loss of 1-2 pounds per week is easily attainable if you are diet compliant and dedicated to exercise. Continue reading

Is the US Government Responsible for the American Obesity and Chronic Disease Epidemic?

Chronic medical conditions is the leading cause of death in the United States. Nearly half of all adults have at least one chronic medical condition. Over the past 20 years there has been a significant rise in chronic disease. Over the past 15 years childhood obesity and diabetes is growing at an astronomical rate. Who is to blame? Nobody can really state exactly who, but  is it possible that the US government, specifically the United States Department of Agriculture (USDA) is responsible?

1992 Food Guide Pyramid

In 1992, the USDA released the first Food Guide Pyramid. The USDA obviously had good intentions, through heavy research the pyramid was developed to prevent, chronic disease, obesity, and dental carries. Over the years the Food Guide Pyramid evolved to in to more user-friendly versions, MyPyramid (2005) and MyPlate (2011). Despite making the guides more user-friendly, the USDA did little to evaluate data and change the science supporting the pyramid.  Unfortunately, the USDA got it completely wrong. Since the ’92 Food Guide Pyramid was released there has been a dramatic increase in chronic disease and obesity. Has the Food Guides failed the American people?

Let us evaluate the guides. The ’92 version has grains, fruits, and vegetables filling the bottom two rows of the pyramid, accounting for 20 of 26 possible servings. The 2005 version is much of the same, with a large portion dedicated to carbohydrates, but like the ’92 version, the largest portion is dedicated to grains. The 2011, MyPlate is simplified for the consumer, but again indicates most of your plate be comprised of carbohydrates. In fact, when you breakdown the percentages the guides recommend the consumer eat approximately 75% of calories from carbohydrate sources. What is wrong with this you ask? Well, below I have outlined 5 reasons why the USDA might be responsible for the rise in chronic disease and obesity.

Five Reasons Why the USDA Might Be Responsible for the American Obesity and Chronic Disease Epidemic

Reason #1: Misleading information

The guides suggest grains (bread, pasta, rice) account for the largest portion of carbohydrate consumption. The guides do not state 100% whole-grain. To the average consumer, this gives the impression that refined breads and pasta is a fantastic option.  So, the lay person, goes to a restaurant orders a plate of spaghetti and a side of garlic bread, and thinks -‘this is a healthy low-fat meal’. After all, according to the guides this meal is well within the guidelines set forth by the USDA.

Additionally, the original guide said 6-11 servings of breads, grains, and pasta / day. Servings is key, because most individuals, myself included, grossly overestimate what constitutes a serving. Another note on servings: it gives a range of servings; 6-11 servings. This tells the consumer that you must have a minimum of 6 servings of grains. This misleading information has led to over-eating and over-eating of the wrong foods.

Reason #2: Satiety

Countless studies have correlated carbohydrate intake to increased hunger, specifically foods with high glycemic index (1, 2, 3). Primarily because of the insulin and blood glucose spike caused following the ingestion of carbohydrates. Newer research indicates that a higher than normal protein diet may actually be the reason for their partial success in inducing weight loss (4). Weigle, et al, found that the subjects felt more satiated with high-protein diet (5). In addition, Weigle’s team found total caloric intake decreased with when consuming more protein (5). There are two theories behind protein’s ability to increase satiety: 1 – High protein foods take longer to digest and leave the gut. 2 – Protein may impact our the hunger and satiety hormones of ghrelin and leptin. So the USDA is telling us to eat foods, that physiologically trigger us to eat more.

Reason #3: Insulin

When we eat carbohydrates insulin is released by the pancreas to begin glucose uptake from the blood. Insulin’s job is to take blood glucose and facilitate storage of glycogen  – our primary energy source. Insulin is also an indirect gate-keeper to fat metabolism, by inhibiting the release of glucagon. Glucagon is a hormone that has the opposite role of insulin. Glucagon is designed to take glycogen and convert it to glucose. Glucagon also creates glucose through lipolysis (the breakdown of fat). If we eat carbohydrates, the insulin response inhibits glucagon – thus prevents us from burning fat.

Reason #4: Elevated Inflammatory Markers

Chronic inflammation is a primary cause of most chronic diseases (6). Excessive consumption of refined carbohydrates, low dietary fiber intake, and a high omega-6 to omega-3 ratios are strongly associated with the production of proinflammatory molecules (7). One large study compared a Western diet and high protein diet. In this study, the western diet group had greater levels of inflammatory markers, including CRP and E-selectin, whereas those on the high protein diet had a significant decrease of inflammatory markers (8).

Reason #5: Importance Fat

In the original food guide pyramid it is stated that fats should be used sparingly. In both the 2005 version and 2011 version, the USDA’s guide says nothing about fat. This gives the impression that fat should be avoided. This is a huge mistake. Fat, specifically, Omega-3 fats – found in nuts, fish, and seeds – is very important. Clinical studies in adults with high cholesterol have shown that nuts lower LDL-cholesterol and improve the overall blood lipid profile (9). Additionally, frequent nut and seed consumption is associated with lower levels of inflammatory markers such as C-reactive protein (CRP), IL-6 and fibrinogen(10).

Does this indicate the USDA got it wrong and led the American people down the wrong path? I believe the aforementioned reasons have led to an increase in obesity and chronic disease in America. Is it really a coincidence that following the release of the guides there has been a dramatic rise in obesity and chronic disease? That being said, I believe in personal responsibility – I think it is up to the individual to make wise decisions. The USDA is not telling people to stop exercising. So, although I believe the USDA may have been a contributor – some blame should be put on the people.

What do you think? Can we blame the USDA’s Food Guides for steering the American people in the wrong direction?

References:

  1. Wien M A, et al. Almonds vs complex carbohydrates in a weight reduction program. Int J Obes 2003. 27:1365-1372
  2. Roberts SB. High-glycemic index foods, hunger, and obesity: is there a connection? Nutrition Review 2000. 58:163-169
  3. Arumugam V, et al. A high-glycemic meal pattern elicited increased subjective appetite sensations in overweight and obese women. Appetite. July, 2007.
  4. Astrup A, Meinert Larsen T, Harper A. Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? Lancet 2004;364:897
  5. Weigle DS, Breen PA, Matthys CC, et al. A high-protein diet induces sustained reductions in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin andghrelin concentrations. Am J Clin Nutr 2005;82:41–8.
  6. Stehouwer CDA, Gall M-A. Twisk JWR, Knudsen E. Emeis JJ. Parving H-H. Increased urinary albumin excretion, endothelial dysfunction and chronic low-grade inflammation in type 2 diabetes: progressive, interrelated, and independently associated with risk of death. Diabetes.2002;51(4): 1157-1165.
  7. Neustadt J. Western Diet and Inflammation. IMCJ. Vol. 10: 2  Apr/May 2011.
  8. Lopez-Garcia E, Schulze MB, Fung TT, et al. Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction. Am JClin Nutr.2004;80(4):1029-1035.
  9. Mukuddem-Petersen J, Oosthuizen W & Jerling J. A systematic review of the effects of nuts on blood lipid profiles in humans. J Nutr. 135: 2005. 2082–2089.
  10. Rajaram, S, Connell, KM, and Sabate´ J. Effect of almond-enriched high-monounsaturated fat diet on selected markers of inflammation: a randomised, controlled, crossover study. BR J of Nut.  2010: 103, 907–912.

ENOUGH! Weight Loss is NOT Rocket Science

This blog should more appropriately be titled my rant of the month:

How many diet fads come out every year? Atkins, Zone, Paleo, Low-fat, South Beach, Intermittent Fasting are some of the most popular, but there are hundreds more pumped out every year. Why do we have new diets every year? Because there is not, nor will there ever be, a diet that can guarantee weight loss. Researchers keep making weight loss a scientific endeavor. The researchers then publish the findings, sell books, get rich and then the diet fades. Enough already, weight loss is not rocket science. It’s simple: balance energy by eating better and getting off of your ass. To prove my point let’s compare the data on a controversial issue: high-protein, low-carbohydrate vs. low-fat diets.

In 2002 a study done from Duke University researchers comparing a high protein low carb diet versus a traditional low-fat diet. The results of this study became much publicized and launched the Atkins Diet revolution. It hit mainstream media with a left and right hook. The diet quickly became one of the best-selling diet plans of all-time. But pundits refuted the data stating unreliable and invalid data. Today, there is valid points of discussion made by both sides.

Like most research and controversial issue, the data is for and against the high-protein diet is equivocal. In 2003, the New England Journal of Medicine published two studies which compared a low-carbohydrate diet to a calorie-restricted, low-fat diet in obese adults (1, 2). After six months both studies showed that low-carbohydrate subjects lost more weight and had significant reductions in markers for cardiovascular disease. This includes decreased triglyceride levels. However, after one year of performing the diets, weight loss and triglyceride levels were similar. But like many diets, compliance is an issue and in both studies there was a high dropout rate – thus data is unreliable.

As I had mentioned, pundits refuted the data. Most stated, that carbohydrate restriction was not the reason for weight loss, rather it was attributed to calorie deficit. This is similar to the systematic literature review done by Bravata, et al concluded that participant weight loss on low-carbohydrate diets was a result of caloric restriction, but carbohydrate restriction (3).

So Atkins, does yield weight loss, but why? Can I really eat a bacon cheeseburger (with no bun) and lose weight? Physiologically, carbohydrates are the body’s primary fuel source. When we eat carbohydrates the food is broken down and stored in skeletal muscle tissue and liver as glycogen, an easy to use energy source. When we eliminate carbohydrates from our diet we also eliminate glycogen stores.  Without glycogen, our body must use fat as energy. Subsequently, our body enters a state of ketosis – a state where ketone bodies are produced when fatty acids are broken down for energy. The loss of glycogen stores – and associated water loss – coupled with increased fat metabolism creates weight loss. In addition, the breakdown of fat is much more difficult than breaking down glycogen. Thus, our body must expend more energy to convert fat to energy (4) – burn energy to create energy.

But there are risks to eating a high-protein, low carbohydrate diet, right? The answer is yes and no. Many have stated a high-protein diet causes kidney and liver issues as well as abnormal insulin metabolism. Levine et al performed a research review  on low-carbohydrate diets and found little data to say a high-protein, low-carbohydrate diet causes health concerns (5). However, many studies have found that the diet does cause common side effects such as constipation, nausea, weakness, dehydration, and fatigue.

Is there a winning diet method? Simply put – the answer is no. While South Beach, the Zone, Atkins and others have all remained the most popular, there is not winner. If there were some magical remedy we would never again have new diet fads. After reviewing all of the data there is one constant: all weight loss is associated with negative energy balance. Meaning, you are burning more calories than you are consuming.

Remember Super-Size Me? The guy who ate McDonald’s everyday and gained weight. Well have you heard of Doug Logeais? He ate McDonald’s everyday for 30 days and lost weight! How, he exercised. He trained most days of the week at a high intensity – he burned more calories than he consumed.  Has anyone seen Michael Phelps’ diet? Big Mac, Pizza, soda, ice cream, 10,000 calories per day in food, but nobody says he has a weight problem. He is a long, lean and the greatest Olympic athlete of all time. Does he need to change his diet? Can you honestly say that he is doing something wrong? He is fit because his exercise off-sets calorie consumption.

My final opinion: regular physical activity combined with a well-balanced diet is paramount.  Weight maintenance requires permanent changes to eating habits and increased physical activity. The specific strategies for making those changes, and making them permanent, will vary from person to person. So, instead of a walking through the local book store of the best-selling diet book, save your money. Take a walk through your neighborhood. Instead of cheeseburger and fries – order a turkey burger and side salad. This is not rocket science – quit trying to make it more difficult than it is.

References: 

1      Samaha FF, Iqbal N, Seshadri P, et al. A low-carbohydrate as compared with a low-fat diet in severe obesity. N Engl J Med. 2003;348:2074–2081.

2      Foster GD, Wyatt HR, Hill JO, et al. A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med. 2003;348:2082–2090.

3      Bravata DM, Sanders L, Huang J, et al. Efficacy and safety of low-carbohydrate diets: a systematic review. JAMA. 2003;289(14):1837–1850.

4      Buchholz AC, Schoeller DA. Is a calorie a calorie? Am J Clin Nutr. 2004;79(suppl):899S–906S.

5      Levine MJ, Jones JM, Lineback DR. Low-carbohydrate diets: assessing the science and knowledge gaps, summary of an ILSI North America workshop. J Am Diet Assoc. 2006;106:2086–2094.

 

 

Stop Destroying your Body!!

Have you ever wondered why the ankle swells after a sprain or why we get a fever or why you get allergies around pollen? This does not happen because our body is weak; it happens because our body is strong and functioning as it should. Swelling after a sprain is needed to heal damaged tissue. Fever from flu is because our immune system is attacking a virus. Runny nose, watery eyes from allergies is a histamine response from your body to protect. Our body is designed to protect itself – we are robots that have specific programs in place to counteract disease or illness. Unfortunately, we are preventing our body from doing its job.

In the cells of your body is a class of proteins called Sirtuins. These have specific jobs that are designed to help the body function, live, and heal. SIRT1 is a specific type of Sirtuin that is specifically designed to facilitate metabolism. Yes this little guy helps breakdown and utilize the food you eat. Previously, Leonard Guarente of MIT found that this protein has many benefits including protection against Alzheimer’s, and Parkinson’s diseases. Most recently, they found that when mice were fed high-fat diets a myriad of metabolic disorders developed when the protein was absent.  These proteins are helping to keep cells alive and healthy.

We are killing these proteins and preventing them from doing their job. Research has proven that diets high in fat produce inflammation (see my blog). During the inflammation process an enzyme called Capase-1 is released. The specific job of Capase-1 is to go out and cleave (destroy) proteins and ultimately alter the primary objective of the protein. Are you following me?

When we eat a high-fat diet SIRT1 wants to begin metabolism, however the Capase-1 enzyme destroys SIRT1 before it can do its job. What happens next? Well, fatty deposit storage increases, followed by multiple metabolic and cardiovascular disorders such as diabetes, obesity, and hypertension (to name a few). By limiting high-fat intake and foods that initiate inflammation, we can allow our body’s natural protective mechanisms to go to work.

Stop Destroying your Body.
Reference:
Massachusetts Institute of Technology. “Protein that boosts longevity may protect against diabetes: Sirtuins help fight off disorders linked to obesity.” ScienceDaily, 8 Aug. 2012. Web. 11 Aug. 2012.

Weight Loss Challenges? Have You Tried Intermittent Fasting?

How many diets have you tried? How many times have you failed? The term ‘fad diet’ is a gross understatement, all diets are fads. I cannot think of a single diet that has been around for years, can you? Most diets are difficult to follow – bland, costly, and inconvenient – subsequently, there is a high rate of non-compliance to the diet strategy.   What if a diet asked you to eat a little healthier and take 1 day off per week? That doesn’t sound that hard does it?

The concept of Intermittent Fasting has been around for many years. In fact, our ancestors were forced to occasionally fast. Recently, I learned about intermittent fasting by John Berardi, Founder of Precision Nutrition System and leading nutritional scientist. I read his book and became hooked on the concept. In the simplest explanation, one day a week, you fast for an entire day (20-24 hours). For example, eat regular meals Tuesday through Sunday. On Sunday night eat dinner at your normal time (7 pm). Then don’t eat until Monday evening at dinner time.  During the fasting period, drink water and take a multivitamin if you want to. When you resume eating, don’t run to a fast-food chain and order 3 double cheeseburgers, an extra large fry, and a milkshake. Just, resume normal, healthy eating.

“I’ll Starve to death”, is the immediate response. No, you won’t. Our ancestors went 2-3 days without eating, they survived. Second, you will quickly learn that you are less hungry at hour 20 than you were at hour 4. We have hormones in our body, which trigger the feeling of hunger, but once you get past the initial hunger phase, the hormone response is suppressed and hunger subsides.

A single day of fasting creates a negative energy balance (expending more calories than consuming) of 2000-3000 calories. Consider that one-pound of fat is equivalent to 3,500 calories, you can see how easy it is to reach the negative energy balance and weight loss. There are physiological benefits that go beyond negative energy balance and weight loss:

  • Improved blood lipid profile (decreased LDL, increased HDL)
  • Reduced blood pressure
  • Reduction of inflammatory markers such as C-Reactive Protein
  • Improved fat metabolism
  • Increased insulin sensitivity (blood sugar control)
  • Enhanced Autophagocytosis (cellular repair)

It should be noted, that the above is based on fasting for 18-24 hours. Fasting for longer periods or more frequently does not enhance or expedite these results. Improving health is never quick and easy. Exercise or diet alone will not create life lasting health improvements.  The improvements noted above are a result of intermittent fasting, combined with overall healthier eating and regular exercise. Ultimate health and wellness come from a combination of diet and exercise.

Two months ago I started a paleolithic diet after doing my own independent research on diet and inflammation (I blogged about it). The data was so overwhelming I had to try it for 30 days. I loved it. Now I am combining a less strict version of Paleo with John Berardi’s intermittent fasting program. After 45 days, I lost 15 pounds and feel fantastic.  Easiest diet I have tried.

Is Your Diet Making You Sick?

Inflammation is the body’s biological response to repair tissue and initiate healing after injurious stimuli has damaged tissue. When an irritant begins to damage tissue, a chemical response ensues. This response causes significant signs: Pain, Heat, Redness, Swelling and loss of function. Inflammation is how we survive and heal. Without this natural response, disease would take over our body. Inflammation is necessary; however, it can also be a serious problem, especially when the condition becomes chronic.

The inflammatory response is the same regardless of the location or the stimulus that caused injury. After trauma occurs hemodynamic changes occur along with the production of exudate or edema. In acute inflammation, the tissue initiates a repair and remodeling event to return tissue to a normal state. If the inflammation fails to resolve, or inflammatory mediators remained elevated, the tissue will begin a cyclical process of a continued inflammatory response; this is when chronic inflammation occurs.

Chronic inflammation is a common factor that may contribute to development of chronic diseases (1). Many diseases are now classified as inflammatory diseases, such as, vasculitis, atherosclerosis, diabetes, and arthritis. Elevated C-reactive protein (CPR) in the blood is a sign of inflammation. Individuals with chronically elevated CRP are three times more likely to have a heart attack than those who have low –levels. Now, studies are finding a correlation between chronic inflammation, chronic disease and poor diet.

Researchers have found the diet has an influence on inflammation. Specifically, excessive consumption of refined carbohydrates, low dietary fiber intake, and a high omega-6 to omega-3 ratios are strongly associated with the production of proinflammatory molecules (2). Additionally, antioxidant’s decrease inflammation, and the low intake of antioxidants contributes to a proinflammatory state exacerbates disease (2). One large study compared a Western diet and a paleo-like diet. The western diet contained more red meat, refined carbohydrates and saturated fat. The Western diet group had greater levels of inflammatory markers, including CRP and E-selectin (3). Those following the paleo-like diet had a significant decrease of inflammatory markers (3).

In addition, the Mediterranean diet, which is comprised of whole grains and omega-3 fatty acids was found to reduce inflammatory markers compared to baseline levels and eliminate metabolic syndrome after two years of following a Mediterranean diet and exercise (4).   Cytokines, which are another key for chronic inflammation, are released by adipocytes. Thus general fat loss can reduce the expression of cytokines.

Clinical studies in adults with high cholesterol have shown that nuts lower LDL-cholesterol while improving the overall blood lipid profile (5). Frequent nut and seed consumption is associated with lower levels of inflammatory markers such as C-reactive protein (CRP), IL-6 and fibrinogen, even after adjusting for confounding factors(6). Consuming a high-almond diet (68 g/d per 8386 kJ) for four weeks significantly decreased serum E-selectin compared with the control diet in healthy men and women (6).

Chronic inflammation is linked to chronic diseases such as coronary heart disease, diabetes, atherosclerosis, and arthritis. The rise of these diseases over the past few decades may be linked to the Western diet of saturated fats, low antioxidants, and refined carbohydrates. A diet rich in omega-3 fatty acids such as fish and nuts as well as whole grains and high fiber have been shown to reduce chronic inflammation markers in the blood. Diet plays a much larger role than previously thought in the prevention of chronic disease. Are you ready to change your diet?

References:

  1. Stehouwer CDA, Gall M-A. Twisk JWR, Knudsen E. Emeis JJ. Parving H-H. Increased urinary albumin excretion, endothelial dysfunction and chronic low-grade inflammation in type 2 diabetes: progressive, interrelated, and independently associated with risk of death. Diabetes. 2002;51(4): 1157-1165.
  2. Neustadt J. Western Diet and Inflammation. IMCJ. Vol. 10: 2  Apr/May 2011.
  3. Lopez-Garcia E, Schulze MB, Fung TT, et al. Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction. Am JClin Nutr. 2004;80(4):1029-1035.
  4. Neustadt J. The food pyramid and disease prevention. Integr Med. 2005;4(6):14-19.
  5. Mukuddem-Petersen J, Oosthuizen W & Jerling J. A systematic review of the effects of nuts on blood lipid profiles in humans. J Nutr. 135: 2005. 2082–2089.
  6. Rajaram, S, Connell, KM, and Sabate´ J. Effect of almond-enriched high-monounsaturated fat diet on selected markers of inflammation: a randomised, controlled, crossover study. BR J of Nut.  2010: 103, 907–912.