Small Frequent Meals? Bad Idea for Weight Loss.

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Bloomberg News is reporting on some very interesting weight-loss news. (I guess there’s not much going on in the financial world…) Two Large Meals a Day Tops Six Mini-Meals for Weight-Loss reveals evidence that contradicts the hallowed advice to eat several small meals per day if you want to lose weight.

Here’s what’s important:

“Over 12 weeks, people with Type 2 diabetes who ate just breakfast and lunch lost an average of 1.23 points in body mass index, or BMI, compared with a loss of 0.82 point for those who ate six smaller meals of the same nutritional and energy content. The data, in a small study involving 54 patients, were presented today at the American Diabetes Association meeting in Chicago.

The study builds on previous results disproving the theory that eating more frequently improves weight loss. That pattern, thought to work because it helps control appetite, was shown to produce no more weight loss than three regular meals in a 2010 study published in the British Journal of Nutrition. The latest report eliminates one additional meal.

In today’s study, sponsored by the Czech Republic’s Ministry of Health, both the frequency of the meals and the timing were important, according to Kahleova. Eating earlier in the day — just breakfast, between 6 a.m. and 10 a.m., and lunch, between 12 p.m. and 4 p.m. — is associated with better results than skipping breakfast, she said.

Two meals a day also led to a greater decrease in liver fat content and a bigger increase in insulin sensitivity than six smaller meals.”

I find it very interesting that the researchers recommend skipping dinner instead of breakfast. That counters what I’ve been doing and what I’ve learned as a good fasting strategy. As I’ve said in recent posts (here and here), I like the idea of continuing the nighttime fast well into the day, then eating later in the day.  In fact, in recent weeks I’ve been trying to eat two big meals on my fast days: a mid-day meal and an evening meal. Perhaps I’m doing this less than optimally if this recent study is accurate.

I think the big picture is that we should spend several hours not putting food in our mouths. There is mounting evidence that being hungry for a while is a good thing. Clearly in this country we eat too much food.  It seems we not only eat too much–we eat too often. Further, the weight-loss gospel that a small-frequent-meal strategy aka “grazing” may be entirely wrong.

If you’re interested in this topic, there are a couple of worthwhile articles from Dave Tate’s site EliteFTS.com.  Logic Does Not Apply Part I: Meal Frequency and Part II: Breakfast are well-referenced and interesting. Both discuss and support the idea of a) skipping breakfast and b) spacing out our meals by several hours.  The writer notes though that small frequent meals throughout the day may be best for putting on weight.  So if you’re looking to gain a bunch of muscle then eat often!

 

 

Things to Read: Taking on Dr. Oz, Don’t Take Your Vitamins, Questions About Barefoot Running,

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There are several interesting things out there to check out.  Here are a few:

The New Yorker on Dr. Oz

Scientists often argue that, if alternative medicine proves effective through experimental research, it should no longer be considered alternative; at that point, it becomes medicine. By freely mixing alternatives with proven therapies, Dr. Oz makes it nearly impossible for the viewer of his show to assess the impact of either; the process just diminishes the value of science.
the New Yorker

Dr. Mehmet Oz is hugely popular.  I don’t know how many people watch his show but it’s a lot. We all know who he is. He’s a Harvard- and University of Pennsylvania-trained heart surgeon and he directs Columbia Hospital’s Cardiovascular Institute and Integrative Medicine Program. He knows a few things. An article in the New Yorker titled The Operator: Is the most trusted doctor in America doing more harm than good? takes Dr. Oz to task for perhaps crossing a line from science and good doctoring to entertainment.

I agree with a lot of what the article suggests. He seems to veer from scientific-based factual information into entertaining yet scientifically questionable material. He’s had psychics on his show and he often discusses “miracle cures,” and “breakthrough fat-burning this-and-that.” I haven’t seen much of him but what I do see and hear sounds very sensational. He seems to promise miracles to desperate people. Sounds a little kooky to me. From the article:

“The Dr. Oz Show” frequently focuses on essential health issues: the proper ways to eat, relax, exercise, and sleep, and how to maintain a healthy heart. Much of the advice Oz offers is sensible, and is rooted solidly in scientific literature. That is why the rest of what he does is so hard to understand. Oz is an experienced surgeon, yet almost daily he employs words that serious scientists shun, like “startling,” “breakthrough,” “radical,” “revolutionary,” and “miracle.” There are miracle drinks and miracle meal plans and miracles to stop aging and miracles to fight fat. Last year, Oz broadcast a show on whether it was possible to “repair” gay people (“From Gay to Straight? The Controversial Therapy”), despite the fact that Robert L. Spitzer, the doctor who is best known for a study of gay-reparation therapy, had recanted. (Spitzer last year apologized to “any gay person who wasted time and energy” on what he conceded were “unproven claims.”) Oz introduced a show on the safety of genetically modified foods by saying, “A new report claims they can damage your health and even cause cancer.” He also broadcast an episode on whether the apple juice consumed daily by millions of American children contains dangerous levels of arsenic. “Some of the best-known brands in America have arsenic in their apple juice,” he said at the outset, “and today we are naming names.” In each of those instances, and in many others, Oz has been criticized by scientists for relying on flimsy or incomplete data, distorting the results, and wielding his vast influence in ways that threaten the health of anyone who watches the show. Last year, almost as soon as that G.M.O. report was published, in France, it was thoroughly discredited by scores of researchers on both sides of the Atlantic.

Dr. Eric Rose was interviewed for the article.  Rose is a professor of surgery at the Mount Sinai medical school.  Rose and Oz worked together, most notably on Frank Torre’s 1996 heart transplant.  (Frank Torre is the brother of former Yankee manager Joe Torre.) He said this:

“I want to stress that Mehmet is a fine surgeon,” Rose said, as he did more than once during our conversation. “He is intellectually unbelievably gifted. But I think if there is any criticism you can apply to some of the stuff he talks about it is that there is no hierarchy of evidence. There rarely is with the alternatives. They have acquired a market, and that drives so much. At times, I think Mehmet does feed into that.”

I asked if he would place his confidence in a heart surgeon, no matter how gifted, who operated just once a week, as Oz does. “Well,” he replied, “in general you want a surgeon who lives and breathes his job, somebody who is above all devoted to that.” Again he mentioned Oz’s experience, but when I asked if he would send a patient to Oz for an operation, he looked uncomfortable. “No,” he said. “I wouldn’t. In many respects, Mehmet is now an entertainer. And he’s great at it. People learn a lot, and it can be meaningful in their lives. But that is a different job. In medicine, your baseline need has to be for a level of evidence that can lead to your conclusions. I don’t know how else you do it. Sometimes Mehmet will entertain wacky ideas—particularly if they are wacky and have entertainment value.”

And there is this observation from researcher Eric Topol:

“Mehmet is a kind of modern evangelist,” Eric Topol said when I called him at the Scripps Research Institute, where he is a professor of genomics and the director of the Translational Science Institute. Topol, one of the nation’s most prominent cardiologists, founded the medical school at the Cleveland Clinic and led its department of cardiovascular medicine. “He is keenly intelligent and charismatic,” Topol said. “Mehmet was always unique, but now he has morphed into a mega-brand. When he tells people the number of sexual encounters they need each year to improve their lives in a specific way, or how to lose weight in three days—this is simply lunacy. The problem is that he is eloquent and talented, and some of what he says clearly provides a service we need. But how are consumers to know what is real and what is magic? Because Mehmet offers both as if they were one.”

Dr. Oz seems like the latest in a long line of American snake-oil salesmen.  The best ones mix truth with fantasy and it sounds like Dr. Oz is doing just that.  On the positive side, the article tells us that Dr. Oz is pro-vaccine.  Read the full article on the cult doctor here.

The New York Times: Don’t Take Your Vitamins

The likely explanation is that free radicals aren’t as evil as advertised. (In fact, people need them to kill bacteria and eliminate new cancer cells.) And when people take large doses of antioxidants in the form of supplemental vitamins, the balance between free radical production and destruction might tip too much in one direction, causing an unnatural state where the immune system is less able to kill harmful invaders.
the New York Times

I’ve discussed various questions about supplements. Now, a recent opinion piece called Don’t Take Your Vitamins is in the New York Times and it goes into more information on the topic.  Here’s a bit:

“Antioxidation vs. oxidation has been billed as a contest between good and evil. It takes place in cellular organelles called mitochondria, where the body converts food to energy — a process that requires oxygen (oxidation). One consequence of oxidation is the generation of atomic scavengers called free radicals (evil). Free radicals can damage DNA, cell membranes and the lining of arteries; not surprisingly, they’ve been linked to aging, cancer and heart disease.

To neutralize free radicals, the body makes antioxidants (good). Antioxidants can also be found in fruits and vegetables, specifically in selenium, beta carotene and vitamins A, C and E. Some studies have shown that people who eat more fruits and vegetables have a lower incidence of cancer and heart disease and live longer. The logic is obvious. If fruits and vegetables contain antioxidants, and people who eat fruits and vegetables are healthier, then people who take supplemental antioxidants should also be healthier. It hasn’t worked out that way.

The likely explanation is that free radicals aren’t as evil as advertised. (In fact, people need them to kill bacteria and eliminate new cancer cells.) And when people take large doses of antioxidants in the form of supplemental vitamins, the balance between free radical production and destruction might tip too much in one direction, causing an unnatural state where the immune system is less able to kill harmful invaders. Researchers call this the antioxidant paradox.

Because studies of large doses of supplemental antioxidants haven’t clearly supported their use, respected organizations responsible for the public’s health do not recommend them for otherwise healthy people.

So why don’t we know about this? Why haven’t Food and Drug Administration officials made sure we are aware of the dangers? The answer is, they can’t.”

The article goes into how the supplement makers have tied the hands of the FDA.  Seems this sort of thing happens in many different arenas from food and drugs to environmental regulations.  It seems over and over again we’re shown that we should get our nutrition from real food, not pills and powders.

The New York Times: Is Barefoot-Style Running Best? New Studies Cast Doubt.

(Somehow all these article came from the great city of New York. Wasn’t really intentional but… there it is anyway.)  I’m a big fan of minimalist or barefoot-style running.  I believe in my case it has helped me regain proper mobility and strength, and has helped me overcome pain and regain my running ability.  That said, simply donning a pair of Vibram 5-Fingers and hitting the road WAS NOT a cure-all for me. A lot more work went into my efforts to fix my running.  The New York Times discusses things in this direction in this recent post in the Well Blog section.

The article discusses research from the Journal of Applied Physiology that looked at forefoot vs. heel striking in runners.  (Advocates of barefoot-style running suggest that barefoot running promotes forefoot striking which is suggested by some to reduce injuries.)  The pertinent findings are these:

In the end, this data showed that heel-striking was the more physiologically economical running form, by a considerable margin. Heel strikers used less oxygen to run at the same pace as forefoot strikers, and many of the forefoot strikers used less oxygen — meaning they were more economical — when they switched form to land first with their heels.

Most of the runners also burned fewer carbohydrates as a percentage of their energy expenditure when they struck first with their heels. Their bodies turned to fats and other fuel sources, “sparing” the more limited stores of carbohydrates, says Allison Gruber, a postdoctoral fellow at the University of Massachusetts Amherst, who led the study. Because depleting carbohydrates results in “hitting the wall,” or abruptly sagging with fatigue, “these results tell us that people will hit the wall faster if they are running with a forefoot pattern versus a rear-foot pattern,” Dr. Gruber says.

That covers running efficiency of two different foot-strike styles.  The article says this about injuries:

The news on injury prevention and barefoot-style running is likewise sobering. Although many barefoot-style runners believe that wearing lightweight shoes or none at all toughens foot muscles, lessening the likelihood of foot-related running injuries, researchers at Brigham Young University did not find evidence of that desirable change. If foot muscles become tauter and firmer, the scientists say, people’s arches should consequently grow higher. But in a study also presented at the sports medicine meeting, they found no changes in arch height among a group of runners who donned minimalist shoes for 10 weeks.

Other researchers who presented at the meeting had simply asked a group of 566 runners if they had tried barefoot-style shoes and, if so, whether they liked them. Almost a third of the runners said they had experimented with the minimalist shoes, but 32 percent of those said that they had suffered injuries that they attributed to the new footwear, and many had switched back to their previous shoes.

This isn’t terribly surprising considering that from a biomechanics standpoint, running is a complicated task. There are numerous joints and muscles involved in the kinetic chain. If any part of that chain isn’t functioning properly then we may get a problem. If we’re conditioned to running in one type of shoe then abruptly change to another shoe, then conditions are very different under our feet and thus the way we run will be altered.

Minmal shoes have been a component of my overcoming various chronic aches and pains–which I should say were acquired while running in conventional “good” running shoes. I initially simply running in my old, bad style in my new minimal shoes.  It didn’t work!  I had to regain competency in my feet, hips, and torso to fix my running issues.  Minimal shoes allowed me to become more aware of my feet and more aware of how I land on the ground. So again, I think minmal shoes can be a very good idea so long as they’re not looked to as a be-all-end-all cure to running injuries.

The Fasting Experiment: Part II

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Got food? Nope.

Back in May I discussed Michael Mosley and his PBS special called Eat, Fast, and Live Longer.  It motivated me to try out fasting. This is an update.

Fasting can take on various different forms. We often think of fasts in terms of total abstinence of food and drink but that’s not the only way to fast.  Fasts may be undertaken for several days at a time, for 24

hrs, or during part of a day.  Reasons to fast include medical instruction, weight loss and other health benefits, or religious devotion.  I’ve employed two types of fasting for weight loss and the various other health benefits discussed in the previous post and below.

Types of fasts

– Intermittent Fasting: Intermittent fasting has days of fasting alternated with days of non-fasting. I’m not doing a full-on fast but rather I’m extending my nighttime fast and reducing my calories on these days.  This pattern has been popularized by Michael Mosley’s FastDiet aka the  5:2 Diet.  (As I’ve said, I find Mosley’s work compelling, but to be fair, the Wiki entry on the 5:2 diet mentions a lack of evidence for its efficacy.  Make your own decision.)  I typically take two rest days throughout the week on Wednesday and either Monday or Friday.  These have been my fasting days.

The strict version of intermittent fasting has men consuming about 600 calories on the fast days, women about 500 calories.  That ain’t much!  I’m training for some athletic events so this isn’t necessarily the ideal time to fast as I need all sorts of nutrients, fuel, and protein in order to engage in and recover from workouts.  My modification simply has me waiting to eat (more on that right below) and generally trying to consume fewer calories.  I actually sort of look forward to trying this very low-calorie fast though.  When I’m ready…

– Restricted Feeding Window: This process is the other component of my fasting project. Essentially, this has you restricting the time during which you eat.  Typical suggestions are to eat only during an 8-hr. time period of the day and to fast the other 16 hrs.  Eating programs such as the Perfect Health Diet and the Warrior Diet advocate the restricted eating window.

Research in mice has indicated favorable benefits of the restricted-feeding window.  The Salk Institute for Biological Studies released a study last year in which a researcher said:

“It’s a dogma that a high-fat diet leads to obesity and that we should eat frequently when we are awake,” says Satchidananda Panda, an associate professor in the Regulatory Biology Laboratory and senior author of the paper. “Our findings, however, suggest that regular eating times and fasting for a significant number of hours a day might be beneficial to our health.”

Further, an article by Brownen in Ageing Research Reviews discusses evidence that both caloric restriction and intermittent fasting may have potential to combat age related illnesses such as Parkinson’s and Alzheimer’s.  This type of information supports my efforts.

My early experience

I’ve combined intermittent fasting with the restricted feeding window for about a month now.  I reduce my calories two days per week and I take in very few calories (about 230) in the morning. This comes from the coconut oil and grass-fed butter in my version of Bulletproof coffee.   The idea is to prolong the overnight fast. Then sometime around noon or later I start eating. I typically do this on Wednesday and Friday which are my rest days.  I’ve fasted on Mondays as well.

Besides the likely health benefits of fasting, I’d also like to lose some weight and get down to 195 lbs.  I’m training for both the Triple Bypass bike ride and the Continental Divide Trail Run and both of those efforts would be a little easier if I were a little lighter. Therefore I’m tracking my caloric intake and expenditure with My Fitness Pal (Myfitnesspal.com).  It’s a fantastic tool for anyone wanting to lose weight.  (If you want to lose weight then you must track your food intake.  If you’re not willing to track your food then you’re not serious about losing weight–and that’s OK.  It’s just not going to happen unless you decide to do it.)  I started using it in conjunction with fasting.  It seems to be a very good combination.  I’ve consistently weighed anywhere from 202 lbs. to about 207.  Now, I’m consistently weighing anywhere from 195 lbs. to 198 lbs.  My body composition has improved as well from about 18% to about 15%.  These changes came about very quickly

My Fitness Pal has you filling out a profile that includes such data as age, sex and activity level.  You then enter in how much weight you’d like to lose and how quickly you’d like to lose it–1 lb. per week for example.  I started off using My Fitness Pal by only tracking my calories and not tracking my exercise expenditure.  At times it was really tough to keep my calories within the prescribed range.  Once I started entering my exercise data My Fitness Pal adjusted my caloric intake and allowed me to consume quite a bit more which was very helpful.  It looks like my rapid weight loss was probably due to my adhering to the recommended caloric intake of a sedentary person.  This while I was exercising quite vigorously and staying below the recommended calories on my fasting days.  Quick weight loss indeed.

More information

If you’re interested in learning more about fasting, I’ve listed some resources below.  I’m new to this and there’s a lot more you can learn.

Depriving yourself: The real benefits of fasting – This comes from the Chicago Tribune. The evidence of the benefits of fasting are discussed:

“When it comes to treating cancer, Valter (cq) Longo, director of the Longevity Institute at the University of Southern California, thinks that short-term complete fasts maximize the benefits. He’s found that a 48-hour total fast slowed the growth of five of eight types of cancer in mice, the effect tending to be more pronounced the more fasts the animals undertook (Science Translational Medicine).

Fasting is harder on cancer cells than on normal cells, he says. That’s because the mutations that cause cancer lead to rapid growth under the physiological conditions in which they arose, but they can be at a disadvantage when conditions changes. This could also explain why fasting combined with conventional cancer treatment provides a double whammy.

Clinical trials assessing the impact of fasting in people with cancer are ongoing. Early results are promising, says Longo, and patients in the advanced stages of cancer, who cannot wait for the results, might find it worth discussing fasting with their oncologist.

Could fasting prevent cancers developing in the first place? Evidence is scant but there are ‘very good reasons’ why it should, says Longo. He points out that high levels of IGF-1 and glucose in the blood, and being overweight are all risk factors for cancer, and they can all be improved by fasting. Another risk factor is insulin, says Michelle Harvie at the University of Manchester, UK.

Studying women whose family history puts them at high risk of developing breast cancer, she put half of them on a diet that involved cutting calories by about 25 percent, and half on a 5:2 fast. After six months, both groups showed a reduction in blood insulin levels, but this was greater in the fasting group. Harvie’s team is now analyzing breast biopsies to see whether this translates to fewer of the genetic changes associated with increased cancer risk.

High insulin is also associated with type 2 diabetes, so perhaps it is no surprise that fasting shows promise here, too.”

Ready, Set, Fast: How Strategic Meal-Skipping Can Help You Lose Fat, Gain Muscle and Get HealthierDr. John Berardi of Precision Nutrition wrote this for The Art of Manliness.  It’s his account of his own fasting experiment.  He gives a good rundown of fasting basics, different types of fasts, links to fasting research, and his take on how to get started.

The UK’s Hot New 5:2 Diet Craze Hits The U.S. – Weight Loss Miracle? – We haven’t discussed the drawbacks of fasting.  This article from Forbes discusses several aspects of fasting including intermittent fasting which the 5:2 Diet is based on.  Some of the downsides of fasting are mentioned here too.

“The main drawback of intermittent fasting that has drawn many vocal critics is that it’s really, really hard to do. There’s no question, you’re going to be pretty hungry – and pretty grumpy – on your fasting days. And when dieting is miserable, people tend not to stick to it. And when they don’t stick to it, they get discouraged, often eating even more once they give up. Other than that, experts cite side effects including dehydration, irritability, anxiety, sleep problems, and bad breath.

Like many fad diets, intermittent fasting is likely to work really well for some people, discourage many more. But you won’t know which group you fall into until you try. So get ready to start coordinating your fast days with family and friends; the 5:2 FastDiet is going to be around for awhile.”

The writer makes a good point.  Fasting isn’t all that easy or fun.  But neither is cancer, diabetes or being overweight.  What’s your health worth to you?