Intuitive Eating

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Diet is the word “die” with a “t” on the end.

I’ve spoken highly of Jason Fitzgerald’s Strength Running podcast. I’ve been listening to past episodes and I just finished Episode 58: Superfoods, Veganism & Fasting: A Registered Dietitian’s Perspective. He interviews Heather Caplan, RD and she gave informative views on diets, veganism, meat, and fasting among other subjects. She also discussed her experience with the eating disorder known as orthorexia or the unhealthy preoccupation with eating healthy food.

I found Caplan’s discussion of dieting vs something called Intuitive Eating most interesting. Intuitive Eating isn’t a diet but rather a thought process and a way of relating to food in a healthy, non-restrictive way. Fitzgerald related diets and Intuitive Eating to a proverb you may have heard: “Give a man a fish, and you feed him for a day. Teach a man to fish, and you feed him for a lifetime.”

Caplan suggested that dieting means giving control to someone or something else (the diet) whereas Intuitive Eating bestows agency on the individual. Intuitive Eating means respecting one’s own feelings around food like hunger, satiety, and enjoyment. Intuitive Eating gives permission and doesn’t restrict. To me, Intuitive Eating is a healthy way out of the self-loathing and negative relationship with food experienced by so many people. The 10 principles of Intuitive Eating are:

  1. Reject the diet mentality.
  2. Honor your hunger.
  3. Make peace with food.
  4. Challenge the food police.
  5. Respect your fullness.
  6. Discover the satisfaction factor.
  7. Honor your feelings without using food.
  8. Respect your body.
  9. Exercise – Feel the difference.
  10. Honor your health.

Listen to the full podcast for more information.

Nutrition Myths and Eating for the Environment

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Nutrition Myths

Nutrition nonsense is everywhere. Fads and half-truths prey on our hopes and desperations. Poor news reporting misrepresents both valid and invalid research findings. Somewhere among all the noise is legitimate information on how to eat well. For that reason, I appreciate The top nutrition myths of 2019 from Examine.com.

Examine.com is a source I trust for valid, evidence-based nutrition and supplement information. In brief, here’s the list of the 19 nutrition myths for 2019:

Myth 1: Protein is bad for your bones and kidneys
Myth 2: Carbs are bad for you
Myth 3: Fats are bad for you
Myth 4: Egg yolks are bad for you
Myth 5: Red meat is bad for you
Myth 6: Salt is bad for you
Myth 7: Bread is bad for everyone
Myth 8: HFCS is far worse than sugar
Myth 9: Fresh is more nutritious than frozen
Myth 10: Food nutrients are always superior to supplemental nutrients
Myth 11: Dietary supplements are necessary
Myth 12: You should eat “clean”
Myth 13: You should “detox” regularly
Myth 14: Eat more often to boost your metabolism
Myth 15: You need to eat breakfast
Myth 16: To lose fat, don’t eat before bed
Myth 17: To lose fat, do your cardio on an empty stomach
Myth 18: You need protein right after your workout
Myth 19: Creatine will increase your testosterone but cause hair loss and kidney damage

Dig into the article for more information.

Meat and the Environment

I am an environmentalist. The threat of manmade global warming is a brutal reality. I do what I can to limit my contribution to the nightmare. If you share these concerns then I hope you’ll read How to Eat Meat if You Care About the Environment from U.S. News & World Report. Briefly, the article lists the following:

  • Limit your meat consumption.
  • Know how different meats stack up.
  • Shop local, if possible.
  • Learn your labels.
  • Be a prudent cook.

My wife and I are especially concerned about greenhouse gas emissions. Our food choices come with come with a greenhouse gas cost. Meat production produces an especially large amount of CO2 and methane. Accordingly, we now limit our meat consumption, especially of beef and lamb which produce the most greenhouse gas. We haven’t gone vegan but we have made the deliberate choice to reduce our animal product consumption.

(Further, by most measures, Americans eat too much meat. It’s not a coincidence that most Americans are also overweight. An additional benefit to limiting meat consumption in favor of plants is that it’ll help most people drop a few pounds and get fitter.)

Animal welfare is also a concern of ours. The article also links to the Environmental Working Group (EWG.) EWG provides this guide to animal welfare standards and labeling of meat and dairy products. We haven’t abandoned meat completely, but we don’t want to contribute to the suffering of animals. This guide has helped informed our food shopping. You might find it useful too.

Problems with Nutrition Research

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Appearances to the mind are of four kinds.
Things either are what they appear to be;
Or they neither are, nor appear to be;
Or they are, and do not appear to be;
Or they are not, and yet appear to be.
Rightly to aim in all these cases
Is the wise man’s task.
Epictetus, 2nd century AD

If you pay attention to the news then you don’t go a day without hearing about nutrition research. Alcohol, chocolate, meat, fat, carbs, protein, fiber, sugar, this diet, that diet, and a galaxy of supplements are under constant scrutiny. You may also notice that studies seem to frequently contradict one another. (The health effects of alcohol are a notable example.) It’s easy to become confused and frustrated as you search for accurate information. (And that’s just with the valid research out there. Throw in the junk “research” behind bogus supplements and snake oil and you may simply want to give up being informed.)

I’m neither a researcher nor a statistician but I respect the need for solid research into health, fitness, nutrition, and the like. I understand that valid research requires a large number of study subjects. The best studies are designed as double-blind placebos. Finally, research results must be replicated several times over in order to be seen as valid and worth taking seriously. Beyond that, I don’t have a good grasp of statistical methods so I can’t always tell if the conclusions drawn from the research are accurate. Thus I’m often confused by what I see and hear around nutrition research.

If you consider yourself a well-informed, educated, healthy person who finds yourself confused by conflicting nutritional studies then an article in the New York Times, More Evidence That Nutrition Studies Don’t Add Up, may help you understand your frustration. The story discusses the shoddy research practices of Cornell University researcher Dr. Brian Wansink.

The article goes beyond Dr. Wansink’s malpractice to discuss general, widespread nutrition research problems:

“Dr. Wansink’s lab was known for data dredging, or p-hacking, the process of running exhaustive analyses on data sets to tease out subtle signals that might otherwise be unremarkable. Critics say it is tantamount to casting a wide net and then creating a hypothesis to support whatever cherry-picked findings seem interesting — the opposite of the scientific method. For example, emails obtained by BuzzFeed News showed that Dr. Wansink prodded researchers in his lab to mine their data sets for results that would “’go virally big time.’”

“’P-hacking is a really serious problem,’” said Dr. Ivan Oransky, a co-founder of Retraction Watch, who teaches medical journalism at New York University. “’Not to be overly dramatic, but in some ways it throws into question the very statistical basis of what we’re reading as science journalists and as the public.’”

“Data dredging is fairly common in health research, and especially in studies involving food. It is one reason contradictory nutrition headlines seem to be the norm: One week coffee, cheese and red wine are found to be protective against heart disease and cancer, and the next week a new crop of studies pronounce that they cause it. Marion Nestle, a professor of nutrition, food studies and public health at New York University, said that many researchers are under enormous pressure to churn out papers. One recent analysis found that thousands of scientists publish a paper every five days.”

Further:

“In 2012, Dr. John Ioannidis, the chairman of disease prevention at Stanford, published a study titled “’Is Everything We Eat Associated With Cancer?’” He and a co-author randomly selected 50 recipes from a cookbook and discovered that 80 percent of the ingredients — mushrooms, peppers, olives, lobster, mustard, lemons — had been linked to either an increased or a decreased risk of cancer in numerous studies. In many cases a single ingredient was found to be the subject of questionable cancer claims in more than 10 studies, a vast majority of which “’were based on weak statistical evidence,’” the paper concluded.

Nutrition epidemiology is notorious for this. Scientists routinely scour data sets on large populations looking for links between specific foods or diets and health outcomes like chronic disease and life span. These studies can generate important findings and hypotheses. But they also have serious limitations. They cannot prove cause and effect, for example, and collecting dietary data from people is like trying to catch a moving target: Many people cannot recall precisely what they ate last month, last week or even in the past 48 hours. Plenty of other factors that influence health can also blur the impact of diet, such as exercise, socioeconomic status, sleep, genetics and environment. All of this makes the most popular food and health studies problematic and frequently contradictory.

In one recent example, an observational study of thousands of people published in The Lancet last year made headlines with its findings that high-carb diets were linked to increased mortality rates and that eating saturated fat and meat was protective. Then in August, a separate team of researchers published an observational study of thousands of people in a related journal, The Lancet Public Health, with contrasting findings: Low-carb diets that were high in meat increased mortality rates.

“’You can analyze observational studies in very different ways and, depending on what your belief is — and there are very strong nutrition beliefs out there — you can get some very dramatic patterns,’ Dr. Ioannidis said.”

Read the article to learn more.

If this topic interests you then you should also read Congratulations. Your Study Went Nowhere, also from the New York Times. Among other things, it discusses an interesting problem with research publication. That is research with positive findings gets published far more than research with negative findings.

For instance, let’s say my study finds evidence that eating peanut butter increases IQ. Meanwhile, six other studies find no relationship between peanut butter and IQ: “Nothing to see here folks!” My positive study is more likely to be published than the negative studies. This is a type of publication bias. Positive studies are thus more likely to be mentioned in the news even if they’re outnumbered by negative studies. The article describes two types of biases:

Publication bias refers to the decision on whether to publish results based on the outcomes found. With the 105 studies on antidepressants, half were considered “positive” by the F.D.A., and half were considered “negative.” Ninety-eight percent of the positive trials were published; only 48 percent of the negative ones were.

Outcome reporting bias refers to writing up only the results in a trial that appear positive while failing to report those that appear negative. In 10 of the 25 negative studies, studies that were considered negative by the F.D.A. were reported as positive by the researchers, by switching a secondary outcome with a primary one, and reporting it as if it were the original intent of the researchers, or just by not reporting negative results.

We never hear a TV news reporter say, “Nine studies found absolutely no relationship between food X and cancer.” In other words, we only hear the bell that’s rung, not all the other bells that aren’t rung. The obvious problem is that if shoddy research findings are reported (vaccines linked to autism is a prominent example) and we may hear reports from multiple credible sources, then we start to believe false information. There are serious consequences to this problem.

 

 

Fructose and Liver Damage

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Diabetes and obesity-related illnesses are rife in the modern world. What we eat and how much we eat seem to be culprits. Recent research suggests that specifically, too much fructose is a significant problem for the human digestive system. An article from The Economist titled How too much fructose may cause liver damage discusses research in the journal Cell Metabolism.  

The article states:

“Specifically, Dr Rabinowitz’s work suggests that fructose, when consumed in large enough quantities, overwhelms the mechanism in the small intestine that has evolved to handle it. This enables it to get into the bloodstream along with other digested molecules and travel to the liver, where some of it is converted into fat. And that is a process which has the potential to cause long-term damage.” 

It seems that small amounts of fructose are digested safely. Too much fructose consumption is a problem. If you look around you, you’ll see A LOT of food sweetened with high-fructose corn syrup. Think that might be a problem?

You may also know that fructose is the primary sugar in fruit. So is fruit dangerous? The article doesn’t discuss fruit but I have a couple of thoughts on any potential harm posed by fructose from fruit:

First, my bet is the amount of fructose one would get while eating fruit is far less than one would get while drinking soda or eating processed food sweetened with fructose. Who among us would sit and gorge on fruit? Ever eaten more than one apple or orange? Doesn’t happen very often. (I’d like to meet the person who managed to become unhealthy by eating too much fruit.)

Second, the fiber in the fruit slows the digestion and thus probably slows the release of fructose. That results in less fructose to deal with per unit of time. That dynamic should help make fructose digestion tolerable. In contrast, most fructose-sweetened foods have little to no fiber, (soda and fruit juice are liquids) and thus creates a big turbo-shot of fructose which is something with which the human digestive system doesn’t have much experience. To that point…

Humans haven’t had access to refined sugar until recently in our long history on earth. Fruit is seasonal. It doesn’t sit around for long. In our past, we had to compete with all the other animals in the forest and the jungle to eat the stuff. Either that or it would fall off the tree and rot. Honey, as you know, is guarded by little stinging monsters which makes acquiring that source of sugar a bit costly.

The candy business started in the early 20th century. A hundred years may sound like a long time but in terms of evolution and the human digestive system, it’s an incredibly short amount of time. So our digestive system—a system refined over millennia of natural selection—has suddenly been deluged by sugar. We’re unequipped to deal with this recent development, so we see the problems described above.

Gluttony Season is Almost Here. What’s Your Plan?

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Halloween kicks off several months of partying, gobbling, and guzzling. Very soon, swirling all around you there will be a galaxy of the richest and tastiest food and drink. Not only do you have a list of occasions for feasting, but also the days grow cold and dark. That means you’re less likely to be active and more likely to huddle in your warm, cozy home.

Is it any surprise that you tend to gain unhealthy weight under these conditions?

In all truth, it’s not a done deal that your health and fitness must suffer. You’re a grown-up. You can make good decisions. With some forethought, planning and awareness, you can avoid the slide backwards into feeble flabbiness.

Here’s an idea: Start your New Year’s Resolution early. Put in some thought and effort before you’re beset on all sides by wicked temptations. If you start building just a few healthy habits now, you can do a lot to minimize the usual holiday temptations and pitfalls. With some thinking and a plan in place, you can feel confident and you can avoid the guilt that often comes with holiday over-indulgence. Here are a few examples:

  • Will you exercise 3-5 days per week? For 30 minutes? (Or if you’re not currently exercising, can you start with just one day per week?)
  • Will you eat 1-2 fist-size servings of vegetables at each meal?
  • Will you limit sweets and/or booze to one day a week?
  • Will you talk to a friend or loved one about eating better and exercising together?
  • Will you consider hiring a trainer now instead of in January or February?

If it’s important then why wait?

 

Diets Don’t Work. So What Should You Do?

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A NY Times story from May popped up on my Facebook feed and it got me thinking. (I’m not sure why a story from May would come up now but I’m glad it did.) Why You Can’t Lose Weight on a Diet is a worthwhile discussion of the biological and neurological mechanisms of weight-loss, weight-gain and what happens when we diet.

(Though it’s not defined in the article, the term “diet” seems to refer to a strict, restrictive type of eating plan which causes prolonged hunger and feelings of deprivation. “Diet” implies the use of white-knuckle willpower. “Diets” are almost never sustainable over the long-haul.)

I won’t go into all the information but here are some important details:

Diets and weight-gain seem closely related.

“Long-term studies show dieters are more likely than non-dieters to become obese over the next one to 15 years. That’s true in men and women, across ethnic groups, from childhood through middle age. The effect is strongest in those who started in the normal weight range, a group that includes almost half of the female dieters in the United States.

“Why would dieting lead to weight gain? First, dieting is stressful. Calorie restriction produces stress hormones, which act on fat cells to increase the amount of abdominal fat. Such fat is associated with medical problems like diabetes and heart disease, regardless of overall weight.

“Second, weight anxiety and dieting predict later binge eating, as well as weight gain. Girls who labeled themselves as dieters in early adolescence were three times more likely to become overweight over the next four years. Another study found that adolescent girls who dieted frequently were 12 times more likely than non-dieters to binge two years later.”

Weird huh? The question is do diets cause weight gain, or do weight-gain-prone people tend to diet? The chick-or-egg question is discussed in the article.

Diets change the brain. Not for the better.

“In the laboratory, rodents learn to binge when deprivation alternates with tasty food — a situation familiar to many dieters. Rats develop binge eating after several weeks consisting of five days of food restriction followed by two days of free access to Oreos. Four days later, a brief stressor leads them to eat almost twice as many Oreos as animals that received the stressor but did not have their diets restricted. A small taste of Oreos can induce deprived animals to binge on regular chow, if nothing else is available. Repeated food deprivation changes dopamine and other neurotransmitters in the brain that govern how animals respond to rewards, which increases their motivation to seek out and eat food. This may explain why the animals binge, especially as these brain changes can last long after the diet is over.

“In people, dieting also reduces the influence of the brain’s weight-regulation system by teaching us to rely on rules rather than hunger to control eating. People who eat this way become more vulnerable to external cues telling them what to eat. In the modern environment, many of those cues were invented by marketers to make us eat more, like advertising, supersizing and the all-you-can-eat buffet. Studies show that long-term dieters are more likely to eat for emotional reasons or simply because food is available. When dieters who have long ignored their hunger finally exhaust their willpower, they tend to overeat for all these reasons, leading to weight gain.”

I LOVE the part about diets teaching us to eat by rules rather than paying attention to hunger. More on that in a bit.

Diets don’t improve health:

“In addition, the evidence that dieting improves people’s health is surprisingly poor. Part of the problem is that no one knows how to get more than a small fraction of people to sustain weight loss for years. The few studies that overcame that hurdle are not encouraging. In a 2013 study of obese and overweight people with diabetes, on average the dieters maintained a 6 percent weight loss for over nine years, but the dieters had a similar number of heart attacks, strokes and deaths from heart disease during that time as the control group. Earlier this year, researchers found that intentional weight loss had no effect on mortality in overweight diabetics followed for 19 years.”

That’s surprising to me. Read more of the article to learn why this might be the case.

What should you do?

The research discussed in the article tells us that diets aren’t only ineffective, they’re actually harmful. Is it time to give up hope? I don’t think so. There are other, better strategies to weight-loss and health than the Spartan drudgery of the typical diet. Here are some suggestions:

Eat when you’re hungry. Stop when you’re no longer hungry.

My client Dorothy had a great insight. She made the distinction between being truly hungry vs. saying “I could eat.”

Question: “Are you hungry?”

Answer: “I could eat.”

If you’re eating ask yourself why. Is it hunger or something else? Are you eating out of boredom, sadness, happiness or some similar emotion? Are you eating because food is in front of you? We eat for all kinds of reasons that have nothing to do with actual hunger.

Further, as you’re eating, continue to pay attention to your hunger. Is it still there? If not, then it’s time to stop eating. We often keep eating until we’re stuffed. You may have been taught to clean your plate. Food often tastes great — so we keep eating!

I suggest that you wait to eat until you are truly, definitely hungry. I’m not saying you should walk around famished but rather know for certain that your stomach is definitely signaling you that it’s time to put something in there.

The idea of eating when hungry and stopping when no longer hungry seems like an obvious and easy concept but make no mistake, it’s a skill. (I say “no longer hungry” rather than “full” because to me, “full” is too much like stuffed.) It requires mindfulness, awareness and deliberate action. Many of us are probably out of practice on this front.

Eat protein

Eating protein at each meal is a very good idea for anyone looking to lose weight. Three reasons, as mentioned in this article from the American Journal of Clinical Nutrition

“1) increased satiety—protein generally increases satiety to a greater extent than carbohydrate or fat and may facilitate a reduction in energy consumption under ad libitum dietary conditions;

“2) increased thermogenesis—higher-protein diets are associated with increased thermogenesis, which also influences satiety and augments energy expenditure (in the longer term, increased thermogenesis contributes to the relatively low-energy efficiency of protein); and

“3) maintenance or accretion of fat-free mass—in some individuals, a moderately higher protein diet may provide a stimulatory effect on muscle protein anabolism, favoring the retention of lean muscle mass while improving metabolic profile.”

Precision Nutrition recommends men eat two palm-sized servings of protein at each meal while women should get one palm of protein.

Lift weights.

Lifting weights (or any kind of resistance training) helps build and preserve muscle mass. Why is that good? Glad you asked:

Further advocacy for weight training is found in a recent interview with Dr. Wayne Westcott, professor of exercise science at Quincy College. The interview stemmed in part from research and news that contestants from the Biggest Loser seem to gain back all their weight and then some in the years following their weight loss. The article discusses several issues, but as it pertains this blog post, this is pertinent:

“But the key isn’t fat, it’s muscle: His [ Dr. Westcott’s] central point is that loss of muscle mass — whether through inactivity or aging or dieting — helps lead to many of our ills, from regaining weight to developing diabetes.

“But it doesn’t have to be that way, if only we’ll do a modicum of strength training — defined as any exercise that uses resistance to build muscle, from weightlifting to push-ups —  and keep doing it.”

Sleep.

I’ve written about the link between lack of sleep and obesity. Dr. Westcott also emphasizes the role of sleep in staying trim. He says, “Sleep is probably more important than all the other put together.”

The journal Current Opinion in Clinical Nutrition & Metabolic Care conducted a review of research on the sleep/obesity link. The key points:

  • The worldwide increase in the prevalence of obesity in the last several decades has been paralleled by a trend of reduced sleep duration in adults, as well as in children.
  • Evidence from both longitudinal and prospective epidemiological studies suggests that chronic partial sleep loss is associated with an increase in the risk of obesity.
  • Laboratory studies show that sleep restriction leads to hormonal alterations, which may favor an increase in calories intake and a decreased energy expenditure and ultimately lead to weight gain.
  • In addition to short sleep duration, evidence suggests that also sleep disturbance, such as obstructive sleep apnea and poor sleep quality, may increase obesity risk.
  • Prospective interventional studies are needed to clarify whether increasing sleep duration or improving sleep quality protects from weight gain or even favors weight loss.
  • Until results from such studies are available, the current evidence supports recommending sufficient amounts of habitual sleep and good sleep hygiene in patients at risk of obesity.

Want to lose weight? Sleep well.

Finally

Diets aren’t just a depressing drag, they may in fact facilitate the exact type of weight-gain you’re trying to avoid. In other words, they don’t work!  Rather than diet, tune into your hunger. Eat when you’re hungry and stop when you’re no longer hungry. Eat protein at each meal, lift weights and get solid, regular sleep.

 

 

 

 

What to Read: Advocating for the 5k, New Fitness Trends, Chemicals in your Food (Aren’t Always Bad)

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Big benefits from the 5k

“Everyone thinks the marathon is the Holy Grail, when a lot of people should really be doing the 5K,” Jason Karp, exercise physiologist.

In the running world, many of us want to progress from the 5k to the 10k, half-marathon all the way to the marathon—and maybe beyond!  More is always better, right? We think 5ks are for beginners and marathons are for the truly fit and powerful among us. And ultra-marathons? Those are for the real champions.

Well, I suggest that more isn’t always better. Sometimes more is just more. Maybe we should reconsider our view of the 5k. (Remember, the 5000m is an Olympic event. It’s not always easy.)

The 5K, Not The Marathon, Is The Ideal Race argues that for most people and most fitness goals, the 5k is the optimal distance.

The latest fitness trends

“Below are the newest and niftiest fitness programs that have been gaining in popularity, and the odds that they will attract the most disciples in 2016.”

In terms of fitness, exercise and strength training, I believe there is very little new under the sun. Lift heavy things. Sweat often. Eat right most of the time. Rest, recover, repeat. Those are the big-picture concepts that have built healthy humans since forever.

That said, if someone wants to make money in the fitness business, presenting this picture in new packaging is a wise idea. Further, if some sort of new fitness trend grabs someone’s attention then all the better. I believe that anything that gets someone to exercise and stick with it is probably a good thing.

Who’s afraid of chemicals?

“If you can’t pronounce an ingredient, then you shouldn’t eat it, right? Unfortunately, it appears that idea may not be the best advice nor very accurate.”

Those of us who value good nutrition tend to avoid processed foods in favor of those in a more “natural” state. The idea sounds reasonable. Many processed foods are unhealthy garbage. Cookies, crackers, breakfast cereal, many frozen meals and all sorts of packaged foods come with lots of calories but very little nutrition. If you look at food labels you often see a laundry list of strange-sounding substances that bear no resemblance to any sort of food we’ve ever heard of. These types of foods often go hand-in-hand with obesity and poor health. In contrast, we know that fruits, vegetables, minimally processed dairy, meat, beans and whole grains are generally healthier for us.

Internet gurus and quacks such as Vani “Food Babe” Hari, Dr. Oz, and Joseph Mercola have engaged in fear-mongering and misinformation which has led to confusion among consumers. (They’ve made a lot of money doing it too.) These people have told us that we must avoid all chemicals at all cost lest we be struck dead at any moment! The horror!

Here’s news for you: Everything is a chemical, including water, aka dihydrogen monoxide. Further, the central tenet of toxicology is “the dose makes the poison.” This means that a wide array of substances from alcohol to sugar to formaldehyde to chlorine to even water can become deadly at a certain dosage. Meanwhile lower dosages may pose no threat at all.

With these concepts in mind, I like the article from Science Driven Nutrition titled The truth about food ingredients. It’s brief and gives a rational breakdown of why many (but perhaps not all) chemicals in our foods are safe.

 

 

 

Physical Activity, Appetite & Weight-Loss

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There is a lot of important research out there on subjects like exercise physiology and nutrition. I’m not a researcher and I have a difficult time deciphering information that I know is useful to me and my clients. So I appreciate Alex Hutchinson’s Sweat Science blog in Runner’s World. He does a great job of discussing complex research findings in language that I can understand.

A recent Sweat Science post titled the Jute Diet details some tremendously important research regarding the intimate relationship between physical activity and appetite. The research is from the 1950s so I was completely surprised that I didn’t already know this information. From the blog post:

image is from the American Journal of Clinical Nutrition

image is from the American Journal of Clinical Nutrition

“What you see is that, above a certain level of physical activity, caloric intake increases linearly and weight is stable. For these workers, the body’s “balance” mechanism is functioning, and those who burn more calories also consume proportionately more calories.

“But below a certain level of physical activity, the appetite balance breaks down. Caloric intake rises again, and these workers are the ones who gain weight. The researchers call this “’he sedentary zone,’ and suggest that the regulation of food intake breaks down in this zone because ‘in his hundreds of years of evolution, man did not have any opportunity for sedentary life except very recently.'”

Hutchinson references other research that supports this idea that physical activity strongly influences body weight. More supporting research can be seen here, here and here. (Beyond that, some of the research shows a dose-response relationship in which more and more vigorous activity yields more weight loss and better weight-loss maintenance.)

I’ve never thought about the effect that exercise has on appetite beyond that it probably increases it. That exercise may make appetite more accurate is very interesting to me.

I have found that I tend to lose weight when I’m training a lot. When I try and track my calories while training I often find that I go over my suggested caloric intake and I still lose weight. I simply eat the amount that feels right and I’m able to maintain or improve my body composition. It’s much tougher to do though when I’m not training hard. That’s been a curious thing to me. This research seems to speak to my observations.

Health & Fitness News: Pain Science, Breakfast – To Skip or Not to Skip?, Carbs vs fat (Whither protein?), 8 Glasses of Water Mythology

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Several articles have grabbed my attention. One is a concise summary of the current understanding of pain. Another discusses breakfast and the flimsy evidence supporting its importance. Next, science looks at the efficacy of reducing carbs vs fats for weight loss. Finally, drinking eight glasses of water a day is based on nothing.

Pain and lifting

The issue of pain is a continual theme in this blog. I’ve dealt with periodic bouts of lingering pain. The upside to this is that I’ve learned a lot about pain. Whether we’re an athlete or not, most of us will encounter non-acute or chronic pain.

It can be scary and depressing to us especially if it limits our ability to train. Interestingly, learning about how pain works can actually help us feel better (low-back pain in this case). Pain is NOT simply an indication of tissue damage. It’s very much a product of the brain. How we perceive our bodies (damaged or strong), our pain (threatening and scary or just a nuisance) and our expectations (“I’m broken and ruined,” or “I’ll be fine.”) are major influences on the pain process.

In that direction, Elitefts.com has a worthwhile article called 3 Things Lifters and Coaches Need to Know About Pain. It’s concise and fairly easy to understand for non-scientists. I think this information is useful for coaches and trainers who will certainly come across an athlete or client in pain. It may also prove helpful to you if you’re in pain. Here is a summary:

1. You are not your MRI or your X-Ray. Many people have tissue damage or degeneration on imaging but walk around without pain everyday. If you’re dealing with pain or an injury, get a thorough medical history and functional examination done by a qualified health professional, preferably one that works with athletes and lifters (they are out there).

2. Understand that pain (particularly chronic pain) isn’t purely related to biomechanics or injury. Biological and psychosocial factors both contribute to a person’s pain experience.

3. When working with clients, don’t create fear or a nocebo effect by berating your clients on their lifting technique, posture, or movement capabilities. Instead, work through your client’s issues with positive coaching and cueing to build a great training effect.

Read the article to get more detail.

Breakfast and weight loss

“Breakfast is the most important meal of the day.”

You’ve heard it. You believe. I’ve preached it to clients. It seems the earth rotates around this statement. But, is this bit of gospel based on anything of substance? Not really.

In The science of skipping breakfast: How government nutritionists may have gotten it wrong the Washington Post discusses research that shows the following:

“In overweight individuals, skipping breakfast daily for 4 weeks leads to a reduction in body weight,” the researchers from Columbia University concluded in a paper published last year.”

Another golden idol knocked from its pedestal! How can this be? Why would the USDA Dietary Guidelines for Americans tell us something that isn’t supported by good evidence?

The Post article does a good job of discussing the answer.

One of the key pieces of evidence, for example, examined the records for 20,000 male health professionals. Researchers followed the group for 10 years and published results in 2007 in the journal Obesity. They showed that after adjusting for age and other factors, the men who ate breakfast were 13 percent less likely to have had a significant weight gain.

“Our study suggests that the consumption of breakfast may modestly lower the risk of weight gain in middle-aged and older men,” the researchers said.

The advisory committee cited this and similar research, known as “observational studies,” in support of the notion that skipping breakfast might cause weight gain. In “observational studies,” subjects are merely observed, not assigned randomly to “treatment” and “control” groups as in a traditional experiment.

Observational studies in nutrition are generally cheaper and easier to conduct. But they can suffer from weaknesses that can lead scientists astray.

One of the primary troubles in observational studies is what scientists refer to as “confounders” — basically, unaccounted factors that can lead researchers to make mistaken assumptions about causes. For example, suppose breakfast skippers have a personality trait that makes them more likely to gain weight than breakfast eaters. If that’s the case, it may look as if skipping breakfast causes weight gain even though the cause is the personality trait.

It’s a reminder of the very important rule: Correlation doesn’t equal causation. Just because one detail appears alongside another detail, it doesn’t mean the one detail causes the other. (Tall people play basketball. Therefore one might conclude that playing basketball makes people tall. Is that right?)

Similarly we’ve seen a recent revision on dietary fat and cholesterol guidelines. We once thought that fat (particularly saturated fat) and cholesterol were the most evil of edible substances. Based upon flawed science, we were told to replace fat with carbohydrates and we’d all be well. Upon further review, it seems we may have been very wrong.

Low-carb vs. low-fat

Sticking with the diet and science theme, there’s been a lot of discussion on a recent study in Cell Metabolism that looks at low-carb vs. low-fat diets. This was a six-day study in a carefully controlled lab environment. The study had the same group of 19 obese participants spend six days on either a restricted-carb or restricted-fat diet. They then went home for several weeks for a “wash-out” period where they resumed their normal eating habits. The participants then returned and they were switched to the other diet. The same number of calories were cut from both diets, the difference being the calories came specifically from either carbs or fat. The participants were observed in a metabolic chamber and their caloric expenditure was very closely monitored. It was a well-designed study.

The result? The low-fat group lost more fat. Discussion over right? If you saw most of the popular-press headlines you’d think so. But there’s more to the story.

First question in my mind is “What about protein?” Though the jury is still out on some aspects of high-protein diets, several studies (here, here, here and here among others) suggest that high-protein diets can be useful for weight loss. The study doesn’t mention protein at all. Seems odd to me in that carbs, fat and protein are the main macronutrients in food. Why would we want to manipulate and study the effects of just two?

A good discussion of the low-carbs vs. low-fat study can be found at Examine.com. Really-low-fat vs somewhat-lower-carb – a nuanced analysis goes into some of the limitations of the study. This article is quite detailed. Read it all if you’re up for it. I won’t go into all of it but here’s a little bit.

One point to remember that this low-carb diet could be called a “lower-“carb diet in that some low-carb diets go much lower than this one. The Examine.com article says:

“The carb levels ended up being 352 grams for Restricted Fat versus 140 for Restricted Carb, and the fat levels 17 versus 108. In other words, (moderately lower carb than typical diets) versus (oh my goodness I can count my fat gram intake on my fingers and toes!).

This trial wasn’t designed to explore a real-life 100-gram-and-under low carb diet and especially not a ketogenic diet. Rather, it was a mechanistic study designed so that they could reduce energy substantially and equally from fat or carbs, but without changing more than one macronutrient. If they lowered carbs much more in the Restricted Carb group (like under 100 grams), they’d then have to go into negative fat intake for the Restricted Fat group. And negative fat intake is impossible (*except for in quantum parallel universes). One more note: all participants kept dietary protein constant and exercised on a treadmill for an hour a day.”

So it’s possible that if carbs were lowered further, we might see a different outcome of the study. Also, this was a six-day study. We must wonder what might happen over the course of six weeks, six months or six years.

Another very important point to remember is that this was a very tightly controlled experiment. It didn’t reflect the real world in which people trying to lose weight have to make their own food choices. Examine.com says:

And to repeat a very important point: this study was not meant to inform long-run dietary choices. In the long-run, the choice between restricting fat or restricting carbs to achieve a caloric deficit may come down to one thing: diet adherence.

While preference for certain foods may dictate which diet is easier to adhere to, this isn’t always the case. For instance, it seems that insulin-resistant individuals have an easier time adhering to a low-carbohydrate diet. Nowadays, new dieters often pair low-carb with higher protein, the latter of which can boost weight loss. And since there are plenty of high-sugar but low-fat junk foods (see Mike and Ike, et al.) but not so many high-fat but low-carb junk foods, low carb intakes can sometimes mean an easier time staying away from junk food when compared to low fat diets.

So we should remember that the dietary rubber meets the road when someone seeking weight loss can modify their diet in any healthy way and then stick to it for the long haul. If it’s less fat then great. If it’s fewer carbs, also great. If it’s some other improvement to the diet then wonderful!

Eight glasses of water a day is arbitrary

Another sacred cow of health and longevity is the admonition to drink at least eight glasses of water a day. That bunk has been debunked but much like a bell that’s been rung, it’s hard to change people’s minds once they’ve heard this information. The New York Times gets into this topic in No,You Do Not Have to Drink 8 Glasses of Water a Day. This one is simple. If you’re thirsty then drink. If you’re not then don’t. (How else would we have made it to the year 2015 if we didn’t have some sort of very good water gauge built into our physiology? Do my cat or dog think about the measured quantity of the water they drink?)

Health & Fitness Information: Fitness for Entrepreneurs, Dean Ornish is Wrong, Pesticides in Produce, Performance Enhancement Methods

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Here are several articles with some interesting information that you may find helpful.

Dean Ornish is wrong

Scientific American offers a critique of the ideas of Dr. Dean Ornish in Why Almost Everything Dean Ornish Says about Nutrition Is Wrong.

Dean Ornish, MD is a very bright guy. He is the founder and president of the nonprofit Preventive Medicine Research Institute in Sausalito, Calif. He is a professor of medicine at the University of California, San Francisco. He received his medical training in internal medicine from the Baylor College of Medicine, Harvard Medical School, and the Massachusetts General Hospital. He received a BA in humanities summa cum laude from the University of Texas in Austin.

Ornish insists that a very low-fat, high-carb vegetarian diet is the best way to good health. The problem is, he cites low-quality studies and draws conclusions that aren’t quite supported by the available evidence. The article states:

“Ornish goes to argue that protein and saturated fat increase the risk of mortality and chronic disease. As evidence for these causal claims, he cites a handful of observational studies. He should know better. These types of studies—which might report that people who eat a lot of animal protein tend to develop higher rates of disease—“only look at association, not causation,” explains Christopher Gardner, a nutrition scientist at the Stanford Prevention Research Center. They should not be used to make claims about cause and effect; doing so is considered by nutrition scientists to be “inappropriate” and “misleading.” The reason: People who eat a lot of animal protein often make other lifestyle choices that increase their disease risk, and although researchers try to make statistical adjustments to control for these ‘confounding variables,’ as they’re called, it’s a very imperfect science. Other large observational studies have found that diets high in fat and protein are not associated with disease and may even protect against it. The point is, it’s possible to cherry-pick observational studies to support almost any nutritional argument.”

And:

“The recent multicenter PREDIMED trial also supports the notion that fat can be good rather than bad. It found that individuals assigned to eat high-fat (41 percent calories from fat), Mediterranean-style diets for nearly five years were about 30 percent less likely to experience serious heart-related problems compared with individuals who were told to avoid fat. (All groups consumed about the same amount of protein.) Protein, too, doesn’t look so evil when one considers the 2010 trial published in The New England Journal of Medicine that found individuals who had recently lost weight were more likely to keep it off if they ate more protein, along with the 2005 OmniHeart trial that reported individuals who substituted either protein or monounsaturated fat for some of their carbohydrates reduced their cardiovascular risk factors compared with individuals who did not.”

Also, regarding Dean Ornish’s research:

“So there’s little evidence to suggest that we need to avoid protein and fat. But what about the claims Ornish makes about the success of his own diet—do they hold up to scrutiny? Not exactly. His famous 1990 Lifestyle Heart trial involved a total of 48 patients with heart disease. Twenty-eight were assigned to his low-fat, plant-based diet and 20 were given usual cardiac care. After one year those following his diet were more likely to see a regression in their atherosclerosis.

But here’s the thing: The patients who followed his diet also quit smoking, started exercising and attended stress management training. The people in the control group were told to do none of these things. It’s hardly surprising that quitting smoking, exercising, reducing stress and dieting—when done together—improves heart health. But the fact that the participants were making all of these lifestyle changes means that we cannot make any inferences about the effect of the diet alone.

So when Ornish wrote in his op–ed that ‘for reversing disease, a whole-foods, plant-based diet seems to be necessary,’ he is incorrect. It’s possible that quitting smoking, exercising and stress management, without the dieting, would have had the same effect—but we don’t know; it’s also possible that his diet alone would not reverse heart disease symptoms. Again, we don’t know because his studies have not been designed in a way that can tell us anything about the effect of his diet alone. There’s also another issue to consider: Although Ornish emphasizes that his diet is low in fat and animal protein, it also eliminates refined carbohydrates. If his diet works—and again, we don’t know for sure that it does—is that because it reduces protein or fat or refined carbohydrates?”

I’m not paying a lot of attention to what Ornish says.

Exercise is more important than business

Why Exercising Is a Higher Priority Than My Business is an article in the Personal Health section of Entrepreneur magazine. The writer Joshua Steimle explains why he puts exercise above such things as client meetings. He says:

“I schedule my workouts during the workday and prioritize exercise over all my work activities. There is some flexibility, but if there is a conflict between a trail run I need to get in, and a meeting with a client, I’ll reschedule the client meeting first. I do this because I and my business can survive the consequences of rescheduling a client meeting, even if it means losing that client. But as soon as I start pushing workouts off, I’ll start missing workouts, and once I start missing workouts, I’m close to stopping workouts altogether.

Exercise must come first, or it’s unlikely to happen at all.

If exercise stops, then my health goes downhill. With the loss of physical health my productivity at work goes down. I become depressed. I lose motivation to do the things that makes my business successful. I’ve learned firsthand that excellence in one area of my life promotes excellence in all other areas of my life. Exercise is the easiest area of my life to control. It’s easy to measure. Either I get it in, or I don’t. When I do, it lifts up all other areas of my life, including my business.”

Smart man!

Avoiding pesticides in produce from Consumer Reports

To this point, I haven’t been fully convinced that organic produce is better for me. Though there’s a lot of fear-mongering and weird conspiracy theories around organic (and GMO) food, I haven’t found overwhelming evidence that organic produce is a) more nutritious or b) safer. An article in Consumer Reports has made me reconsider that stance.

Eat the Peach, Not the Pesticide recommends that we always buy organic whenever possible:

“Experts at Consumer Reports believe that organic is always the best choice because it is better for your health, the environment, and the people who grow our food. The risk from pesticides on conventional produce varies from very low to very high, depending on the type of produce and on the country where it’s grown. The differences can be dramatic. For instance, eating one serving of green beans from the U.S. is 200 times riskier than eating a serving of U.S.-grown broccoli.”

The article provides an interactive guide so you can see where various fruits and vegetables lie on the spectrum from high- to low-risk:

“If you want to minimize your pesticide exposure, see our risk guide. (Download our full scientific report, ‘From Crop to Table.’) We’ve placed fruits and vegetables into five risk categories—from very low to very high. In many cases there’s a conventional item with a pesticide risk as low as organic. Below, you’ll find our experts’ answers to the most pressing questions about how pesticides affect health and the environment. Together, this information will help you make the best choices for you and your family.

This short video from Consumer Reports summarizes their findings.

Gaining a competitive edge

I’m a fan of Alex Hutchinson’s Sweat Science colum in Runner’s World. Hutchinson is a former physicist, an award-winning science journalist and a runner. (Check out his bio.) He always does a good job of discussing the research that’s available on any number of fitness and sports related topics from training methods to diet to whatever else you can think of.

Recently he wrote Advice to a Young Athlete. The article started as a response to a cyclist who wrote to him asking for advice on getting to the elite level. Hutchinson insists first and foremost that talent and hard work are the essentials. Beyond that there are a galaxy of things (supplements, training methods, etc) that may or may not work.

In this piece he discusses the following:

  • caffeine
  • acidity buffers: baking soda, sodium citrate and beta-alinine
  • beet-root juice
  • creatine
  • recovery methods: massage, ice baths, compression garments, sleep
  • nutrition: fruits/veggies (Eat more.), fat vs. carbs, “training low,” and hydration
  • brain training
  • race preparation: warm-up, taper, heat training

If you’re an endurance athlete or a trainer/coach the you should read the column.