For The Love of Food

Welcome to Friday’s For The Love of Food, Summer Tomato’s weekly link roundup.

Lots of great food and health science this week in my top 10, along with the death of the evil Smart Choices food labeling campaign (woohoo!). Also be sure to check out the wonderful Anti-Fast Food article from Zen Habits. And what week would be complete without a lame celebrity gaffe endorsed by the always misguided Diets In Review? Oh right, any week.

Happy reading 🙂

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For The Love of Food

• Scientists claim junk food is as addictive as heroin <<This study adds a lot of validity to David Kessler‘s argument about the role of the brain‘s reward and addiction circuits in overeating. Apparently sugar and salt make you crazy. Be careful this weekend. (Grist)
• Smart Choices suspended! May it rest in peace. <<Nuf said. (Food Politics)
• Moderate amounts of protein, rather than a lot, might be best for muscle <<Low-carb acolytes seem to treat high-protein as the new low-fat–something we’re all free to eat in unlimited quantities so long as there is no evil carbohydrate around. Probably the story is a little more complex than that. (Los Angeles Times)
• Gwyneth Paltrow’s Controversial Fitness Comment <<B.S. of the week Rumor has it that wannabe fitness guru Gwyneth Paltrow was overheard saying, “When you’re 35, you either starve yourself, or you do serious cardio.” GP herself gets some B.S points because neither starving yourself nor “serious cardio” will help keep you slim (they’re pretty much the same). And double B.S. points go to Diets In Review (worst online diet info ever) for friggin’ agreeing with her! *slaps forehead in disbelief*
• The Anti-Fast Food Diet <<Superb article on the benefits of Slow Food over at Zen Habits. One of the most simple and beautiful descriptions I’ve read on quality eating. (Seriously great job, Leo).
• Why You Don’t Have to Soak Your Nuts ~ Plus: Chai Almonds! <<Funny and brilliant article about nuts by a blogger I just discovered. Holly does a great job of debunking diet lore with amusing prose and a fabulous recipe to boot! (Sustainable Suppers)
• The Life Span of a Rodent May Aid Human Health <<Think cancer is random and inevitable? Wrong. There is abundant evidence in nature that specific, regulated biological processes are responsible for cancer. Isn’t science cool? (New York Times)
• Statin drugs might slightly boost diabetes risk <<There is a downside to every drug, even statins. Do you know what actually prevents diabetes? You guessed it, diet and exercise. (Medline)
• Knowing about calories causes people to eat more <<I love this. Although it is still not clear what this data means, it does suggest that knowledge of calories (all dietary numbers?) doesn’t help much. I prefer to focus on eating good, healthy food. (Weighty Matters)
• Jerusalem Artichoke Soup with Bacon <<This recipe for sunchoke soup not only looks delicious, there are also some tips to prevent the less-than-desirable aspects of eating this delicious root. (Chocolate and Zucchini)

You read anything awesome this week?

Collards, Carrots and Lentils

A new study published yesterday in the Archives of Internal Medicine suggests that both weight loss and risk factors for heart disease can be improved following a vegan version of the low-carb, high-protein Atkins diet.

The “Eco-Atkins” diet focuses primarily on soy, nuts and wheat proteins (gluten) to increase the amount of vegetarian protein in the diet. Carbohydrates were restricted to 130 g/day, which is on the higher end of most low-carb diets. All starchy foods such as bread, baked goods, potatoes and rice were eliminated. Carbohydrates were provided in the form of whole, intact grains (barley and oats) and low-starch vegetables.

In a small (47 participants), short-term randomized controlled trial, this diet lowered bad LDL cholesterol by 20%, without negatively impacting good HDL cholesterol (statin drugs improve cholesterol levels by 30%). The diet also substantially lowered blood pressure and other markers of cardiovascular disease, such as triglycerides and apolipoprotein B.

The original meat-based Atkins diet has been shown to be effective for temporary weight loss (after 1 year the effects of the Atkins diet are diminished), but cardiovascular risk factors such as LDL cholesterol and blood pressure are not substantially improved under the traditional Atkins regimen.

Interestingly, a traditional Atkins-style diet based on animal protein was not used as a control in this study, so a true comparison of the diets cannot be made using the present data. Instead the researchers chose a control diet representative of a typical high-carb, low-fat vegetarian diet that included eggs and dairy products. Both diets tested in this study represented a 60% decrease in total calories.

Because of the study design, we cannot conclude that this diet is more effective than the Atkins diet for health, though you would predict it would be if future studies made this comparison. On the other hand, it does seem that a plant-based high-protein diet is more effective at improving health than a high-carbohydrate lacto-ovo vegetarian diet, at least in the short-term in a highly controlled environment.

This study took place over the course of 4 weeks, and all the food was provided for the particpants by the researchers. Thus, compliance in the program was very high. It is not clear if the participants would have had the same level of success if they were instructed to provide their own food to comply with the dietary programs.

Despite this, satiety levels were notably improved in the high-protein group and it would be expected that the increase in satiety would encourage greater compliance in a free living situation.

A small four week study, however, tells us very little about the effectiveness of this diet. While it is possible to improve risk factors such as cholesterol and blood pressure in such a short period of time, disease outcome is the true measure of a successful diet. Also, this study did not test the feasibility of the Eco-Atkins diet in the long-term, and it is likely many dieters would object to a strictly vegan regimen.

Interesting points raised by this preliminary study include:

• Plant-based, high-protein diets may be more effective at improving cholesterol and other cardiovascular measures than traditional lacto-ovo vegetarian diets.
• Short-term weight loss is primarily determined by the number of calories consumed, not macronutrient content.
• Low-carb diets that include intact whole grains and plant-based protein can be effective at improving both weight and cardiovascular risk factors in the short-term.
• Plant-based high-protein diets can increase satiety compared to high-carb vegetarian diets.

However, many questions must be addressed before this diet can be recommended to individuals trying to improve cardiovascular measures and lose weight.

New questions:

• Can the Eco-Atkins diet be maintained in the long-term by normal individuals?
• Does the Eco-Atkins diet continue to improve cardiovascular risk factors including weight loss after 4 weeks?
• What would result from this study if beans and lentils were used instead of soy and gluten?
• Does the Eco-Atkins diet improve disease outcome?
• Does the Eco-Atkins diet extend life?
• Does the Eco-Atkins diet affect quality of life?
• Can these effects be attained through other diets that include some animal protein, more whole grains or more fat?
• Is the effectiveness of the Eco-Atkins diet affected by an individual’s level of insulin resistance?
• Can adding fish further improve the results of the Eco-Atkins diet?
• Can a further reduction in carbohydrates improve the results?
• Will you get these same results if the study is NOT funded by the soy industry?

In summary, the results of this study are interesting and encouraging, especially for those of us who think both carbohydrates and meat should be limited in a healthy diet. I very much look forward to future studies exploring this idea.

What concerns me most is the lack of marine omega-3 fatty acids (fish) in the Eco-Atkins diet, which could potentially improve cardiovascular measures even further. Fish is also important for cognitive health and may lower cancer risk.

I am also worried that a strictly vegan diet would not be feasible in the long-term for many Americans. Moreover, it is not necessarily the healthiest option available. Vitamin B12 deficiency is a particular concern, but could be addressed with supplements. Generally, however, I do not recommend relying on supplements for optimal nutrition.

Finally, this study was funded by a company that makes soy and gluten products. Personally I would have prefered to see these protein sources used in combination with other things such as beans and lentils. Many people question how much soy can be safely consumed and gluten intolerance is more common than ever, so wouldn’t it be interesting to know if there were safer alternatives? It really annoys me to see science being influenced by industry funding.

What do you think of the Eco-Atkins diet?

A widely publicized study out this week in the New England Journal of Medicine shows that there is virtually no difference between low-carb, low-fat, high-carb or high-protein diets when it comes to weight loss. I don’t often like to toot my own horn, but if you read my post on Monday about the Top 10 Food Facts Everyone Should Know (see point #10), then this was not news to you.

For several years now data has been accumulating that the relative composition of different macronutrients (fat, carbs, protein) in your diet has little to no effect on long-term weight loss. What makes this study stand out from the pack is how well it was designed.

The Study

This was the largest, longest run study of this kind ever conducted, including nearly 650 over weight individuals of diverse racial, socioeconomic, geographic and education backgrounds. The participants were highly motivated to lose weight and were given detailed instructions on why their assigned diet was considered an effective weight loss strategy (this was to remove bias caused by the media about popular diets).

For you carbophobes out there, the importance of dietary carbohydrates was addressed directly. The amount of carbohydrates in the different diets varied from 35% (very low) to 65% (very high). All participants, including those on the high-carb diet, were instructed to choose foods that had lower glycemic index. Carbohydrate composition had no significant effect on long-term weight loss.

All subjects received substantial behavioral therapy to help them meet their goals, and detailed measurements of health and weight loss were collected from each individual throughout the study. The participants were told to keep food journals and use online support provided, as well as weekly dietary counseling.

Importantly, all the diets resulted in similar calorie deficiencies to promote weight loss. Not surprisingly, after 6 months all the participants had lost a substantial amount of weight, but after 1 year had gained about half of it back. During the final year the subjects had more difficulty sticking to their assigned diets, particularly those assigned the most extreme regimens (very low-fat or high-protein).

Conclusions

Regardless of diet, all participants experienced similar, modest (5% body weight reduction), but clinically relevant weight loss that is mainly attributed to a reduction in calories.

Interestingly, the measure that best correlated with weight loss success was attendance at the dietary counseling sessions.

Since the study is over can we now assume that many of these participants have gone back to their old eating habits? I would bet yes.

What can we take away from this study?

You can lose weight on any diet, but for most people it is very difficult and not sustained. This is because cutting calories is very tough for most people.

This study also suggests that losing weight with standard diets is very difficult and, in most cases, only moderately helpful. It seems future research should focus on how to increase adherence to a lower calorie diet. Gaming the system by manipulating macronutrient composition doesn’t seem to be working.

Why you should focus on whole foods, not nutrients

Another thing we can take from this study is that if weight loss is your goal, calories are what count. (Some of my friends responded to this finding brilliantly: “DUH.”) The nice thing about a diet based primarily on vegetables is that lowering caloric intake is relatively easy. As long as some effort is made to achieve a balanced diet (enough plant protein and fats), satisfaction after a meal can be attained with far fewer calories.

Vegetables are very bulky, highly nutritious and have very few calories. It’s not easy to gain weight when you eat kale, beans and brown rice for dinner.

Like I explained a few weeks ago, since I have focused on health (rather than weight) and a vegetable-based (rather than macronutrient-based) diet, I have lost weight effortlessly. I am also less stressed about food in general, and have completely lost my old cravings for sugar and fat.

Best of all, I do not feel like I have given up anything whatsoever. In fact I would argue I have gained the freedom to eat what I want, whenever I want it. And the food I eat is much more satisfying and delicious. I guarantee you this tagine tasted better than any Atkins bar, rice cake or BigMac.

My life now is much more delicious.

Are you ready to give up diets and focus on health?

In honor of the food issue this week at Synapse, I compiled a list of ten essential diet and nutrition facts you might not know:

1. “Vitamins” are not the same as whole foods. Instant ramen and a multivitamin is not a healthy meal. There is no substitute for a diet of whole foods rich in vegetables, beans, grains and fish.
2. A healthy diet can prevent or even reverse four out of the six leading causes of death in the US. Evidence indicates that diet is more important than genetics in the vast majority of heart disease, stroke, cancer and type 2 diabetes cases.
3. The thinnest, healthiest people in the world eat “high carb” diets. But they definitely do not eat the processed, refined carbohydrates that flood Western culture. If you want to lose weight and live longer without disease, eat more vegetables and whole grains.
4. You get plenty of calcium. Americans consume more calcium than most countries on earth, yet still sport some of the highest rates of osteoporosis. This debilitating disease is more likely caused by insufficient vitamin D, not enough exercise and/or too much protein. Also, excess calcium is linked to prostate cancer and milk to ovarian cancer. Calcium does not support weight loss either.
5. “Fiber” is not the same as vegetables and grains. Fiber supplements do not offer the same benefits as fiber-filled foods, and do not help with weight loss or protect against disease.
6. The best sources of protein are plants and fish. It is relatively easy to get complete protein (i.e., all the essential amino acids) from a diverse diet. Protein from red meat offers more risk than reward. (Yes, pork is red meat.)
7. Fruits and vegetables protect your vision. Both cataracts and macular degeneration are strongly tied to diet.
8. Fats from factories are dangerous. Processed oils and trans fats (not total dietary fat) are associated with heart disease, type 2 diabetes, cancer and obesity. Replacing them with natural oils could save your life.
9. Fats from plants and fish are essential. Mono- and polyunsaturated fats protect against heart disease, type 2 diabetes and memory loss. In moderation they can also aid in weight loss, since they increase the satiety you feel after a meal.
10. You can lose weight on any short-term diet, but you will probably gain back more than you ultimately lose. This is often true even if you stay on the diet. Focusing on long-term health is the best strategy for sustained weight loss, but it requires patience.

What are other common myths about diet and nutrition?

UPDATE: For more information on the health value of oils from fish, please read my answer in the comments section.
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