Why “healthy” can backfire, are grains really necessary and some weight loss troubleshooting tips.

August 30, 2011 | Join us today at noon PST as we discuss the latest food news stories and I answer your burning food and health questions.

To watch live and join the discussion click the red “Join event” button, login with Twitter or your Vokle account. There is no password for this event.

I encourage you to call in with video questions, particularly if your question is nuanced and may involve a back and forth discussion. Please use headphones to call in however, or the feedback from the show is unbearable.

To keep up with live events, get access to exclusive content and have Darya personally answer your food and health questions, sign up for the Tomato Slice newsletter.

We had another great discussion with lots of excellent questions this week in episode 8.

Watch to learn the necessary steps for getting healthy and losing weight (the order is important!), and some of my favorite tips for different body types.

As always, show notes mentioned during the episode are below. I’l be holding office hours this coming Monday, June 6, at 3pm PST if you want to stop by and chat.

May 24, 2011 | Tonight on Summer Tomato Live I’ll be giving tips and tricks on how to lose weight permanently without dieting. Join us at 6:30pm PST to find a plan that works best for you, including live Q&A and weight loss troubleshooting.

Participation is only available to subscribers of the newsletter Tomato Slice. You can sign up at any time, even during the show, and the password for participation will be emailed to you immediately.

Click here to sign up and get the password

Read this for more information on the show and newsletter

To watch live and join the discussion click the red “Join event” button, login with Twitter or your Vokle account, and enter the password when prompted.

I encourage you to call in with video questions, particularly if your question is nuanced and may involve a back and forth discussion. Please use headphones to call in however, or the feedback from the show is unbearable.

Show notes:

Useful links:

• localharvest.org

Relevant articles:

• How To Start Working Out When You Don’t Like To Exercise
• NEAT – how to exercise without exercising
• 8 Reasons Breakfast Makes Your Life Better
• How I Lost 60 lbs In 1 Year With A New Healthstyle
• How To Break A Diet Soda Addiction: Tips From A Former (Diet) Cokehead

Relevant videos:

• Darya’s Healthstyle
• Sugar toxicity

Thanks to those of you who participated in this episode on the role of dairy in health and weight loss. Show notes are below.

Please note that the date for the probiotics episode (#6) has changed to Monday, April 25 @ 6:30p PST (previously Tuesday, April 26).

April 11, 2011 | Does milk really protect against osteoporosis? Will too much calcium give you prostate cancer? Can you reduce acne if you stop eating dairy? What’s the deal with raw milk?

The answers may surprise you.

Tune in tonight at 6:30pm PST to join our live discussion about the pros and cons of dairy.

Live participation is only available to subscribers of the newsletter Tomato Slice. You can sign up at any time, even during the show, and the password for participation will be emailed to you immediately.

Click here to sign up and get the password

Read this for more information on the show and newsletter

To watch live and join the discussion click the red “Join event” button, login with Twitter or your Vokle account, and enter the password when prompted.

I encourage you to call in with video questions, particularly if your question is nuanced and may involve a back and forth discussion. Please use headphones to call in however, or the feedback from the show is unbearable.

Show notes:

There is a huge amount of politics surrounding this science, because of the powerful influence of dairy industries around the world. This makes data difficult to interpret. The following review and its rebuttal regarding the role of milk in type 1 diabetes is a perfect example of what I mean:

Dairy & type 1 diabetes

• Literature review
  http://www.nature.com/ejcn/journal/v59/n5/full/1602104a.html#bib11

• Critique of review based on funding influences
  http://www.nature.com/ejcn/journal/v60/n3/full/1602322a.html

Dairy and osteoporosis

• Recommended calcium intake = 1,000 mg for adults

• Osteoporosis is more common in Western countries than in Asia, Africa or So. America
  • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3004072/figure/F0001/
• Western and developed countries consume the most dairy, and as countries consume more osteoporosis becomes more common
  • http://www.ncbi.nlm.nih.gov/pubmed/15775506
  • http://www.ncbi.nlm.nih.gov/pubmed/18947030
  • http://www.foodscience.uoguelph.ca/dairyedu/intro.html
• Correlation between high calcium intake and hip fractures
  • Eat, Drink & Be Healthy, by Walter Willett

• Also, much of the world is lactose intolerant
  • http://en.wikipedia.org/wiki/Lactose_intolerance
• Some evidence that dairy protects against osteoporosis
  • http://www.jacn.org/cgi/content/full/19/suppl_2/83S
• Calcium supplementation does not protect against fractures
  • http://www.ncbi.nlm.nih.gov/pubmed/18286218?dopt=Abstract
  • but might with vitamin D http://www.ncbi.nlm.nih.gov/pubmed/17720017?dopt=Abstract
• Vitamin D, calcium, fruits and vegetables, protein important for bone health
  • http://www.ncbi.nlm.nih.gov/pubmed/19968914
• Diet “acidity” (from protein & other sources) is not a factor in osteoporosis
  • http://www.ncbi.nlm.nih.gov/pubmed/19754972

Dairy and acne

• Dairy consistently shown to promote acne, probably via hormonal mechanisms
  • http://onlinelibrary.wiley.com/doi/10.1111/j.1365-4632.2009.04002.x/full
• Treat acne with low GI foods (skip sugar & flour) and omega-3 fatty acids

Dairy/calcium and heart disease

• Calcium supplementation increases CVD risk
  • http://www.ncbi.nlm.nih.gov/pubmed/20671013
  • http://www.bmj.com/content/341/bmj.c3856.long

Dairy/calcium and prostate cancer

• Calcium increases prostate cancer risk
  • http://www.ncbi.nlm.nih.gov/pubmed/20516117
  • http://www.ncbi.nlm.nih.gov/pubmed/21335998
  • http://www.ncbi.nlm.nih.gov/pubmed/20843485
• Reduce risk with legumes, nuts, seafood
  • http://www.ncbi.nlm.nih.gov/pubmed/20232354

Dairy/calcium and colon cancer

• Calcium decreases colorectal cancer risk
  • http://www.ncbi.nlm.nih.gov/pubmed/21335998
  • http://www.ncbi.nlm.nih.gov/pubmed/19423533
  • http://www.ncbi.nlm.nih.gov/pubmed/19237724
• Though data is inconsistent
  • http://www.ncbi.nlm.nih.gov/pubmed/8333412

Dairy & breast cancer

• Dairy and meat do not promote cancer in adult women
  • http://www.ajcn.org/content/90/3/455.long
• Some studies show reduced risk of cancer (both from China)
  • http://www.ncbi.nlm.nih.gov/pubmed/21442197
  • http://www.ncbi.nlm.nih.gov/pubmed/21128178
• Milk from cows given rBGH (hormone from Monsanto) increase cancer risk
  • http://www.preventcancer.com/press/releases/july8_98.htm

Dairy & weight loss (very tough to find studies not funded by dairy industry)

• Moderate weight loss from dairy (but rarely from intervention studies w/o caloric restriction)
  • http://www.ncbi.nlm.nih.gov/pubmed/21320381
• Possible mechanisms include:
  • Ca++
  • protein
  • conjugated lineoleic acid (CLA)
  • medium-chain fatty acids
• My interpretation: dairy not likely to have big impact on body weight

Cheese protects against cancer and heart disease?

• http://www.ncbi.nlm.nih.gov/pubmed/20335553
• http://www.ncbi.nlm.nih.gov/pubmed/19179058
• http://www.ncbi.nlm.nih.gov/pubmed/21447660

Extras

• Raw Milk, A Potentially Risky Elixer, by Bill Marler

Last night was the first episode of Summer Tomato Live where we discussed the new best-selling book, The Four Hour Body by Tim Ferriss. Thanks everyone for watching and submitting your questions, the show was a huge success and we had a great conversation.

[note to self: get haircut]

The entire show is available above. Normally the videos will be available a week after the live broadcast, but for this first episode I want to give everyone a chance to see what the show is about in case you’re interested in subscribing.

I’ve partnered with Foodzie and Zürsun Heirloom Beans to provide free samples of Zürsun cranberry beans (great for Slow Carb Dieters) as well as a free Foodzie Tasting Box ($20 value) to the first 150 subscribers. Spaces are filling up quickly, so sign up soon if you want the bonuses (for more info about the show and newsletter read this). US shipments only.

Subscribe to Summer Tomato Live ($3.99/mo)

The next live show is scheduled for Wednesday, March 2, at 6:30pm PST. The reason I’m choosing a different day of the week is so that Tuesday night karate class or any other regularly scheduled activity won’t be a barrier to subscribing. If this system doesn’t work for you, please let me know. If a fixed day is better for most people, we can try to make that happen.

Wondering what the next show is about? Me too! Please vote for the next Summer Tomato Live topic (if you’re reading this in an email, please click over to the blog post to vote in the poll):

[poll id=”8″]

Poll closes Friday at midnight PST.

Show notes from episode #1:

The book: The Four Hour Body by Tim Ferriss, a #1 New York Times best-seller.

Slow Carb Diet: How to Lose 20 lbs. of Fat in 30 Days… Without Doing Any Exercise (note: In the book there is one extra rule than is listed in this original post, “Don’t eat fruit.”)

Recommended pressure cooker: Fagor Splendid 6-Quart Pressure Cooker

Useful links:

• How (and why) To Cook and Freeze Large Batches of Lentils
• How To Cook Dried Beans Using a Pressure Cooker
• Intact Grains vs Whole Grains
• Does Fruit Make You Old and Fat?
• How To Cook And Freeze Brown Rice

Please add any tips or suggestions you have about the show in the comments. Thanks!

Many studies have been published associating lack of sleep with increased body weight, but I have never read through the literature myself to explore the connection.

This week fellow scientist Matthew Constantin of Best Weight Loss Triumph gives us a thorough review of the science of sleep and weight gain.

Matthew Constantin, PhD, is a biologist and postdoctoral research scientist at Saint Louis University. Twice awarded research grants from the American Heart Association for his studies on cardiovascular disease, Matthew also has a keen interest in the related field of obesity treatment and enjoys explaining the latest scientific research on weight loss in a way that is easy for everyone to understand.

His website contains reviews of some of the so-called best rated weight loss programs and offers a savings coupon for Medifast, a clinically studied weight loss intervention.

Obesity and Reduced Sleep: Will Sleeping Less Make Me Fat?

By Matthew Constantin, PhD

We have long known that too little sleep causes fatigue and a slowing of neurocognitive functions, resulting in a variety of symptoms like slowed reaction time and difficulty concentrating. Recent research, however, has discovered a new result of reduced sleep: metabolic effects that include an increased risk of obesity [1].

Western society has seen a rapid rise in overweight and obesity in recent decades. Accompanying this widespread weight gain has been a significant and rapid decrease in the amount of time the average person spends sleeping.

While young adults were sleeping close to 9 hours each night at the beginning of the 20th century [2], this had decreased to less than 8 hours by the late 1960s [3]. The trend is continuing into the 21st century. As of 2005, 16% of American adults were getting less than 6 hours of sleep at night, up from 12% in 1998.

Sleep and Obesity: A Subjective Study

Science has linked self-reported sleep habits and obesity for a number of years, but the precise relationship between the two has been difficult to establish. Because obesity is a risk factor for a number of diseases that can negatively impact sleep, such as sleep apnea, asthma, depression, and arthritis, it is hard to know whether reduced sleep leads to obesity or obesity leads to reduced sleep.

To shed some light on this question, data collected from 1986 to 2002 in the Nurses’ Health Study (NHS) was analyzed [4]. Women in this study were asked to report their sleep habits and body weight every two years.

The results of the study suggest that women who self-report receiving less sleep are more likely to gain weight and are at an increased risk for obesity in middle-age. In 1986, when the first round of data was collected, it was found that women who reported sleeping 7 hours in a 24 hour period weighed 2.6 kg less than those who slept 5 or fewer hours, and 1.3 kg less than those who slept 6 hours.

This pattern continued over the following 16 years, with women who reported getting 5 or fewer hours of sleep weighing the most every time weight data was collected and those getting 7-8 hours of sleep weighing the least. In 2002, those in the 6-hour group had gained 7.2kg (15.8lb) and those in the 5-hour or less group gained 9kg (19.8lb), while those in the 7-hour group had gained only 4.8 (10.6lb) kg.

Other prospective studies have found similar results among both adults and children, but there are a couple of caveats. Because the information in the studies is self-reported, it is subject to inaccurate estimates by the reports. Many people overestimate sleep time when self-reporting. It is also unknown whether shorter sleepers are heavier because of an increase in fat or an increase in lean muscle—a distinction which makes a significant difference for health repercussions.

Sleep and Obesity: An Objective Study

In response to the limitations of subjective studies on sleep and obesity, two groups of adults aged 65+ (one of men and one of women) took part in an objective study that also looked at sleep duration and weight. Rather than relying on self-reported data, participants’ sleep patterns were assessed through the use of wrist actigraphy, which determines if a person is asleep or awake by measuring wrist movement.

This objective measurement of sleep duration confirmed the results of the subjective study, finding that reduced sleep was associated with an increased Body Mass Index (BMI) among both men and women. When compared with those getting 7-8 hours of sleep per night, average BMI of those who slept less than 5 hours was higher by 2.5 units in men and by 1.8 units in women. Moreover, men getting 5 or fewer hours of sleep were 3.7 times more likely to be obese, while women were 2.3 time more likely.

Increased weight doesn’t necessarily mean an increase in fat and its related health problems—more muscle also means more weight, but is generally associated with improved health. The objective study looked at this question and found that the increase in weight associated with reduced sleep was a result of increased fat rather than muscle. Overall percent body fat in those sleeping less than 5 hours was 1.7% greater than those getting 7-8 hours, and percent body fat in the trunk 1.9% greater.

Why Could Reduced Sleep Make You Fat?

Research has clearly shown that reduced sleep is associated with greater weight, but why does reduced sleep make a person fat?

One strong hypothesis is that less sleep leads to increased or altered food intake. Animals studies have found that sleep deprivation leads to elevated levels of hunger [5], with particular increases for high-fat and high-carbohydrate foods. This increased hunger with sleep deprivation may be a result of the corresponding change in hormones that regulate hunger, with gherlin levels found to increase and leptin levels to decrease.

Alternatively, rather than a change in feelings of hunger, increased food intake could be the result of increased eating even in the absence of hunger. Reduced impulse control and trouble delaying gratification are known consequences of sleep deprivation.

It’s also possible that simply being awake more often will lead to increased eating when food is readily available, especially if time awake is spent in sedentary activities that encourage snacking.

As S.R. Patel mentions in his 2009 review paper titled “Reduced sleep as an obesity risk factor”, there are several other possibilities that have been proposed. One is that the feelings of fatigue that are associated with sleep deprivation may result in a disinclination to exercise. Another is that reduced sleep results in a reduction in involuntary activities such as fidgeting, which are known to have effects on weight regulation [6].

Finally, acute sleep deprivation has been found to result in a drop in core body temperature, meaning your body needs to spend less energy in order to maintain thermoregulation with the surrounding air. This change in thermogenesis (the process of heat production) may encourage the storing of fat, although a recent study found no effect of sleep deprivation on resting metabolic rate.

Conclusions

Current evidence clearly shows that short sleep is associated with obesity, but a causal relationship remains unclear. Does a reduction in sleep lead to weight gain, or is there some other reason for the association? We don’t yet know for sure. But as modern society sets aside less and less time for sleep and becomes increasingly prone to obesity, it is a possibility that must be considered.

With so few effective ways to prevent and treat obesity, wouldn’t it be wonderful if simply sleeping a bit more could keep us both thinner and healthier?

References

1. Patel, S.R. Short sleep and obesity. International Association for the Study of Obesity. Obesity Reviews 10 (Suppl. 2), 61–68.

2. Terman L, Hocking A. The sleep of school children, its distribution according to age, and its relationship to physical and mental efficiency. J Educ Psychol 1913; 4: 269–282.

3. Tune GS. Sleep and wakefulness in normal human adults. Br Med J 1968; 2: 269–271.

4. Patel SR, Malhotra A, White DP, Gottlieb DJ, Hu FB. Association between reduced sleep and weight gain in women. Am J Epidemiol 2006; 164: 947–954.

5. Spiegel K, Tasali E, Penev P, Van Cauter E. Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Ann Intern Med 2004; 141: 846–850.

6. Levine JA, Eberhardt NL, Jensen MD. Role of nonexercise activity thermogenesis in resistance to fat gain in humans. Science 1999; 283: 212–214.
Matthew Constantin

I used to look like this. Not anymore.

Nothing makes me happier than helping someone discover real food. Not only does their health physically transform, but they learn about a world of tastes and flavors that can be truly life changing.

My friend E began her healthstyle upgrade at the beginning of 2010, and I’m delighted that she agreed to share her story with Summer Tomato readers.

E. Foley is a geek girl extraordinaire. She writes amazing online dating profiles for geeks and non-geeks, helping clients all over the world find love. Her writing can be found at Examiner.com, Dating Sites Reviews, and elsewhere as a ghostwriter. By day, she is the Copywriter at ThinkGeek.

Follow her @geeksdreamgirl on Twitter.

Dating profiles for geeks = http://geeksdreamgirl.com

Why I Love WeightWatchers But Would Never Go Back

By E. Foley

My name is E and in 2003, I became a Lifetime Member of WeightWatchers after losing nearly 50 pounds and reaching my goal weight of 145.

Fast-forward to 2010, and I now weigh over 230 pounds. I’m 5’7″.

I gained back every pound I lost on WeightWatchers and then some. I did try to lose it. Over and over and over again I rejoined WeightWatchers and lost a handful of pounds before slipping back into bad habits and regaining them.

There is so much I love about the WeightWatchers program, but in the end, it’s Darya’s Healthstyle that has been the best choice for me.

Things I Loved About WeightWatchers

Weekly accountability

Knowing that I had to step on the scale in front of a staff member every Saturday motivated me to stay on track.

Group support

It may sound dumb, but it really felt good to have the group applaud for me when I had a good week. Knowing they’d be there to support me on a bad week was also comforting.

Balanced nutrition

I’ll get into this more later, but the WeightWatchers program, if followed to the letter, is nutritionally sound.

Role models

All the staff members are Lifetime Members, and there are always a few Lifetime Members who attend weekly meetings.

Things to ponder

Every meeting gave me something to think about, a food or recipe I wanted to try, or a warm fuzzy feeling that propelled me into the week.

Reasons Why I Can’t Go Back to WeightWatchers

Gaming the System

When I achieved Lifetime status, it was on the Flex plan. This plan allows you a certain budget of Points per day which you can spend on various types of food. The Points value of the food depends on its calories, fat, and fiber. Many vegetables are zero points, which you’d think would encourage their consumption. Not so. When I reached my goal weight, I was burning calories like mad at a gym. Some days I did two cardio classes in a row and then yoga or Pilates. This allowed me to earn Activity Points which I then spent on those tasty (but sugary!) Milk & Cereal bars that are anything but healthy.

When I regained the weight and went back to WeightWatchers, I jumped back into the same Flex program. The game for me was figuring out how to play the numbers so they added up on paper to the magic number. It got to the point where I could be “perfect” on paper but not lose a single pound.

Frustrated, I’d quit.

WeightWatchers’ Attempt at Healthstyle Fails

Later, WeightWatchers rolled out the Core program and I saw success again. Core allowed members to eat lean meats, fat-free dairy, fruits and vegetables “until satisfied.” A weekly Points budget allowed eating things that weren’t Core (namely carbs, sugars, and fats). Also included on the “free to eat” list was your daily serving of heart-healthy oils.

But Core wasn’t popular among the WeightWatchers membership. In my meetings, I’d often be the only person in the room on Core, so advice in the meeting was tailored toward Flex members. Sometimes I’d get lucky and have a leader who was on Core, but not always. Even though I was losing weight regularly on Core, the lack of support for the program made going to meetings not as helpful or motivating. WeightWatchers finally eliminated the Core program, going back to a One-Plan-Fits-All mentality.

Eat Healthy OR Filling

Remember how I said that the plan is nutritionally sound if followed to the letter? The problem with WeightWatchers is that as long as you lose weight, no one questions what you’re eating. I wish I still had my food journals from those days, because I can tell you I went full weeks without consuming a vegetable or fruit.

In the meetings, the leader would talk about getting your heart healthy oil in every day, and inevitably, someone would complain about having to “waste Points” on olive oil, when they could just use a few spritzes of aerosol cooking spray instead. When you’re working with 20 points per day (which is what I was eating when I was close to my goal weight), it does seem like a waste to use 4 of those points for a tablespoon of olive oil. Especially when 4 points could be spent on bread or meat or cheese. Or a Milk & Cereal bar.

Diet For Life?

My biggest problem with WeightWatchers is that it never felt like a way to eat for the rest of my life. Maybe it did for a while, but once hard times hit, I didn’t have the incentive to stick to my guns and eat healthy, mainly because what I ate when I was on program wasn’t all that tasty. (WeightWatchers has tons of recipe books, but all the recipes are pretty bland and uninspired.)

Finding Darya Was The Best Thing That Happened To Me

Dr. Brian Wansink, author of Mindless Eating, says that “the best diet is the one you don’t know you’re on.” This is exactly how I feel about my new healthstyle.

I don’t feel stressed out about food.

I don’t feel deprived of things I want to eat.

I don’t look forward to the day I get to “eat normal” again.

I don’t feel like the way I am eating is a ball and chain.

I don’t eat food that doesn’t taste delicious.

My Healthstyle

Breakfast: Every other Sunday, I make a giant batch of breakfast hot pockets from scratch. I have played with the dough recipe a bit to decrease the white flour down to 5 cups white, 3.5 cups wheat, 1.5 cups almond meal. Since my boyfriend is vegetarian, we use the sausage substitute. They freeze well and reheat in the microwave in 95 seconds. I love them because I am not a morning person, so I wake up as late as possible and eat on my drive to the gym.

Exercise: I am blessed to have a work schedule that allows me to work out from 8:30-9:45 a.m. just about every day. I do miss the gym from time to time, but I’m there more days than I’m not, which is a great start!

Lunch: I love salad bars, but they’re so expensive. So I started up a Salad Club at my work! We have anywhere from 4 to 6 people who participate each week, pitching in various veggies and fruits and toppings and dressings. If you’re curious, follow me on Twitter and you can see a picture of my Salad Club every weekday. When I’m lunching at home, it’s usually kale with toasted nuts and garlic and whatever leftover grain I have in the fridge.

Snacks: Back in my WeightWatchers days, I avoided nuts. Too high in calories, too high in fat, too many Points! Now, I have a variety of nuts on my desk at work and usually eat an ounce or two of nuts every day. They really help bridge the gap between meals and prevent me from snacking on the junk food in the office kitchen.

Dinner: I make all sorts of great things for dinners now. We still have our old standbys (vegetarian tacos & Annie’s mac n’ cheese), but more often than not, I’m surfing the internet for recipes after buying whatever looks good in the store (Sadly, being on the East Coast makes the farmers market thing a little less feasible in the winter. But spring is almost here!!). I think my favorite so far is the stuffed portobello mushrooms (pictured here).

The Bottom Line

I don’t feel like this is a diet. I feel like I’m eating better and tastier foods than I have in my whole life. I’ve eaten more nuts and olive oil in the past 3 months than I have in 3 years. But I’m losing at a steady rate of about a 1/2 pound per week. No, it’s not fast or impressive. But I’m eating amazing food, I’m never hungry (for long!), and I’m not killing myself at the gym to do it. If it takes me 3 years to get down to 140-150 again, that’s fine by me. The weight loss is just a pleasant side effect of my healthstyle, and I have Darya to thank for all her advice and personal coaching.

If you’ve been lurking on the blog and wondering about working with Darya to get your healthstyle on, take the step and do it. I feel so much better and the weight is melting off while I’m eating the most delicious food of my life. You can do it, too.

What is your healthstyle?

Good nutrition advice is not easy to come by, but we have to start somewhere.

It is probably obvious to most of you that public education on diet and health is vastly inadequate. We learn virtually nothing in school, and what they do manage to pass on is less-than-useful or just simply wrong.

Advice changes from year to year, sometimes drastically.

Everyone claims to be a nutrition expert, but very few people are actually trained enough to understand the complex and sometimes contradictory findings made by scientists in the field.

But although there are few sources you can trust, some books do stand out as valuable for understanding the basics of health and nutrition. Good Calories, Bad Calories by Gary Taubes is by far the most thorough I’ve found, and is essential reading for anyone who has an honest desire or need to understand how diet impacts health.

Taubes makes a detailed and compelling case that refined carbohydrates are the primary cause of weight gain and “diseases of civilization” such as heart disease, hypertension and diabetes. In my view, any honest and opened-minded scientist would have to largely agree with him.

Good Calories, Bad Calories is 468 pages and contains over 100 additional pages of references, which is nothing short of astonishing. Taubes explores every aspect of the science behind weight control including the most puzzling and frequently ignored evidence, which he argues is the most important.

Scientists depend on statistics, but have a tendency to ignore outliers which can make data difficult to interpret. Taubes instead points to these anomalies as evidence of flawed or incomplete theories, and suggests that isolated populations (outliers) such as the Inuit and Maasai tribes actually help the most in explaining diet-related health patterns.

Taubes argues extensively (sometimes a bit heavy-handedly) against lazy scientific thinking that relies too heavily on conventional wisdom and the appeal of simple ideas. This point is a major theme of the book and is exemplified by chapter 2, “The Inadequacy of Lesser Evidence.” He goes to great lengths to explain how our tendency not to scrutinize established theories breeds scientific closed-mindedness and can perpetuate flawed ideas for decades.

Ultimately Taubes uses this argument to directly challenge one of the most prevailing health theories in Western civilization: the cholesterol–heart disease hypothesis.

Taubes provides hundreds of pages of data and analysis to make the point that total cholesterol is not a good predictor of heart disease or mortality. Specifically LDL cholesterol is only loosely associated with heart disease (at best) and HDL cholesterol (the higher the better) is a much better indication of vascular health. (Read more: How To Raise Your HDL Cholesterol)

Once this basic premise of health is thrown into question, Taubes carries you through the logic of why a high-fat diet cannot be responsible for heart disease (remember the Inuit) and instead presents why quickly digesting carbohydrates are the most likely culprit.

Fundamental to this argument is the tie between heart disease and type 2 diabetes (along with other “disease of civilization” or metabolic syndrome), which are both inextricably linked to carbohydrate consumption. The logical conclusion from his analysis is that all calories are not created equal, despite what we are told daily by the nutrition community and the media. Understanding the logic behind this argument can fundamentally change the way you approach food and is the best reason to read Good Calories, Bad Calories.

Despite this, Taubes’ book is rarely the first I recommend to people who come to me for nutrition advice. There are a few reasons for this, but the main one is that Good Calories, Bad Calories is not an easy read. I’m a scientist and nutrition data junkie, and this book still took me months to get through (I normally read 4-5 per month). For your average eater, a book like this can quickly become a burden and many people will give up before getting to the good part (about half way through it starts to pick up substantially).

In the first few chapters I was put off by the book’s almost defensive tone. A large part of the first section is dedicated to discrediting the character of a pioneering scientist and father of the dietary fat–heart disease hypothesis, Ancel Keyes. Presumably this depiction is intended as background so the reader understands why Keyes so aggressively disseminates a theory that isn’t fully proven. However, I found the extensive character attack unbecoming for a book espousing science and experimental data, and it seemed unnecessary.

Another reason I resist recommending this book as nutrition advice is that it doesn’t offer much in the way of actual advice. Taubes certainly provides compelling evidence that carbohydrates are best avoided and that dietary fat is safer than presumed, but how much of this knowledge can be translated directly to daily life isn’t clear. For practical advice, I prefer Michael Pollan’s In Defense of Food (based largely on the same data).

Scientifically I also have a few issues with Good Calories, Bad Calories. First, the vast majority of the experiments Taubes cites are early diet studies, many from the turn of the century. While these experiments are clearly important, most of them do not reflect long-term (more than 6 months), real life dietary habits. These studies were also almost entirely dependent upon self-reported dietary intake, which is known to be quite inaccurate.

Much of Taubes’ argument about calories is based on the premise that overweight people eat the same amount or less than lean people. This was once thought to be the case, but recently more thorough studies have shown that overweight and obese people do indeed eat more. The problem is that all people (both lean and obese) are poor judges of food intake, and this discrepancy is largest with the biggest meals consumed. This means people who eat the largest meals tend to underestimate their calories the most, and meal size is correlated with body weight.

This does not mean that I disagree entirely with Taubes’ theory on calories. I was more convinced by the rodent studies he presented where dietary intake was tightly controlled and measured. In some of these, obese animals did seem to eat the same or less than leaner animals (always be careful reading too much into rodent data). Interestingly, the difference in body weight was always accounted for by differences in physical activity, a point I find extremely fascinating.

Since mice obviously do not exercise for the purpose of fitting into skinny jeans, the activity differences observed between obese and lean mice is clearly a fundamental change in metabolism (balance of energy use and intake). If this is true and can be manipulated by diet composition rather than voluntary exercise (which causes overeating), as Taubes suggests, this has tremendous implications for treating obesity and disease through selective diets and metabolic manipulation. I think Taubes makes a strong case for this and it is a point that should be taken very seriously by the scientific community.

My final issue with the book is how the data was presented to seemingly support a diet of almost entirely meat and animal products. While Taubes does not come out directly and say “the healthiest diet is 100% meat,” people without a knack for thinking like a scientist can easily come away with this impression (I’ve seen it).

[note: My guess is this is why I get so many emails from people asking me to help them choose between this book and The China Study (click for review), which both come off as scientific but also as diametric opposites. Personally I do not see a huge conflict between the data presented in the two books, but see it as an issue of interpretation. On this point, my vote goes to Taubes for his superior logic and reasoning.]

My own interpretation of the data presented in this book, however, is not that all carbohydrates are the enemy, but rather that quickly digesting (processed) carbs are the real problem. Taubes never refutes this as far as I could tell, though he does glorify meat-based diets (again remember the Inuit) as the best for optimal nutrition, while belittling the case for a balanced diet. But there is an important difference between saying “meat is good” and “all plants are bad,” which he never directly asserts.

Yet many people still take from this book that a protein and fat-based diet is the healthiest option, which is a flawed interpretation. Vegan diets with no animal products whatsoever can be perfectly healthy, as can largely meat-based diets, and that both are perfectly legitimate is a point that is easily forgotten by the end of Good Calories, Bad Calories.

But while the value of eating plants is an important question for the practical implications of Taubes’ theory of calories, it is not fundamental it.

Summary

Taubes’ meticulous research and overly-thorough analysis represent both the strengths and weaknesses of this book. His case for the role of metabolism in health and obesity, and against the dogma that “a calorie is a calorie” is a tremendous contribution to the field of nutrition. However, this depth can make Good Calories, Bad Calories cumbersome and difficult to read.

Final Grade: A

What did you think of Good Calories, Bad Calories?

You may also enjoy:

• Dr. Robert Lustig’s lecture on the dangers of frutcose
• My guest post at MizFitOnline.com, When Is A Calorie Not A Calorie
  

Quarter Pounder

Today one of my best and oldest friends, David Goodman, shares his remarkable story of how he dropped 20 pounds this year so far “without hardly trying.”

He says the influence I’ve had on him through conversations and articles here at Summer Tomato has helped him make better food choices almost subconsciously.

David and I have a long diet history together (he’s the friend from college I mention in the link), and I am honored to have him share his success story with you. Though he says he is only beginning his journey, I think we can all agree he has made tremendous progress already.

Congratulations Dave!

Dr. Darya: Or how I learned to stop worrying about my weight and love food

And drop 20 lbs in nine months.

by David Goodman

In December of 2008 I weighed 225 lbs. As of yesterday, I weigh 205 lbs.

It’s actually hard for me to view this as a big accomplishment. I have been planning to lose a lot more weight. (My goal is to weigh closer to 165 lbs). But the funny part is that while I have been “planning” to lose all this weight, I have, as Darya pointed out, lost a significant amount. And I have lost it, I can assure you, without being on a diet.

Darya told me that this was exactly the kind of weight loss she believed people could achieve by following her advice. She also reminded me that if I kept up this same pace every nine months, it wouldn’t be that long until I reached my goal. And significantly, I certainly won’t be gaining more weight, which is often the trend for people as they get older.

When Darya asked me to think about how I lost these 20 lbs, the reason was hard to pinpoint. Because it hadn’t occurred rapidly, and because I didn’t actively try to lose weight with a restrictive diet, it was almost like it didn’t “count.” Also, because I haven’t reached my ultimate goal, I don’t really feel like a success story just yet.

On the other hand, losing weight without trying is pretty awesome. And if this weight loss keeps up and stays off, I’ll be right where I want to be in 18 months.

So how did this happen, you ask? As far as I can tell, it went like this:

Darya and I have been talking about food for the past year. I have never been much of a cook and I ate out for most of my meals. I think I was eating fast food about 5-10 times a week.

As I talked to Darya and read her blog, I found myself thinking more and more about “good” food. In fact, without really meaning to I started categorizing food into two groups: “real” food and “crap” food. From what I could tell, simply put, real food grows in the ground, or eats food that grows in the ground. Crap food is made in laboratories and/or mass produced. It is fried or filled with sugar or both.

At first my categorizing food as crap didn’t really stop me from eating it. I was used to my routines and didn’t think about actively changing. Talking and thinking about health, nutrition, and good food made me want to behave differently, but I figured I would need to make major life changes to accomplish that, and I hadn’t gotten around to it yet. This is what I meant when I was “planning” to lose weight.

But I think it was hard to read and talk about healthy food and not incorporate some of that into my life. Slowly, without realizing it, I just started eating green vegetables more often. I definitely put more nuts, fish, and brown rice into my diet too. I don’t think I was eating those foods very much at all before I started talking to Darya about healthy food.

(Read more: Get Fit By Becoming A Food Geek)

Most of all, I stopped eating fast food so much and started making more meals at home. This happened so gradually that it is hard to remember the exact chain of events. Nine months ago it was 5-10 times a week for fast food. These days I usually go more than a week without having it at all. Last week I only had fast food once (I had a cheeseburger at In-N-Out. Sorry Darya, but in my defense, I was pretty drunk).

(Read more: Don’t Eat This, Don’t Eat That: Why Fast Food Is Never Healthy)

My eating is still far from perfect. I could do a lot better on the size of my portions and I still eat crap food from time to time. Also, to reach my ultimate goal of 165 lbs I think I am going to have to start exercising more. During the last nine months the most I did was go walking a few times a week. My gym attendance was inconsistent at best. But I think what my experience really shows is that gradual progress is possible with a few basic, common sense changes to what we eat.

Also, the food that I have been making and eating at home has been delicious. I don’t miss the crap food that I haven’t been eating and I look forward to the fresh, healthy food that I’ve been preparing.

Maybe this losing weight thing doesn’t have to be so hard. Maybe it’s just a matter of paying more attention and really being conscious about what we are eating and whether or not it’s really good food.

(Read more: How To Get Started Eating Healthy)

Have you lost weight eating real food? What are the biggest challenges for you?
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In a nation where obesity and health loom large in our public dialog, there is no escaping the simple fact that we eat too much.

On average Americans consume 500 more calories per day than we did in 1970 (more than we ever have), mostly in the form of refined and processed foods. This corresponds with a 25-30 pound increase in body weight and obesity rates near 30%.

Debates rage over the specifics of what is causing our weight and health problems, but it seems clear enough that the critical element is the amount of food we choose to put in our mouths.

But does everything we eat represent a true choice?

In his book The End of Overeating, former FDA commissioner Dr. David Kessler examines the role of the brain in eating behavior and the mechanisms involved in what he calls conditioned hypereating.

According to his findings specific combinations of sugar, fat and salt hijack the reward pathways of our brain and force us to behave more like food addicts than hungry organisms. This leads to a cycle of conditioned hypereating that makes the habit harder to break with each repeated episode.

But whether or not we are addicted to food is a point of debate. In my interview with Kessler, he made clear he does not use the word addiction for fear of oversimplifying conditioned hypereating. Our relationship with food is more complicated than it is with something like alcohol or tobacco because a human can live without cigarettes, but food is vital to survival.

When pressed to describe the neural differences between addiction and conditioned hypereating, however, Kessler conceded, “The fundamental circuits are the same.”

For this reason, treatment of conditioned hypereating can draw from the success of substance abuse treatments. These tactics involve cognitive and behavioral therapies we can use to train ourselves to override our instincts and adopt new behaviors in response to stimulus cues.

For conditioned and compulsive behavior, cognitive strategies are necessary because intuitive inclinations and “listening to your body” do more harm than good. If your body is telling you to have a cigarette, this does not mean it is in your best interest to do so.

At the FDA Kessler was instrumental in the fight to regulate tobacco, and now he believes some of the same lessons can be applied to the treatment of overeating.

“What took me a decade to understand is you need to change the valence of the stimulus.”

The positive emotional reaction associated with indulgent foods is at the center of our motivation to seek them out. Twenty years ago cigarettes had tremendous allure. But the FDA was successful at demonizing the tobacco industry, and the public no longer sees smoking as glamorous and attractive.

And smoking rates have plummeted.

Changing a conditioned behavior requires a fundamental shift in how we think about a stimulus. In conditioned hypereating the stimulus is food, which makes the task especially difficult, but not impossible.

To break the cycle of conditioned hypereating we must redirect our automatic response to the kinds of foods that cause us to overeat. Kessler calls these hyperpalatable foods, which are loaded with layers upon layers of sugar, fat and salt. The goal is to replace our automatic responses to these foods with different, equally enjoyable actions that are not detrimental to our health and do not reinforce compulsive behavior.

I asked Kessler what is the first step in controlling our eating habits and overcoming conditioned hypereating.

“I can tell you the last step. Change your relationship with food. If sugar, fat and salt are your friends, you will lose. You have to get to the point where that is not what you want.”

The End of Overeating outlines the four basic steps of habit reversal: awareness, competing actions, competing thoughts and support.

But Kessler believes the critical step is fundamentally changing the way we view what we eat, cooling down our emotional response to hyperpalatable foods. In essence, we must train ourselves to stop wanting what we believe we want.

According to the book, the first step in this transformation is becoming aware of the power food holds over us, which requires understanding how our brains work. We must recognize that when we are tempted to indulge, the urge is not generated internally but is a reaction to a cue that makes us respond automatically. You may think you are hungry, but really you are just reacting to an emotionally charged stimulus that tells you to eat.

Once you recognize a cue for what it is you have a brief moment to decide not to take the bait. To successfully divert yourself to another course of action you must have a plan ready in advance that allows you to do something completely different.

Considering alternative activities and the reasons you might prefer them can help you tremendously at this point of decision. Rather than focusing on the positive emotions you will experience by giving in to your desire for hyperpalatable foods, also remember the negative emotions that follow if you give in and the positive aspects of the alternative action.

For instance, it may help to remember that every time you get cued and give in, you are strengthening the neural circuitry that compels you to this behavior in the first place. If you even briefly entertain the possibility of indulging, you create a state of ambivalence that leads to torment, obsession and cravings. However, when you successfully divert your attention to another rewarding activity you have made a small step toward cooling down the positive valence of the food.

It is the state of mental torment and ambivalence that increases the positive emotional charge of a food, building and strengthening the neural reward circuitry that causes conditioned overeating. This may be one of the reasons dieting almost always results in long-term weight gain, since constant deprivation makes hyperpalatable foods more difficult to resist and creates severe anxiety.

Mentally, the best strategy to overcome conditioned hypereating is to develop new, positive associations with food that are independent of palatability–something you care more about than the fleeting reward of overeating. Kessler says this is a deeply personal process and must reflect an individual’s own set of values. For example, it helps some people to become vegetarian, while others value organics or local food. These decisions remove virtually all hyperpalatable food from the lives of people who choose these paths.

It also helps to develop aversions to hyperpalatable foods. Some may learn to demonize “Big Food,” while others turn away after educating themselves about health concerns. Developing a more sophisticated culinary palate can help make hyperpalatable foods less palatable. Kessler himself developed an aversion to over-sized portions, which he now sees as repulsive piles of sugar, fat and salt.

Developing positive associations with healthier foods while demonizing the hyperpalatable foods we have been conditioned to crave can fundamentally change your emotional response to stimulus cues. As you learn to recognize your brain’s response to cues, you can override conditioned behavior by consciously deciding to take alternative actions because you want to.

You will never win an internal battle with yourself. Instead use what you know about the brain’s reward system and give up trying to summon willpower to resolve the torment of conflicting desires. Reprogram your habits by closely examining your relationship with hyperpalatable food and begin making deliberate decisions that are consistent with your goals, breaking the cycle of conditioned overeating.

To read more about conditioned hypereating and habit reversal read The End of Overeating, by Dr. David Kessler.

Have you read The End of Overeating? Have you overcome conditioned hypereating?

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Vegetables

I don’t know about you guys, but I had a crazy weekend. In a very uncharacteristic move (I usually work weekends) I found myself at 5 different parties over a 3 day period. Four of these parties involved food.

I did my best to stick with my plan to eat healthy, and mostly I did, but the sheer volume and frequency of eating and drinking was a bit too much and by Sunday night I felt pretty gross.

It is natural to occasionally let your healthstyle slip, and there’s no need to get upset about it, but it is important to get it under control as quickly as possible. This is the essence of weight maintenance–something we all need to master if we want to stay healthy.

I never follow strict schedules or diets, but there are a few rules I keep in mind when I want to get my health and weight back into my comfort zone. These things work best for me, but please let us know what works best for you in the comments section.

10 Weight Loss Rules

1. Cook at home The most important thing for me when eating healthy is cooking for myself. Eating small portions of healthy food is nearly impossible at restaurants. Every breakfast, lunch and dinner this week will be made from scratch from the beautiful veggies and fruit I got at the farmers market on Saturday.
2. Small portions I will be cooking and serving myself smaller portions of food this week, approximately 80% of the volume I would normally eat. I will cut down on everything in general, but most of the calorie reduction will come from starchy carbohydrates and protein. Basically, vegetables (and the olive oil I cook them in) are the only foods I will not restrict.
3. No dessert I didn’t mention cutting out sugar in point #2 because I don’t consider sugar a regular part of my diet. However, normally I allow myself to indulge in dessert for special occasions and other events. This week I will politely turn down any offers of extra calories.
4. No carbs Flour-based products, also not a staple of my diet, are off the table this week too. No bread at all in any form, no pasta, noodles, white rice, etc. I will still eat whole grains like my morning muesli and the occasional addition of brown rice or quinoa to salads and dinners, but these servings will be smaller than usual.
5. Less protein Many self-proclaimed fitness gurus will disagree with me on this one, but I find that my optimal protein intake for weight loss is not as high as you might think. I have nothing against protein as a weight loss tool (especially when greater weight loss is necessary), but protein adds a lot of calories to your diet compared to vegetables. So really this rule is more about portion control than protein itself. For the next few days my protein will come from lentils, nuts, whole grains and fish. Servings will be about 3 oz. I will still be careful to get enough protein and fat in each meal so I don’t increase my appetite.
6. No alcohol Alcohol can be healthy, but it can also impair your judgment about what and when to eat. It also has quite a few extra calories and can create hormone imbalances when consumed regularly. I’m going to skip the wine with dinner, at least until Friday.
7. Daily workouts I always try to work out every weekday, but excuses come easier on some days than others. No excuses this week: weights and cardio Monday through Friday. I may even try to work in a hike or some other physical activities next weekend.
8. Stay hydrated People will argue about how much or how little water is really necessary, but none of this changes the fact that water makes me feel better. Water helps me control my appetite, feel more awake and have better workouts. I always carry around my CamelBak, but this week I will try to fill it up a little more often.
9. Enough sleep For me, the hardest healthy habit to maintain is getting enough sleep. I usually stay up too late and get up early, but this can really take its toll over time. For the next several days I will try to keep myself on something of a regular sleeping schedule.
10. Be good next weekend I have found one of the more futile activities is eating right and being healthy all week then completely throwing all self-restraint out the window on weekends. To really recover from a bad weekend, I need a full 7 days of self-control and good behavior. In essence this will translate into two good weeks, since the inertia from one healthy week can sustain me until the following weekend. The only real barrier is that first weekend, filled with parties and dinner invitations. It’s fine to go out with friends, but skip the fried mac and cheese and hold it together for just a few more days.

What are your favorite tips for getting your health back on track after a wild weekend?