Monday, August 4, 2014

Previously posted on Diet.com, Dr. Abby bashes "The Bead Diet"

Have you heard of “The Bead Diet?” According to their website, www.accuweight.com, people lose 15 pounds a month, with most people losing more.




This three part program includes applying pressure to tiny beads behind the ear (acupressure), performing “Chi Gong Breathing,” and a crazy food plan.



Acupressure is designed to trick the body into feeling full, by creating balance through the hypothalamus. This part of the brain governs fullness and the amount of food eaten.



“Chi Gong Breathing” is supposed to harness the life force, “chi,” to improve health and longevity, and increase feelings of peace and harmony. They also claim that it enhances energy levels, attention, concentration, and mental alertness.



Next comes the food. There is no specific information on the site, but I’ve been told that for two days you eat milk products, and for two days fruits and veggies. The site promotes lots of artificial sweetener.




The nutritional balance of the food, along with acupressure, supposedly tricks the body to ignore the reduction of calories. This prevents starvation mode. The body uses stored fat for energy, resulting in weight loss and amazing medical results. If you exercise and feel faint, they suggest a bit of honey in water, and a sugar-free electrolyte drink if necessary.



They encourage eating between noon and 6PM because the body needs nutrition during those hours. Eating outside those hours might cause the body “to cannibalize itself using not only fat, but muscle, organ mass and negatively affect your metabolism.” YOWZA!



Finally, after losing all the weight you want, they promise maintenance within 3-5 pounds of goal, apparently your new set point.



Does this sound too good to be true? Even if everything goes according to plan, the claim of maintaining that level of success sounds preposterous. It would be more believable if they provided some decent research confirming this. After all, they have been operating for 11+ years, yet there is not a single follow-up study on their website.



The only study cited followed 16 subjects on the plan for 13 weeks. They lost an average of 46 pounds. Since when is sixteen subjects considered strong science, especially without any follow-up???



We all know that most people can lose weight on any fad diet, but few people can keep it off without developing an eating disorder; ie. preoccupation with food and weight. I believe the two part system of dieting to lose weight, and then trying to maintain the loss, is what has failed. There needs to be one way of living, which strives towards health and fitness.
Dessert for Breakfast!


Here’s a headline to celebrate: “Dessert at Breakfast May Help Dieters!” I wanted to toast to it, with cookies instead of toast!


I hungrily continued reading about this extraordinary study. Researchers divided 144 obese subjects, into a low carb breakfast group (LC), and a high carb plus protein-and-dessert breakfast group (D). Dessert eaters could choose from cookies, chocolate, cake or ice cream. Daily calories remained the same for both groups, but the LC breakfast contained 300 calories, while the D group enjoyed 600 calories for breakfast. Everyone ate the same lunch, but dinner consisted of 600 calories for the LC’s and 300 calories for the D’s.


At the end of 16 weeks, both groups lost about 32 pounds. However, after another 16 weeks, the dessert group lost an additional 13 pounds, while the others regained all but 3.5 pounds! Isn’t this the best news ever?


Here’s the science: Those on the dessert regimen maintained lower levels of ghrelin, which is the hormone responsible for hunger. As a result, they reported being more satisfied, with significantly reduced hunger and cravings than the LC breakfast group. The LC breakfast group experienced increased cravings for sweets, fats, carbohydrates/starches and fast foods!


But here’s the piece de resistance...


Both groups had similar insulin and glucose levels before the study, and both groups improved at week 16. However, by the end of follow-up, the dessert group enjoyed even better levels, while levels became much worse for the LC breakfast group!


The same thing happened with cholesterol and triglycerides. Both groups were similar, but by the end, total cholesterol, triglycerides and LDL (bad cholesterol) were significantly lower for the dessert-eaters, than the low carb breakfast group! In fact, the good cholesterol (HDL) was significantly higher! Yahooooo!!!!!!!!!!!


It looks like dessert-eaters were so satisfied at breakfast that they were able to continue their diet into the end zone. The joy of eating dessert at breakfast, combined with reduced ghrelin, is a winning combination that can probably be sustained forever. Would you complain if I prescribed that for you? The low carbers could not continue adhering to their regimen, and regained most of their weight.


I have often suggested that my patients eat treats for breakfast, such as a whole grain waffle, with natural ice cream, and a drizzle of chocolate syrup. Those who comply, never binge on ice cream later. It seems better to have preferred foods when there is more control, such as in the morning, which seems to get it out of their system.


Having treats for breakfast also eliminates the “forbidden food” syndrome, by lowering its reward value. If you know you can have cake for breakfast, there is less desire for it at other times. We call it “prescribing the symptom.”


Bottom Line: Eating a high carbohydrate, high protein breakfast including dessert, can help people to maintain a healthy weight management plan.

JAMA Reseach Breakthrough: Fat Helps Diabetes!

As previously posted on Diet.com!


The Journal of the American Medical Association reported that normal weight diabetics were twice as likely to die than overweight or obese diabetics! These findings involved over 2,500 diabetic patients in long term studies.
diabetes
View THE NEW YORK TIMES article here!

As surprising as this sounds, the same effect has been previously documented in people with heart failure, hypertension and kidney disease.

Why is this surprising? Because we are constantly bombarded with messages proclaiming that thin is healthy and fat is disgusting. These messages come from industries making billions by training us to believe this. Scientists simply can't compete with their huge advertising and marketing budgets. Research makes headlines for a day and gets buried, while scientists quietly go about their work.

The "obesity paradox" is a term suggesting that people with certain chronic diseases tend to have lower mortality rates if they carry excess pounds. How much more evidence do we need, before we call it a blessing?

Researchers at Dallas' Cooper Institute studied 22,000 men for 8 years. They found that men who were overweight but fit were two times less likely to have died than those who were lean but unfit.

The Harvard Nurses' Health Study found that physically active people had lower death rates, regardless of weight, than thin people who exercised less than an hour per week.

Even our own government studies (NHANES) confirm that overweight people tend to outlive thin people.

How about we toss out the scale, and strive to live a healthy lifestyle? Eat more natural foods, listen to hunger and satiation, move your body and cope effectively. That's about the best we can do.

Monday, October 21, 2013

Dairy Kills Anti-oxidants!

Previously posted on Diet.com!

Here’s a news flash: Dairy Kills Anti-oxidants!!!

I’ve been hot on the trail of this research in pursuit of healthy living, as opposed to “dieting.” We’ve all heard that dark chocolate is healthier than milk chocolate, and now I know why. It appears that milk interferes with absorption of anti-oxidants, and animal protein is the culprit.

Do you put milk in your coffee? If so, you just annihilated coffee’s antioxidants. Same goes for green tea. And believe it or not, those highly nutritious blueberries tossed into morning cereal with milk, were just rendered impotent.
This is important information for anyone trying to live healthfully, since antioxidants are powerful molecules that can ward off cancer and disease. Rendering them ineffective is most unfortunate.

Switching the focus from dieting to healthful living has been an enlightening journey for me, and one that has helped many of my patients to improve risk factors and body image issues, regardless if weight is lost. For instance, when people diligently exercise, but don’t lose weight, they can become discouraged and stop. But benefits of exercise are often found by developing strength and endurance, while potentially improving blood pressure, cholesterol and insulin resistance, even if the scale doesn’t move. Sometimes a few pounds may even be gained, since muscle weighs more than fat, but the benefits remain.

Increased awareness of high anti-oxidant foods, which boost our immunity and health, has finally entered our awareness. Yet, the fact that yogurt disables the fruit mixed into it was news to me. I even did a video advocating natural ice cream with a drizzle of dark chocolate syrup, without knowing that the ice cream disabled the dark chocolate syrup! Who knew that strawberries with real whipped cream are no longer such a healthy choice?

The good news is that dark chocolate syrup seems to retain its powerful nutrition when mixed with almond, coconut, or soy milk, since there is no animal protein interfering with absorption. Strawberries dipped into dark chocolate are also high on the good list. A little knowledge can go a long way, to maximize health.

Monday, July 1, 2013

Obesity Should NOT Be Classified as a Disease!

As seen on Diet.com!

The American Medical Association recently designated obesity as a disease, and in doing so, has created a terrible disservice, and potentially damaging situation.  Why bother striving to live a healthy lifestyle, when you can just take a pill for temporary weight loss, which typically results in weight gain? 

Onto the next solution, as medical, surgical, and hokey diet businesses thrive, at our expense.  There is not a single remedy available that seems to keep weight from returning, in the vast majority of people. 

Go ahead, eat like a pig, and never move your butt! They’ll just gut your guts, and you’ll be fine.  (Except for awful side effects, and often dismal long term results). “On sale now, and paid for by your insurance company,” (since there is finally a formal diagnosis.)  Oops, time for a raise in rates!

The AMA went against the recommendations of its own Council!  The Council stated that obesity should not be classified as a disease, since the primary diagnostic measurement, BMI, is flawed!  And seriously flawed, at that.  It does not consider whether body mass is fat or muscle, or whether you eat healthfully, or ever put on a pair of sneakers!

Could there be any advantages, for anyone who doesn’t stand to make money off this?  Can it possibly make us healthier? 

Only if they come up with a magic bullet, because treatments now have incredibly high relapse rates.
Only if they solve poverty quickly, because the greatest concentration of obesity is in those areas. 

Should we pay for them to be on meds or have surgery?  What if most of the population is classified as overweight or obese?  Should everyone be on meds forever???

It’s crazy talk. 

Here’s the truth.  People come in small, medium and large, and we should all simply strive to become our personal best.  The other day, I was on the beach, and about 5 adolescent girls in bikinis passed by.  One said to another, “You don’t have to exercise, you’re naturally thin!”

Is this the message we should be teaching our children?  It’s absurd.  Exercise is healthy for everyone, just as partially hydrogenated oils are toxic for all.  And by the way, I have no idea who said it to who.  They all looked thin to me!

If there’s a silver lining to all of this, fat people might finally receive a bit more sympathy from others.  If they are “ill,” and it’s not “their fault,” there is a more sympathetic tone.  What a refreshing change, from suggestions that “they are weak-willed, lazy, and disgusting.”  Perhaps this will diminish discrimination against people of size, and engender pity, instead of disgust and shame.  How exciting….

Society would be much better served if we simply protected larger peoples’ feelings by accepting that diversity is good in a species.  We must recognize that everyone should strive to be healthy, equally, regardless of size.  There are different advantages and disadvantages to being small, medium or large.

What if North Korea decided to nuke us and our food supply was contaminated?  Who would survive until the next harvest?

Let’s face it; it’s survival of the fattest!

Diagnosis be damned.

Monday, April 15, 2013

Shame on You, Dr. Oz!


Previously posted on Diet.com!

Once again I must take issue with you.
But I digress.

Has anyone ever heard of Garcinia cambogia?  It’s Oz’s newest darling. He was gushing over this stuff, calling it the “holy grail of weight loss!” 
Well, of course I was excited to drink the Koolaid too, but first I hungrily googled the heck out of it… which I wondered if Dr. Oz had done.
If so, he might have mentioned the study in the Journal of the American Medical Association, a twelve-week randomized, double-blind, placebo-controlled trial. “Garcinia cambogia failed to produce significant weight loss and fat mass loss beyond that observed with placebo.”

Oops!  Faux pas!!!

In fact, this study was actually criticized for using a high-fiber diet, which is thought to impair its absorption.  Criticized?  A high fiber diet is basically fruits, vegetables and whole grains.  Too bad eating healthfully is contra-indicated for this panacea.

The NYU Medical Center newsletter succinctly reviewed an eight week study of 60 overweight individuals finding some weight loss.  Another trial found no effect on appetite.  One more study tested to see if it could cause weight loss by altering metabolism, but no effects on metabolism were found.

Taken together, I’d say this is all very underwhelming.  Furthermore, I would toss the lot of them down the drain, because none have any long term follow-up.  Everyone knows that most people gain back lost weight, regardless of how it’s lost!  How dare he sing such glaring praises, before any credible evidence is in!

I could see why Dr. Oz might be giddy about it, before results are conclusive.  This natural extract supposedly boosts serotonin, which helps with mood, and might conceivably reduce emotional eating.  Furthermore, it supposedly inhibits an enzyme from turning sugar into fat, and instead encourages the liver to turn it into energy and lean muscle mass, instead of fat.

So what happens after people go off this?  Don’t know; there isn’t any research.  But there is a body of work to suggest that the body may overcompensate, such as losing weight on amphetamines, and then rebounding when going off.

I believe the two part system, of trying to lose weight and then trying to maintain that loss, has failed most people, regardless of how weight was lost.  We need one way of living healthfully forever. 

A healthy lifestyle includes a variety of natural foods, listening to hunger and satiety, coping effectively, and moving your body.  Genetics account for the rest, including actual weight.  The scale will reflect that ideal combination of heredity and lifestyle; nature and nurture.  Some people will be heavier, and some will be thinner, which is OK.  Diversity is natural, and desirable.

If someone was restricting food before moving towards a healthy lifestyle, they will gain weight.  If they were overeating and not moving their body, their weight will naturally move towards a healthier point in their set point range.  Weight fluctuation is a byproduct of living a healthy lifestyle, and not a valid goal or indicator in itself.

Let’s finally get off the scale, and focus more on health.

Monday, January 14, 2013

“Obesity Crisis; Real or Imagined?”

As seen on DIET.com!
Being overweight (BMI  25–29)) was associated with LOWER mortality than “normal” weight, in an analysis of nearly 100 studies! This impressive review, published in a prestigious medical journal, included nearly 3 million people from around the world. Lower mortality rates were also found for “grade one obesity” (BMI 30-35), compared to normal weight people (BMI 18.5-24). 

Happy New Year to me!  I’ve been talking about this phenomenon for ages, based on many individual population studies.  But this is the mother of all studies!

So what do we do now?  Encourage people to gain weight instead of lose weight?  Should government subsidies provide cheaper, low quality, potentially toxic foods to fatten us up?  Should pharmaceutical industries create drugs that coax weight gain instead of weight loss?  Should surgeons be sued for weight loss surgeries that mutilate digestive systems, before having adequate evidence of creating long-term health?  These ideas sound may sound absurd, but no more absurd as the opposite.

My message has not changed.  People naturally come in all sizes, and everyone must strive to live a healthy lifestyle.  Every overweight person will not live longer; these studies simply reflect trends.  There are probably evolutionary advantages to all sizes, which ought not be messed with.  Super -obese people may live  longest if our food supply dried up, but may die off a bit sooner if not needed for survival.  Don’t they deserve respect for this important role?

So how can we reduce stigma, bias and discrimination against people of size, while helping everyone to become healthy?  First of all, stop beating yourself up for feeling fat!  It is abusive, demeaning, degrading, and counter-productive.  It is exactly the same as if you called other people those ugly names.  Offer yourself the same respect you would offer friends or strangers.

 Next, our government should eliminate ” ideal weights” and “BMI’s.”  Assess health according to lifestyles, biological markers, (blood pressure, cholesterol and insulin resistance), and perhaps some physical measures of strength and endurance.  

 Exercise often improves all of these indicators, for people of all sizes!

Nuts, avocados, dark chocolate, fruits, whole grains and salmon are healthier than partially hydrogenated oils, processed foods, and chemicals for everyone.  Responding appropriately to hunger and satiation might work better than portion control, and coping effectively is always a plus… regardless of pounds on a scale.

 Americans are living longer than ever, despite being fatter.  This doesn’t sound like a crisis to me!  In times of abundance, people maximize height, weight, and longevity, but we must realize the price for living longer.  Being mortal, we must die from something.  Deaths from cancer in the US are astronomically high, compared to cancer deaths in India, because they don’t live long enough in India for those cancers to develop!  It’s not because we’re fatter!

 So let’s stop the hysteria, and use the wonders of medical science to replace a knee, control diabetes and manage other maladies, without blaming fat people for being fat.  We don’t blame thin people for being thin, despite their higher death rate than overweight people!

 Genetics account for at least 60% to 80% of our weight, so let's do the best we can with what we have.