Dessert for Breakfast!

Originally posted @ Diet.com

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.

More blogging on Fit/Fat Times blog

For original postings, and to view more of the discussion, click here.

To Sharon X; post #115 - Sharon said: "Dr. Abby A. wrote: “BMI discriminates against women, since we are genetically programmed to store more fat in hips breasts and thighs, yet are held to the same BMI standards as men.” This statement is illogical because men almost always carry more lean muscle than women (testosterone vs. estrogen) at the same weight, so the man at 5Åå9Åç
and 180-lbs is automatically going to be leaner than a women at that height and weight. Muscle weighs more than fat."

Great Point, Sharon X! After thinking about it, it seemed that you were right, so I bounced it off a highly credible and influential researcher, Paul Ernsberger, Ph.D. He wrote back to say, " She’s right in so far as, for a given BMI, a woman will have a higher % body fat. This is only important if you believe that % body fat is important, which I do not."

I wrote back and said, "Paul, am I correct in assuming that even though a woman probably has a higher body fat at any given BMI, it's irrelevant because it has nothing to do with fitness, as measured by endurance and/or strength?"

He wrote back and said "yes." So I thank you again for making me think, and for helping us towards a greater understanding of these issues.

Responses To My NY Times Post

Here is a conversation that is posted on Tara Parker-Pope's NY Times "Well" blog. Click here for original posts:

To: Dr. Abramowitz (#91),
Excellent post.

Continuing the thread from one of Tara’s other columns (Maybe you have already commented upon this), how would you suggest physicians address weight loss issues with obese or mobidly obese individuals who are metabolically unhealthy? Would it be better for doctors to not focus on weight per se, but to discuss life style changes generally known to be associated with improved metabolic health; while offering verbal praise during future visits for any incremental improvements in target biomarkers?

— Posted by W

Here's my response: RE: W - #113 Regarding your question: "Would it be better for doctors to not focus on weight per se, but to discuss life style changes generally known to be associated with improved metabolic health; while offering verbal praise during future visits for any incremental improvements in target biomarkers?" YES, W - This sounds like the perfect answer! The word "weight" should no longer be mentioned, in my opinion, and the ritualistic weighing of the masses should be extinguished for good.

There are many factors for health and longevity that can be suggested, including physical activity (regardless if weight is lost), eliminating transfats, listening to bodily signals of hunger and satiation, and drinking green tea or red wine. (The latter can be easily incorporated as tinctures or capsules; I put a few drops of green tea concentrate in my juice, and take a resveretrol capsule - all the benefits with minimal effort!)

Doctors must educate themselves about how to be fit at any size. They should ask patients questions about lifestyle, instead of assuming that overweight people are sloths. Gathering information about previous weight loss attempts and weight regain might be enlightening, as many overweight have tried numerous weight loss plans, which inevitably plan. It would be nice if doctors offered compassion and understanding for the struggles that fat people have endured when trying to follow damaging diets and discrimination from others. Overall, research has found that dieting leaves people fatter than those who have never dieted!

Here's another response:

108.
August 20th,
2008
11:46 am


Dr. Aronowitz, #91–
Thank you–I always enjoy your postings to this blog. I have a question about set-points, though.

Why is it that for many “yo-yo” dieters, our set-point seems to *rise* with each regain of weight after a substantial weight loss?

I am a 54 year old woman. Over the past nearly 4 decades, I have lost a total of well over 200 pounds and regained more like 280. Each time I’d lose between 40 to 60 pounds on a carefully-followed diet (Weight Watchers, 4 different times, and others as well); and then within 5 years I would have gained it all back PLUS about another 10 to 15 pounds.

The upshot is that I am now about 60 pounds heavier than my “setpoint” was when I was 18. I suspect that repeated weight loss and regain somehow nudges the setpoint ever higher and higher, but I wonder if you have any thoughts on that point. Thanks.
— Posted by me
_

My Response:

RE: #91. Thanks, ME! Regarding your concern, "I suspect that repeated weight loss and regain somehow nudges the setpoint ever higher and higher, but wonder if you have any thoughts on that point." YES! I believe that each time weight is lost and regained, the body's survival mode kicks in by making more "efficient" use of the calories it's given. This means storing more of them as fat, to ensure enough stored energy to use for the next famine. The body can't distinguish between self-imposed semi-starvation (i.e. a "diet") and a nuclear holocaust where food supplies are tainted, and we can't eat until the next harvest. I have watched hundreds of patients diet and regain weight, and believe that it takes a lot fewer calories to regain the lost weight than would be expected.

General knowledge states that a simple formula - calories in vs. calories burned results in a certain weight. However, our genetic blueprints vary tremendously in how our bodies use calories. Did you ever have a skinny friend who can eat all the crap in the world and still stay thin, while others practically gain weight with the smell of baked goods? There are so many factors operating, and we must treat our bodies as a miracle of nature - by taking pretty good care of it and being grateful for letting us experience pleasures on earth.

Fit And Fat?

This post was originally posted on Tara Parker-Pope's wonderful blog entitled "Better To Be Fat and Fit Than Skinny and Unfit. Click here for original post.

There are thousands of genes responsible for creating our individual "set points." Set point is a range, which can be influenced to some degree by lifestyle. For instance, someone who is supposed to weight around 150, may weight 120 or 180, depending on feeding and activity levels, but it seems impossible that they could ever weight 400 lbs, since the body speeds or slows metabolism to maintain homeostasis. Similarly, someone who is programmed to weigh around 400 lbs might weigh somewhat more or less, but could never weigh 150lbs, without gutting their guts...and even then, it seems highly unlikely.

The Weight Control Registry documents people who have lost significant amounts of weight and kept it off, but we know that they are a minority of the population, since most people regain lost weight. What we don't know is how many people develop an eating disorder in order maintain the loss.

As a psychologist specializing in weight management, I could tell if someone has an eating disorder by the extent to which they are preoccupied with food, exercise, weight and body image. To maintain a severe weight loss, people generally must live in a state of semi-starvation. A primary psychological symptom of starvation is preoccupation with food. This is for survival, much like if you can't get enough water, all you can think about is finding water, or when sleep deprived, the drive to sleep trumps all else. The NY Times once did a video montage of Mike Huckabee's constant references to food on the campaign trail.

Statistically speaking, a normally distributed bell curve dictates that 68% of people are "average," 14% are somewhat more or less, and 3% are extreme. This holds true for things like height, weight and IQ. BMI arbitrarily splits up the average range, by separating "normal" from "overweight" without any statistical integrity. If someone falls into the 70th percentile for height, do we call them "overheight?" Furthermore, BMI is not a measure of fitness; we would do better to routinely consider measures of endurance and strength.

BMI discriminates against women, since we are genetically programmed to store more fat in hips breasts and thighs, yet are held to the same BMI standards as men.

In this time of cultural abundance, the bell curve has shifted slightly to the right, with obese people becoming more obese … since their genes direct their bodies to store fat in times of abundance. This has been the most significant group of gainers. Perhaps this is for survival of the species, since they could live off their fat longer, if there was a famine. This perspective might offer newfound respect for body size diversity.

On average, most Americans have gained approximately 20 pounds in 20 years, which is a pound a year, or 10 calories per day....which is not even measurable. One explanation is our aging population, since some gain is normal. Another explanation is the increased availability of food and health care, which means that we are maximizing genetic potential for height, weight, and even IQ. Nobody talks about the corresponding increase in HEIGHT, which is a fact as much as the increase in weight.

In fact, a very influential cancer study earlier this year found that weight was the #1 correlate for many cancers; alcohol was the 2nd, and the 3rd was height! Media never espoused that taller people had more cancer - perhaps because on the surface, it seems absurd. However, a chart of international ages of deaths revealed that Americans were among the longest living people, while Indians had much shorter life expectancies. Indians also had lower BMI's, so what was happening is that better nourished countries produced people who were taller and heavier, and lived long enough for cancer to develop. Indians never lived long enough for slow growing deadly cancers to develop!

There's plenty of solid research suggesting that fitness is more important than weight, but stigmatizing overweight people offers permission to discriminate. It also fuels the 40 billion dollar diet industry, by making us hate ourselves, and then selling faulty remedies which fuel yo-yo dieting, which may negatively impact cardiac fitness, insulin sensitivity, blood pressure, and self esteem, while making us fatter to protect against the next self-induced famine.