The Yo-Yo Diet Returns Again (and Again)

Have you struggled with yo-yo dieting and weight-loss frustrations?  Are you concerned about your weight but are not sure what to do?

Millions of Americans share your struggle to shed the extra pounds gained so easily in the age of fast and processed food, supersized proportions, and sugar laden beverages.  We are a society that has uncovered the link between obesity and diabetes as a result of our prosperity and dietary indulgences.

Diets come and go and so does the weight.  Rapidly losing pounds through radical and unsustainable diets inevitably fails and often leads to a return to the same or higher weight.  In fact, over 90% of dieters regain lost weight within one year.

Experts have analyzed the situation and have lucid explanations for the yo-yo effect.  I’m going to give you my opinion built only on my own experience.

First, short-term extreme dieting can’t be sustained and therefore does not lead to a change in eating, sleeping and exercise habits.  The same behaviors that led to long-term weight gain return unless new patterns are formed.  In particular, the use of food to deal with stress or as the basis for social interactions is deeply rooted and difficult to modify unless done in a purposeful manner with long-term health in view.

Second, crash dieting often involves severe calorie restrictions which leads to a reduced base metabolic rate (BMR), according to recent studies.  In other words, your body automatically adapts to low calorie situations by using less energy.  As a result, after an initial diet induction phase, often associated with rapid weight-loss, progress is slow.  And, a return to former daily calorie intake may (I’m theorizing) lead to a greater energy imbalance resulting in rapid weight gain.  The equation for fat gain looks something like:  (calories stored as fat) = (consumed calories) – BMR – (calories used during activity).  So, reducuing your BMR increases the likelihood of future weight gain if old habits return.

Short-term dieting for the sole purpose of weight loss is one dimensional and does not necessarily have long-term health as its objective.  Weight or BMI may be associated with risk factors but these are not a comprehensive health metric.  Overall health should be in view which may actually preclude some weight-loss strategies.

Over the past year I have had success that was built on a change in eating habits, a reduction in processed and fast foods, the introduction of sustainable exercise programs and consideration of sleeping patterns.  I’m working on a post outlining the choices that were particularly helpful and some that were not… stay tuned.


Forever Fat?

I understand that maintaining a healthy weight following a successful weightless diet is difficult but this seems overly pessimistic:

Researchers claim that fat people, who lose weight either by dieting or exercising, will put it all back on again within a year.

The article does back off from the overarching generalization but claims that those of us who lose weight don’t have a chance to keep it off long term. Something tells me there is a great opportunity for a service industry to help dieters meet this daunting challenge. Anyone interested?

A Diet Soda Free Life

My Life without diet coke is still sweet

A few days ago a mentioned my one remaining nutritional vice. To be more accurate I should have said diet soda is/was my biggest vice. I’m now on day three w/out the aspartame laden beverage and not yet enjoying life w/out it.  However, I am noticing a number of positives:

First, I’m saving the cost of several diet cokes including expensive impulse purchases at the check-out counter.

Second, it may be my imagination, but I simply don’t seem to be as hungry through-out the day.

Third, although I’ve replaced diet drinks with water, I’m not nearly as thirsty.

There’s nothing scientific about what I’ve written – it’s my anecdotal experience that began when two credible studies were reported that pointed out unintended physiological consequences of drinking diet softdrinks (and other products using aspartame).

I’m not sure I will remain diet soda free for life but want to give my current lifestyle change a couple of weeks.

As always, thanks for reading.

Adding Alcohol Reduces Diabetes Risk

The age old question of alcohol consumption, diabetes, risk factors, insulin resistance and complications.  I personally enjoy a beer – once every couple of months – but don’t make alcohol part of my normal routine.  However, researchers have completed a massive study involving 38,000 men over a four years period and found that those increased their alcohol consumption had a lower incidence of Diabetes:

RESULTS A total of 1,905 cases of type 2 diabetes occurred during 428,497 person-years of follow-up. A 7.5 g/day (approximately half a glass) increase in alcohol consumption over 4 years was associated with lower diabetes risk among initial nondrinkers (multivariable hazard ratio [HR] 0.78; 95% CI: 0.60–1.00) and drinkers initially consuming <15 g/day (HR 0.89; 95% CI: 0.83–0.96), but not among men initially drinking ≥15 g/day (HR 0.99; 95% CI: 0.95–1.02; Pinteraction < 0.01). A similar pattern was observed for levels of total adiponectin and hemoglobin A1c, with a better metabolic profile among abstainers and light drinkers who modestly increased their alcohol intake, compared with men who either drank less or among men who were already moderate drinkers and increased their intake. Likewise, compared with stable light drinkers (0–4.9 g/day), light drinkers who increased their intake to moderate levels (5.0–29.9 g/day) had a significantly lower risk of type 2 diabetes (HR 0.75; 95% CI: 0.62–0.90).

CONCLUSIONS Increases in alcohol consumption over time were associated with lower risk of type 2 diabetes among initially rare and light drinkers. This lower risk was evident within a 4-year period following increased alcohol intake.

The results does seem consistent with what we’ve seen in the past with the exception that an increase rather than absolute consumption was studied. I don’t know that this should motivate a change in dietary habits for those who are undiagnosed or have pre-diabetes but it certainly will be used by some to justify their chosen lifestyle.


How to begin and enjoy an exercise program

Begin and enjoy and exercise programOver the past six months I’ve adopted an exercise routine that has helped me reach a few but very significant health related goals, not the least of which is weight loss.  This time around I’ve been more consistent and actually look forward to my (almost) daily workout.

Exercise doesn’t have to be drudgery to burn calories, improve cardiovascular health and stamina and provide a much need outlet for stress.

I’m not a fitness guru or a health provide but I do have a few tips that helped me:

  • Join a convenient health club close to home – this was a significant reason why I’ve been able to succeed.  In this demanding age of overtime and activity, convenience saves driving time and encourages greater consistency.
  • Starting out, avoid over-exertion – nothing kills an exercise program like soreness and exhaustion.  You may be enthusiastic and anxious to get in shape but be patient and take it easy (at first)
  • Design an exercise routine that is enjoyable – I picked the treadmill instead of a stair master for interval training and use free weights in preference to machines.  Returning to the gym is so important that I prioritized those activities that I preferred above some that came highly recommended.
  • Keep a journal of exercises, weights, distances, times, etc. which enables weekly progress to be seen - even though I was out of shape, seeing regular gains in strength and stamina were motivational.  Later, looking back over months, I’ve been able to see significant improvement which would not have been remembered to the same degree
  • Set realistic and practical goals – I decided not to dream of becoming an olympic pole vaulter but instead strive to burn fat, improve stamina and gain strength in specific ways.  My goals were not tied to how I look but rather were aimed at improving health, managing blood sugar (and stress) and gaining energy so that I could be there for my family.
  • During aerobic training, listening to book-on-tape or watching movies – the time simply slips away when I have something engaging to watch of listen to.
  • Take guilt-free time off when needed – when you’re tired don’t feel guilty about resting – you need it.

On days in which motivation has been low, I went anyway and come back feeling refreshed and more energetic then when I left.   Exercise is key to managing diabetes and good health in general – it improves both physical and mental performance.  Further, discipline now provides freedom and opportunity to engage more activities later.

My Top Reasons for Eating Breakfast – and why you should too

Late last year I had a rough visit with the doctor. Rough because he pointed out the blatant health risks in the bluntest of terms associated with my eating habits and resulting BMI. Needless to say, he made an impact and I changed, lost weight and have adopted a new lifestyle.

breakfast is esstentialAmong several modifications to my daily habits is a return to breakfast. My fast pace and stress filled lifestyle gave rise to the coffee-on-the-go morning meal which inevitably made me irritable and starved by noon.

Doc told me to eat a large breakfast and I’ve followed his advice.

Having thought, read and acted upon doc’s advice, I’d like to share with you my top reasons for eating breakfast:

  • Stops impulse binging and overeating as a result of hunger and craving – no more mid-morning hypo, fast food cravings. Instead I eat an equally healthy lunch
  • Enables normal metabolic rate and activity – the body needs fuel and when it doesn’t it begins to slow down calorie consumption. Breakfast gets the metabolism up and running and burning calories at a normal rate.
  • Maintains a normal insulin response — studies indicate that skipping meals leads to hyper insulin response when calories are later consumed, which in turn encourages fat accumulation
  • Provides energy when you first need it — I need energy first thing in the morning and am now able to hit the ground running
  • Gives clarity of thought – I’ve experienced a noticeable difference and an improvement in concentration and efficiency
  • Gives Essential nutrients — the nutrients that are bypassed by skipping breakfast are essential to good health
  • Lower cholesterol, which reduces the risk of heart disease as suggested by researchers
  • Satisfies hunger- I always said I’m not hungry in the morning – well, now that I’ve adopted healthy eating habits I am. No more late night snacking leads to a healthy appetite in the morning
  • Time for Morning Contemplation – taking time out first thing in the morning is enjoyable and provides an opportunity to think, pray and prepare for the rest of the day
  • Family time – breakfast has increase the time I spend with my family

As I mentioned above, this has made a big difference in my health and daily routing, not the least of which is weight loss.  I’ll detail some of my other changes in future posts but hope that this one will encourage my friends to consider breakfast as an essential to the start of each day.

Are you getting enough sleep? One-third of you are not

We’ve pointed to the health benefit of sufficient sleep in the past but our cultural trajectory appears to be heading in the opposite direction:

More than one-third of Americans routinely sleep fewer than seven hours a night, which affects their concentration and general health, new government research shows.

Insufficient sleep also impairs work performance and the ability to drive safely, found researchers for the U.S. Centers for Disease Control and Prevention (CDC), which published two sleep studies March 4 in its Morbidity and Mortality Weekly Report.

“Over the last 20 years there has been a decline in overall sleep duration in adults,” said lead author of one report, Lela McKnight-Eily, a clinical psychologist and epidemiologist at the CDC’s National Center for Chronic Disease Prevention.

Changing lifestyle habits, including longer workdays and late nights on the computer, have pared away much-needed sleep time, she noted. “Within our culture there seems to be a belief that sleep isn’t a part of overall essential health,” she said.

Some time ago I wrote this post:  Here’s what you can do to ensure you’re not among the one-in-three with bags under their eyes. Unfortunately I have the toughest time following my own advice.  There’s always a project I’m working on, whether for work or home, that keeps me going late at night.

Why do we continually hear that diabetes diagnoses and treatment are ineffective?

We continue to hear year after year that both diagnosis and treatment of diabetes is inadequaete.  For example:

Nearly 90 percent of U.S. adult diabetics — more than 16 million adults aged 35 and older — have ineffective treatment of blood sugar, blood pressure, and cholesterol. That percentage is 99 percent in Mexico, said the researchers at the Institute for Health Metrics and Evaluation at the University of Washington in Seattle.

Frankly, I don’t know why a problem that is this often researched, reported and editorialized is not acted upon in an effective manner.  Here are a few guesses regarding why our progress in this area has been slow:

  1. Diabetes is a challenging disease to identify because is exists in a continuum of states begining with insulin resistance and hyperinsulemia.
  2. Finding an alternate or suplimentary tool for diagnosis faces stiff resistance among the medical community if it is not fully vetted with a large, mult-center and internationally approved clinical study.  After all, “new” mean changing the practice of medicine which requires significant proof. 
  3. The cost of (2) may be an large impediment
  4. Our society tends to rely too heavily on doctors and/or medications to cure with a sliver bullet.  Effective treatment of diabetes requires change in one’s lifestyle, expectations and resource allocation.  The disease is not life threatening (generally) on a day-to-day basis which makes it difficult for many to “sacrifice” their present desires for the future.

These were off the top of my head … I’ll add more as I think of them.

Thanks for reading.

Weight Loss May Beat Intensive Insulin Therapy …

Weight-loss and major lifestyle changes may be more effective than intensive insulin therapy for overweight patients with poorly controlled, insulin-resistant type 2 diabetes, according to a diabetes researcher at UT Southwestern Medical Center.

[Read more...]

Get to Sleep – Here’s How

We’ve written for years about the correlation between diabetes, obesity and the lack of sleep. While some prioritize other activities above a good night’s rest, others simply have difficulty getting the 7-8 solid sleep that doctors recommend. Here’s a list of bedtime ideas from a variety of sources:

Sleep only when sleepy

Don’t oversleep or nap during the day.

Have a light snack before bed

Laugh a little. What a comedy, joke with a friend and drop your stress hormones.

Put your work in perspective and get a hobby. A joint study of 314 workers conducted by the University of South Australia and the University of Rotterdam found that workers with higher levels of active leisurely activities, such as exercise, hobbies, and social activity, were able not only to bounce back from workplace stress better than their always-on-the-job coworkers but also sleep significantly better than others.

Use sunlight to set your biological clock

Connect. Studies at UCLA reveal that women’s friendships and relationships with their children can block stress hormones.
Stay away from caffeine, nicotine and alcohol at least 4-6 hours before bed. (Nicotine is a stimulant)

Stretch and relaxation – Some people find that a gentle stretching routine for several minutes just before getting into bed helps induce sleep. Others practice relaxation techniques. Libraries or bookstores have books on developing stretching or relaxation routines.
Put yourself on a regular schedule, going to bed and getting up at the same time each day.
Forgive others and let go of the past.

Be realistic. Rather than worrying about what you want to do match your expectations with what can actually be done.

Create a pre-sleep ritual. Ideally, nights should be as relaxing as possible, but try telling this to a working mom who needs to get a million things done.
Wind down for the night at least 30 to 60 minutes before bed.

Exercise early in the day.

Avoid drinking large amounts of fluid late in the day. A full bladder doesn’t make for a good nights sleep.

Cut down on alcohol. Alcohol might help you get to sleep, but it results in shallow and disturbed sleep, abnormal dream periods, and frequent early morning awakening.

Check your iron level. Iron deficient women tend to have more problems sleeping, so if your blood is iron poor, a supplement might help your health and your ability to sleep.
Change your lifestyle expectations. According to a poll by the American Psychological Association, 4 of the top 10 stressors we experience are related to money. Do with less, be healthy and be happy.
A good sleep environment can help:

  • Make sure your bed is large enough, and comfortable. If you are disturbed by a restless bedmate, switch to a queen- or king-size bed. Test different types of mattresses. Try therapeutic shaped foam pillows that cradle your neck or extra pillows that help you sleep on your side. Get comfortable cotton sheets.
  • Make your bedroom primarily a place for sleeping. It is not a good idea to use your bed for paying bills, doing work, etc. Help your body recognize that this is a place for rest or intimacy.
  • Keep your bedroom peaceful and comfortable. Make sure your room is well ventilated and the temperature consistent. And try to keep it quiet. You could use a fan or a “white noise” machine to help block outside noises.
  • Hide your clock. A big, illuminated digital clock may cause you to focus on the time and make you feel stressed and anxious. Place your clock so you can’t see the time when you are in bed.

    Studies Confirm the Benefit of Sleep

    For years we’ve discussed the link between rest and diabetes management. Recent studies suggest that healthy young individuals become more insulin resistant following sleep disturbances:

    For the study, nine volunteers spent two or three nights at a sleep lab on two visits. On the shorter visit, they were allowed to sleep undisturbed. On the longer, whenever they went into slow-wave sleep, they heard sounds loud enough to interrupt the sleep stage but not wake them.
    Afterward, the volunteers were found to be less sensitive to the insulin the body produces to regulate sugar levels. And they did not produce more insulin to make up for it.
    People with weight problems often do not sleep well, the researchers said. The same is true for many people as they age. The findings suggest that if sleep can be improved, perhaps the risk of diabetes may be lowered.

    It is an interesting result and one that those with an ability to make a lifestyle choice should certainly consider.

    Get a Good Nights Rest

    We’ve pointed to the correlation between poor sleep patterns and the risk for developing diabetes. However, recent studies appear to be closer to pinpointing the mechanisms involved and provide further motivation for those with diabetes to prioritize their time in bed:

    Successive nights of disturbed sleep appear to put people at greater risk of developing type 2 diabetes, according to research in which scientists interfered with volunteers’ sleep patterns.
    The research is the first to show that disturbed sleep can affect the production of insulin, and consequently a person’s ability to metabolise glucose. It could have huge implications for understanding and tackling the diabetes epidemic that is predicted to grip western countries due to increasingly obese populations.
    According to the leading charity Diabetes UK, there are more than 2.3 million people with diabetes in the UK, and up to 750,000 more who have the condition but do not know it.
    Between 85% and 95% of diabetes cases are type 2, which typically develops later in life and is linked to obesity.

    Lifestyle better than drugs?

    Lifestyle methods may be just as effective as prescription drugs in preventing diabetes … a new study suggests that weight loss could be a better method than taking rosiglitazione to avoid type two diabetes.

    The Harmful Effects of Stress

    Stress can interfere with your ability to make insulin and process glucose and is reported by some to increase the risk of developing diabetes. It also seems that stress decreases the ability to manage diabetes:

    When you’re stressed, your blood sugar levels rise. Stress hormones like epinephrine and cortisol kick in since one of their major functions is to raise blood sugar to help boost energy when it’s needed most. Think of the fight-or-flight response. You can’t fight danger when your blood sugar is low, so it rises to help meet the challenge. Both physical and emotional stress can prompt an increase in these hormones, resulting in an increase in blood sugars.
    People who aren’t diabetic have compensatory mechanisms to keep blood sugar from swinging out of control. But in people with diabetes, those mechanisms are either lacking or blunted, so they can’t keep a lid on blood sugar

    Now scientists from Wake Forest University School of Medicine make say that findings from their study suggest that emotional stress may not only contribute to the development of cancer but may also reduce the effectiveness of cancer treatments.

    Fourteen Habits of the Overstressed and Unhappy

    Interested in increasing your risk for reduced immune function, cancer, cardiovascular diseases, and even flu? Not a problem, just keep yourself in a constant state of stress using these fourteen pointers (adapted from Hyscience and Psych Central):

    TAKE PLENTY OF STIMULANTS. Caffeine or nicotine induced hyperactivity is an excellent contributor to stress and coffee, cigarettes, energy drinks and soda will do the job just fine. I’m partial to mass quantities of diet coke.

    GET RID OF YOUR SOCIAL SUPPORT SYSTEM. – You don’t have time for friends anyway.

    PROCRASTINATE. You can take care of it later, at the last minute, with your boss standing over you and your job on the line.

    STAY UP LATE: Sleep is for wimps and those who have too much time on their hands. Besides, the best reruns are on between one and two a.m.

    WORRY ABOUT THINGS YOU CAN’T CONTROL – After all, a meteorite could hit you while you’re asleep or your bladder could explode (see diet coke comment above).

    NEVER EXERCISE. Exercise is tiring and wastes a lot of time that could be spent worrying.

    GUILT IT UP – You’ll never meet the expectations for everyone around you so you might as well spend your life stressed-out and guilt ridden.

    NEVER LAUGH – This is another activity of the well balanced which should be avoided by the truly stressed out.

    PERSONALIZE ALL CRITICISM. Anyone who doesn’t sing your accolades is obviously attacking you. Be offended, internalize and feed the stressful bitterness.

    ANGER MANAGEMENT – (Forget anger management)…. “Serenity now” is a phrase for those who want peace, calm and tranquility.

    TAKE YOUR WORK HOME – Really, 10 hours at the job is inadequate for the high salary you’re paid.

    SPEND MORE MONEY THAN YOU MAKE – There’s nothing like being called by creditors when you have no money in the bank.

    BECOME A PERFECTIONIST. You’re not one already? Perfectionism will contribute to your anxiety level, enabling you to reach a new stress plateau.

    WATCH 24 – Ok, this might not contribute to long-term stress but I needed on more and watching Jack Bauer fight terrorism is raised my blood pressure beyond legal limits.

    If, on the other hand, you value your health, happiness and sanity, do the opposite and take a look at the pointers published by Richard.
    Did we miss a few of your favorite stressful activities? You can add them below.

    Correlations Between Blood Sugar and Cancer – an informal discussion

    There are often diet and lifestyle similarities in groups or subgroups of individuals who develop disease. For example, researchers for some time of pointed out the correlation between the consumption of diet soda and obesity and have examined the link between the consumption of fatty foods and increased breast cancer risk.
    However, the correlations themselves do not provide evidence of causality and may or may not be a real contributor to the increased incidence of disease. Through time there have been myriads of investigations, often based upon a prospective analysis of an existing database, which identify a potential relationship between a particular factor and a specific condition or disease. Although scientists are generally upfront regarding the limitations of their findings, media reports often fail to explain that a particular link is not necessarily indicative of a cause and effect relationship.
    The many unobserved variables can lead investigators to identify fortuitous correlations between multiple factors and effects which are the product of something that is unknown or simply not considered. Despite considerable research, the cause of chronic fatigue syndrome remains unknown. However, correlations exist between the malady, viral infections, psychological stress and other immune disorders. Yet, no evidence exists which identifies any of these as causal.

    [Read more...]

    Exercise is good for your memory too

    Most individuals with Type 2 Diabetes are told by their doctors to eat right and exercise. Exercise, in particular, is thought to help enhance the body’s ability to regulate blood glucose by enhancing the one’s sensitivity to insulin.
    For similar reasons, exercise reduces the risk of developing diabetes and is an effective means for fighting obesity.
    There is an added benefit. Researchers have now shown that exercise enhances age related memory. It initiates the growth of new brain cells in a region called the dentate gyrus, a part of the hippocampus that is known to be affected in the age-related memory decline that begins around age 30 for most humans.

    stay-at-home moms are most likely to sleep poorly

    Working mothers juggling kids and a job have the most serious episodes of insomnia, while stay-at-home moms are most likely to sleep poorly, according to the National Sleep Foundation‘s 2007 Sleep in America Poll (pdf).
    In addition, the poll found that women who sleep less than sevn hours a day are significantly more likely to:

    • Report having a good night’s sleep only a few nights a month or less (45% vs. 21%, 30%);
    • Be working full time or more than one job (83% vs. 73%, 64%);
    • Drive drowsy at least once a month (39% vs. 25%, 17%);
    • Consume more caffeine each day (3.30 cups/cans vs. 2.39, 2.14); and
    • Experience any symptom of insomnia at least a few nights a week (78% vs. 63%, 64%).

    Beyond a decreased quality of life, we’re concerned about the increased risk in diabetes due to poor sleep and in particular, sleep apnea.

    [Read more...]