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.

You’ll be interested to know …

Kids and adults who eat candy tend to be …. thinner?  How can that be?

The American diet – not good.  But, as it turns out, American’s are not having a problem with portion control.  Instead, we’re eating too many portions (snacks).

Coffee, known for great health benefits, protects the brain from Alzheimer’s

Diet soda – not good for dieters (or anyone else)

Recent studies confirm that it is probably best to say no to the “potato” and that that the french fry is worse than the cigarette.

Adult stem cells appear to show the most promise for diabetes treatment

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

Diet Soda’s Unintended Deleterious Effect?


In the every evolving world of medical research, reports that diet soda is linked to weight gain and increased fasting glucose level have periodically been reported. At the same time, contradictory articles suggest that as an alternative to sugar laden (fully leaded) soda, diet soft drinks have an advantage.

One of the reasons this topic interests me is that diet soda remains one of the few vices left in my daily nutritional regimen. Out of the picture are fast foods, deserts, simple carbs, chips, potato/French fries and alcohol. However, I partake in diet cola through-out the day.

New research is being reported at the 2011 American Diabetes Association’s Scientific Sessions by epidemiologists from the School of Medicine at The University of Texas Health Science Center San Antonio that suggests diet soda is no friend to those pre-disposed to Type 2 Diabetes:

In the constant battle to lose inches or at least stay the same, we reach for the diet soda. Two studies presented Saturday [June 25] at the American Diabetes Association’s Scientific Sessions suggest this might be self-defeating behavior.

Epidemiologists from the School of Medicine at The University of Texas Health Science Center San Antonio reported data showing that diet soft drink consumption is associated with increased waist circumference in humans, and a second study that found aspartame raised fasting glucose (blood sugar) in diabetes-prone mice.

To their statistically based results, the authors added comment and drama:

“Data from this and other prospective studies suggest that the promotion of diet sodas and artificial sweeteners as healthy alternatives may be ill-advised,” said Helen P. Hazuda, Ph.D., professor and chief of the Division of Clinical Epidemiology in the School of Medicine. “They may be free of calories but not of consequences.”

Here are the details

Human study: The San Antonio Longitudinal Study of Aging

To examine the relationship between diet soft drink consumption and long-term change in waist circumference, the Health Science Center team assessed data from 474 participants in the San Antonio Longitudinal Study of Aging, or SALSA. This is a large, population-based study of the disablement process in elderly Mexican Americans and European Americans. Dr. Hazuda, senior author of the presentation, is SALSA’s principal investigator and has led the study for two decades.

Measures of height, weight, waist circumference and diet soda intake were recorded at SALSA enrollment and at three follow-up exams that took place over the next decade. The average follow-up time was 9.5 years. The researchers compared long-term change in waist circumference for diet soda users versus non-users in all follow-up periods. The results were adjusted for waist circumference, diabetes status, leisure-time physical activity level, neighborhood of residence, age and smoking status at the beginning of each interval, as well as sex, ethnicity and years of education.

Diet soft drink users, as a group, experienced 70 percent greater increases in waist circumference compared with non-users. Frequent users, who said they consumed two or more diet sodas a day, experienced waist circumference increases that were 500 percent greater than those of non-users.

Abdominal fat is a major risk factor for diabetes, cardiovascular disease, cancer and other chronic conditions. “These results suggest that, amidst the national drive to reduce consumption of sugar-sweetened drinks, policies that would promote the consumption of diet soft drinks may have unintended deleterious effects,” the authors wrote.

Co-authors include Sharon P. Fowler, M.P.H., faculty associate, and Ken Williams, M.S., P.Stat., adjunct assistant professor and biostatistician, in the Division of Clinical Epidemiology.

Mouse study: Aspartame consumption in diabetes-prone mice

In the related project, Ganesh Halade, Ph.D., Gabriel Fernandes, Ph.D., the senior author and professor of rheumatology and clinical immunology, and Fowler studied the relationship between oral exposure to aspartame and fasting glucose and insulin levels in 40 diabetes-prone mice. Aspartame is an artificial sweetener widely used in diet sodas and other products.

One group of the mice ate chow to which both aspartame and corn oil were added; the other group ate chow with the corn oil added but not the aspartame. After three months on this high-fat diet, the mice in the aspartame group showed elevated fasting glucose levels but equal or diminished insulin levels, consistent with early declines in pancreatic beta-cell function. The difference in insulin levels between the groups was not statistically significant. Beta cells make insulin, the hormone that lowers blood sugar after a meal. Imbalance ultimately leads to diabetes.

“These results suggest that heavy aspartame exposure might potentially directly contribute to increased blood glucose levels, and thus contribute to the associations observed between diet soda consumption and the risk of diabetes in humans,” Dr. Fernandes said.

These two translational research studies resulted from collaboration between Fowler and Drs. Hazuda and Fernandes and their research teams. The Institute for the Integration of Medicine and Science (IIMS) funded the work. IIMS is the Health Science Center entity that oversees the university’s Clinical and Translational Science Award (CTSA), a National Institutes of Health-funded program to encourage the rapid translation of scientific discoveries from the laboratory through the testing process and to practical application for the health of communities.

I’m not a medical expert in the field but wonder if (1) there are assumptions related to outcomes revealed by the following, “might potentially directly contribute” and “may have unintended deleterious effects”. In addition, the human study did not establish causality or an underlying mechanism which would conclusively reveal diet soda consumption causes weight gain (or waist circumference increase).

Never-the-less, it does seem clear that there is a strong relationship between obesity and diet soda and that there is an unintended physiological response associated with aspartame consumption that is both unintended and undesirable.

Now, will this lead to a change in your consumption of diet soda?

As for me, I’m going to eliminate the drink from my diet and report back to you the impact.


A “Cure” for Type 2 Diabetes

In case you haven’t already heard, researchers are now reporting that Type 2 Diabetes may (possibly) be reversed by a restricted low-calorie diet:

Adhering to the strict 600 calorie-a-day diet causes fat levels in the pancreas to plummet, restoring normal function, found Prof Roy Taylor of Newcastle University.

The discovery, a “radical change” in understanding of the condition, holds out the possibility that sufferers could cure themselves – if they have the willpower.

Until recently received medical wisdom was that Type 2 diabetes was largely irreversible.

But this small-scale study indicates that defeating it could be easier than commonly thought.

Prof Taylor asked 11 volunteers, all recently diagnosed, to go on what he admitted was an “extreme diet” of specially formulated drinks and non-starchy vegetables, for eight weeks.

Hyscience comments:

As the article goes on to point out, the trial study involved only 11 patients that ate a “meal-replacement” milkshake of 150 calories three times a day. This was supplemented with three portions of non-starchy vegetables including cabbage, broccoli, peppers, tomatoes, cucumber and lettuce. After one week, their pre-breakfast blood sugar levels had returned to normal and an MRI scan revealed that the fat levels in the pancreas were also normal, down from around eight per cent to six per cent.

Notes to self:

  • Great news – perhaps (I think)
  • “small-scale study” –  The smaller the study the less likely the results will be supported over time, esp. considering all of the potential influential factors.  Something like 33% of all reported major medical studies is contradicted within five years.
  • Radical change in management – pharma and device companies may need to revisit their strategic roadmap if this research is supported by larger scale studies


French Fry – worse than a cigarette?

I don’t think the comparison is entirely fair and perhaps a case of apples vs oranges but it is one that I’ve heard.  Regardless, french frys have got to be one of the most unhealthy sides in Western cuisine.  First, as a simple sugar, the potato is an icon of high glycemic index for those who maintain a lower carb diet.  The starch in potatoes is rapidly digested and hits the blood sugar about as fast as sugar (my experience).

So, take something akin to a piece of candy and deep fry it in grease and pour salt on top (and/or cheese) and you get the American french fry.  High carb, high fat and high sodium.

All that said, there are variants of fries that are better than others and many fast food restaurants have taken steps to reduce the amount of saturated fat while maintaining high standards regarding the purity of the cooking oil.  All the info you need is here.

Who has the worst eating habits?

When I think about bad eating habits the following immediately come to mind:

  1. Skipping Breakfast
  2. Fast Food and, in particular, supersizing
  3. Fried Food
  4. Soda
  5. Unbalanced emphasis on simply carbohydrates
  6. Snacking late at night, especially on sweets
  7. Lack of fruits and vegetables
  8. Eating to relieve stress
  9. Overeating

Poor eating habits often are influenced by one’s access to quality food, as suggested by USDA reports to congress.

In the U.S., this is really not an excuse for an unhealthy lifestyle but does mean we have to work a little harder to improve our health through the right nutritional choices.  Only a small percentage of Americans are actually constrained to the point that they cannot obtain healthy and nutritious food.

And, it is poor eating habits – our choices – that are leading to obesity and related health problems, such as Type 2 Diabetes, stroke, cancer and coronary artery disease.   The overall spending related to our choices is quoted in the $147 billion range.

The nutritional portion could be measured by the amount of soda, fast food and sweets consumed, which is exactly what a recent report did last month that lists the 10 states with the worst eating habits.

10. New Mexico

Amount Spent on Fast Food Per Capita: $737 (8th most)

Gallons of Soft Drinks Purchased Per Capita: 58 (12th least)

Pounds of Sweet Snacks Purchased Per Capita: 111 (13th least)

[Read more...]

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.


Artificial Sweeteners

I’m living a relatively sugar free life but that doesn’t mean I don’t get to enjoy sweet tasting food and beverages.  Why?  Artificial (intense) sweeteners.  The FDA has approved several including:

Aspartame - an artificial sweetner that is ubiquitous in American society, occuyping a place in most diet sodas, Crystal Light and a host of other foods. It is know as “NutraSweet”. Aspartame is 200 times sweeter than sugar and is synthesized rather than extracted. Despite controversies concerning its saftey (and some wild claims), aspartame is viewed by the FDA as one of the most thoroughly tested and studied food additives every approved.

Sucralose - an artificial sweetener that is not digested which makes it non-caloric. Incredibly, it is 600 times as sweet as sugar and, unlike aspartame, is suitable for baking (i.e., stable when heated). The most common brand name is Splenda although it is also marketed under the names SucraPlus, Candys and others.

Stevia - as natural extracted from a plant in the sunflower family, the sweetener has a slower onset and longer duration than sugar but may have an after taste. Interestingly, it was once banned in the United Staets and the European Commission are currently deciding whether to approve it. However, recent studies suggest no adverse effects and that stevia may improve insulin sensitivity.

Saccharin – found in Sweet ‘N Low was once thought to cause cancer until scientists discovered that the animal model (rats) was invalid. Warnings have been removed and the sweetener has found a resurgance of use.

My favorate is Granulated Spenda – I use it every morning on my multi-grain cereal (yum).


Coffee Drinkers be Encouraged

You may not know this about me but I love a good cup of coffee.  Fresh ground coffee beans, filtered water, perfect temperature … and I’m good to go first thing in the morning (with my whole grain cereal).   In the past, I often noted the health benefits of drinking coffee despite the seemingly negative view many health conscious individuals seem to hold.

Well, here’s another benefit:

Women who have at least one cup of coffee — or even five cups — daily may be reducing their risk of stroke by as much as 25 percent, new Swedish research shows.

And women who don’t drink coffee at all may actually be increasing their risk for stroke, the researchers noted.

That seemed clear-cut to me although I’d like to the same research repeated on men (I volunteer as long as I’m not in the control group).   Clear cut, that is, until I read the next sentence:

However, the researchers added, these findings are preliminary and should not cause any change in coffee-drinking habits.

Another set of “preliminary” findings strikes again … never-the-less, I think this does bode for coffee consumers.

Eat Whole Grain – the glycemic index is back, again

low-glycemic index

Some things seem to be reported in never-ending cyclic patterns.  This might be one of them but I tend to think that it is actually the journalists interpretation that brings about the feeling of deja vu rather than the researcher’s investigation.

It’s not necessarily the amount of carbohydrates you consume as it is the type (or the glycemic load), so says a “new study” recently reported by Reuters after being published in the American Journal of Clinical Nutrition:

How many carbs you eat might be less important for your blood sugar than your food’s glycemic load, a measure that also takes into account how quickly you absorb those carbs.

That’s the conclusion of a new study of healthy adults, which questions the way people with type 1 diabetes determine how much insulin they should take before meals.

Well, measuring how fast carbohydrate is absorbed has been around for a long time and we’ve been avoiding simple carbohydrates in preference to whole grain cereals and complex carbs as long as I can remember.  Perhaps I’m missing something or the actual research was under-reported but there is a reason I’m eating the 7-grain cooked cereal in the image above rather than corn flakes – the difference in glycemic index!

Never-the-less, any study that can help educate us on the damaging impact of post-prandial variability has value and perhaps a read of the research as reported rather than interpreted will add additional insight.

[Read more...]

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.

Eat more salad!

It appears those green leafy vegetables may have some benefit in preventing Type 2 Diabetes:

Increasing the amount of green leafy vegetables in an individual’s diet could help to reduce the risk of type 2 diabetes. An increase of 1.15 servings a day was associated with a 14% decrease in incidence. The data did not show any significant relations between the consumption of fruits, vegetables, or fruit and vegetables combined on the incidence of diabetes. As there was significant heterogeneity between studies, however, we carried out a sensitivity analysis. This showed no significant interactions between the outcomes of variables examined, and thus could not identify differences that occurred between the studies.

Skipping breakfast takes its toll

It leads to weight gain:

University of Minnesota School of Public Health Project Eating Among Teens (EAT) researchers have found further evidence to support the importance of encouraging youth to eat breakfast regularly. Researchers examined the association between breakfast frequency and five-year body weight change in more than 2,200 adolescents, and the results indicate that daily breakfast eaters consumed a healthier diet and were more physically active than breakfast skippers during adolescence. Five years later, the daily breakfast eaters also tended to gain less weight and have lower body mass index levels an indicator of obesity risk compared with those who had skipped breakfast as adolescents.


Those Terrible Post Meal Highs

Did you know that the dreaded post meal peak in blood glucose can do more damage than a sustained rise in blood sugar? New research suggests:

A causal relationship between hyperglycaemia and oxidative stress leading to vasoconstriction (a narrowing of the blood vessels) and thus high blood pressure. Acute glycaemic variability appear to play particular important roles in this mechanism.

Conveniently, the research also pointed to the benefits of the emerging technology of Continuous glucose monitoring to help self monitoring people with diabetes keep track of this post meal peak.

Pistachios Help Reduce Stress

Yes, they’re high in fat and are exceptionally good to eat. However, that doesn’t disqualify pistachios from a healthy diet. A recent study at Penn State has confirmed that eating pistachios may trim down the body’s response to the stress of everyday life by reducing the body’s reactions to “stressors” (factors that speed up a reaction rate or keeps the reaction rate the same). – NewHopeBlog

The Soda Scandal

Go ahead, drink your sugar laden beverages and slam another 32 oz big gulp. However, you should be warned that recent studies have provided compelling evidence that consuming moderates amounts of soda doubles the risk for developing Type 2 diabetes. The results follow a prospective analysis of more than 91,000 women followed for 8 years and provides one of the “most striking” links between soft drinks and health outcomes, the investigators note in the American Journal of Public Health.
Now, we’ve recent read about a link between the consumption of diet soda and obesity. Yet, investigators associated with the current study concluded that when diet soda replaced regular soda in the analysis, there was no increased risk, “suggesting that the risk was specific to sugar-sweetened soft drinks.” The latter conclusion, in my opinion, is more believable.
The most scandalous result, however, is not that soda is bad for you (I think we all knew this already), but rather that industry funded research may be tainted:

Furthermore, there was a “remarkable difference” in results from industry-funded and non-industry-funded studies on soft drink consumption and health outcomes, Brownell said, “with the industry-funded studies much more likely to find the results favorable to industry.”
“The bigger issue here, in this arena in particular but in science in general,” Brownell said, “is how you can get a distorted view of reality if industry-funded studies are considered in the mix — and usually they are — especially, when industry uses these studies in advertising, lobbying, and in talking to the press.”
[note: Dr. Kelly Brownell is director of the Rudd Center for Food Policy and Obesity at Yale University in New Haven, Connecticut]

In my opinion, soda is a lot like desert – sweet tasting empty calories. And, a super sized mega big gulp is like eating an entire cake or a dozen cookies except the delivery of carbohydrates is far more efficient and the impact on blood sugar more profound.