In the end, Only Calories Count: Wrong

I’ve been seeing this headline a lot lately:

Diets That Reduce Calories Lead to Weight Loss, Regardless of Carbohydrate, Protein or Fat Content

Well yes that’s true. But quite frankly, it misses the point.

A person who is overweight does not have a weight problem. She has a weight symptom. Her problem is hunger.

There is no point trying to manage weight if you do not manage hunger. There is only so long you can fight your body’s desire to reach and maintain its target weight. And by target I don’t mean the one you have for yourself that makes you look good in a bathing suit. It’s the one your body feels is necessary given your diet composition, your level of activity and your genetic propensity for fat and sugar regulation.
 

Most people don’t know why they are overweight.

They think they know why but they don’t.

The standard answer from patient and doctor alike is “over-eating” which tells you absolutely nothing. I’m here to tell you that there is no such thing as over-eating short of the kind that leaves you feeling unwell because you’ve surpassed the volume comfortable for your stomach.

Over-eating, in the most common sense, refers to any food consumption that precedes weight gain. It’s a tautology. All things being equal, if two people follow the exact same diet and one gains weight, he is said to have “over-eaten” while the other “ate in moderation.” It’s like saying the tree was green because it was green.

The goal of any weight-loss diet should not simply be to create a caloric deficit, but to adopt sustainable lifelong eating habits which make it easy to reach and maintain an ideal weight. That is not to suggest it will ever be easy to drop detrimental eating habits which have been acquired over a lifetime and are probably central to one’s eating culture. But the changes must be sustainable physiologically.

Skinny people may admonish fat ones for failing to show self control, but the fact is that a modern diet makes some people constantly hungry. Fighting that kind of psychological torture day-in day-out is not possible. Gross caloric deficits can be sustained for short periods of time but falling off the wagon is inevitable unless hunger is addressed.

So it is true that the macro-nutrient composition of a diet is irrelevant if you are simply trying to achieve a caloric deficit.

However it is completely relevant if you are trying to control hunger in order to achieve a sustained depletion of fat stores.

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Fat cell number is set in childhood

There’s some fresh research out substantiating the theory that fat cell numbers are set by the end of adolescence and remain stable in adulthood, regardless of weight loss. Fat size can vary but cell numbers remain constant.
 

Fat Cells and Size

The research has also shown that each year, approximately 8% of fat cells die off and are replaced. As such, cell numbers are maintained.

So no news here.
 

But what I’d be interest to know, is whether liposuction would be successful in effecting a long term reduction in the number of fat cells or if, over time, cells removed are repopulated.

In other words, does the body
(a) work towards maintaining a certain number of fat cells that is set in adolescence, or
(b) simply have a tendency to replace a given number of cells each year and thus surgery is a viable long-term method to reduce fat cell numbers?

If surgery truly reduces fat cell numbers for good, then liposuction could effect a permanent change in a person’s fat distribution pattern. If it cannot, then the results will only be temporary and that pear shape will eventually return.

I suspect that (a) is true and that, suck up what cells you might, eventually they will be repopulated.

This suspicion is based on some research I vaguely recall in which obese mice had some fat removed from their bodies and then immediately increased their food consumption to compensate until the fat mass was restored.

Of course the increase could have been effected by the enlargement of the residual cells. But given that our genetics program us to deposit fat in specific places (varying slightly from individual to individual), it would seem that taking a vacuum to your big butt would have no impact on your general tendency to put fat in that area.

Saying that, I’m not familiar with the long term results of liposuction so I may just be talking out of my own big butt.

Questioning the Gospel on Breakfast

BreakfastWe’ve seen the headline splashed everywhere this week: Study shows eating breakfast helps teens lose weight.

So now everyone one has jumped on the bandwagon to reiterate mom’s advice that breakfast is the most important meal of the day.

I just don’t buy it.

I’m not convinced that just because the average teen diet is improved by eating breakfast, it means that we all need to get a meal in before 10 am.

Dr Biffa has put forward the case and I accept all his points. Namely:

  1. Caloric restriction can reduce the metabolic rate
  2. Skipping breakfast can make you ravenous later in the day
  3. Skipping breakfast can make you seek out carbs later in the day

All of this: definitely possible. But it strikes me that these are issues for people who are running on glucose and suffer from swings of blood sugar levels.

If you are a high carb consumer, then yes, getting regular small doses is better than the roller coaster ride. And given that the study was done on teens, it’s probably a fair bet to say that their diet was loaded with carbs.

But the analysis that says “if doing X is better than what you are usually doing, then X must be good” is flawed. X might be good but it also might suck as far as all the other viable options go.

Modern Forager takes this kind of thinking apart in his post: So What’s The Real Scoop On Whole Grains?

Yet we’re constantly told that whole grains prevent diabetes, heart disease, cancer, and every other malady under the sun. I will accept that whole grains are better for you than refined grains. That doesn’t really boggle the mind. What does boggle the mind is why all of these studies refuse to pit a whole grains-rich diet against a grain-free, produce-rich hunter-gatherer diet.

Exactly. Better doesn’t mean best. It might not even mean good. And it certainly cannot mean “absolutely best for everyone.”

Which brings me around to breakfast.

There have been many people who have reported good results from intermittent fasting. This is in effect an extreme form of “skipping breakfast.”

For an excellent yes-I-know-this-is-an-anecdote-and-not-research datapoint, read this great account of how skipping breakfast helped Lee Shurie cure his diabetes without meds (he also lost a few pounds in the process):

Upon waking in the morning I tested my sugar levels and found they were typically in the 150 mg/dl range. I expected them to come down by noon, but was surprised that they stayed above normal for quite some time. As the day went on I became worried (and hungry!), but I held off eating until nearly 6 PM, when my blood sugar level was normal. At this point I wanted to eat a huge meal, but I ate a normal dinner instead. As the evening progressed I snacked on healthy, low glycemic foods.

After following this regimen for days, which stretched into weeks, I discovered it provided whole new level of physical energy and mental alertness. After the first few days I was already “un-training” my body of the expectation that food would be provided at set meal intervals. After a week or so I no longer felt hungry until about 4 PM. On some days, I do not get hungry until 7 or 8 PM, but if I do get hungry earlier, I wait until 6 PM to eat. The one exception to this schedule is if I am doing strenuous exercise; I might have a small mid-afternoon snack (an apple or a few nuts).

I suspect that once you have trained your body to work off slow burning ketones instead of fast burning glucose, you do not need to be teathered to the 3-5 meals a day routine. I also suspect that “back in the day” when we were foragers, that skipping breakfast was a regular occurance.

As such, without a bit more compelling evidence, I find the case for the biological imperative weak. Call me cynical.

What about breakfast being the most important meal of the day? This slogan is brough to you by the same system that has helped make 65 percent of Americans overweight; it has helped to sell a lot of breakfast cereal and toaster pastries. You can see for yourself whether you’re better off with breakfast or without it. Put it to the test. – The Fast-5 Diet, pg 28

Of course everyone is different and some people will do better with breakfast. No doubt the average carb junkie is better not skipping meals. But once you’ve got the sugar monkey off your back, there can be a lot of reasons why a diet without breakfast works for you.

Best Comeback Ever

In a story reminiscent of the pain Brian Cormier detailed in his post on Jimmy Moore’s blog, Dianne Sylvan recounts a great moment of of inspired retort.

It’s not the first time people have made comments like that to me. They only do it when you’re alone, because if you’re with friends you’re upholding the Fat Girl Contract–you’re playing the part of asexual sidekick to whoever is the pretty girl. But if you’re by yourself, and gods forbid having a good time or–gasp!–eating something besides a salad with the dressing on the side, you’re fair game.

If you walk up to a black man and call him that dreaded “n word” or tell him he should be tap dancing and eating fried chicken, you’ll be thought of as a bigot, but if you insult someone’s appearance to their faces in public or tell a fat woman she should be on Atkins, it’s considered “helpful advice.” You don’t know this woman, why she’s fat, or anything about her life, but it’s okay to be cruel, because obviously she’s lazy and self-indulgent and you, as a skinny evangelist, have the right to say whatever you want if you think it’s for her own good. People don’t believe this kind of shit happens, but it happens every day.

I don’t want to spoil the punchline so read it in full: I nearly punched someone today.

Welcome to My Big Ass Home

Here’s an unusual combo…

Someone has managed to pull together two of my favorite topics – getting fit and decluttering – into one book under the theme of “you’ll remain a mess if your place is a mess.”

I have not read this myself (see Jeri’s Organizing & Decluttering New for a full review) but I am intrigued and have already added it to my Bookmooch wishlist.

I am curious to know if there is any objective analysis of the idea that slobs are fatter (which is the obvious conclusion from this advice).

It is certainly an interesting twist on a couple of divergent “get your act together” themes, though I’m sure the author has had to tread very carefully to avoid insulting readers by insinuating stereotypes.

In short:

(1) tidy up,
(2) take more time to eat properly and
(3) find the time for this by stop watching so much TV

… you fat, slobby, couch potato !

Roundup

Tidbits over the last month worth a mention…

Shake it Baby
In a bizarre experiment, mice were “vibrated” for 15 minutes a day resulting in fat loss and corresponding bone density increases. Can we vibrate those pounds away? Well we had one of those crazy machines in the basement for years and it did nothing for mother…

Vestigial What?
Just last month I had a doctor telling me I should “chop off my appendix” given my history of IBS and “it’s useless anyway.” I was sceptical that mother nature was that inefficient and opted to keep it to the rolling eyes of the specialist. Well ha, ha! HA! Appendix not useless afterall. Seems like it’s a little factory and warehouse of good bacteria. Pwned!

Type 3
Discovery supports theory of Alzheimer’s disease as a form of diabetes. All that sugar is going to your head. Levels of brain insulin and its related receptors are lower in individuals with Alzheimer’s disease.

Finish that Avocado
Monounsaturated Fat Improves Insulin Sensitivity. Eating a diet rich in monounsaturated fat reverses insulin resistance compared to diets rich in carbohydrates or saturated fat.

Big Where it Counts
Big hips mean big brains. Curvy women birthed children with superior cognitive abilities.

What is Overweight?

Have you ever wondered where the BMI guidelines come from? Could they be completely arbitrary just like all the most of the other health advice we’ve been dished out? A new study published in JAMA provides some clues:

A new US study suggests that while the link between weight and causes of death varies considerably, being modestly overweight may actually lower death risk in a number of circumstances by providing the body with essential nutritional reserves during recovery from illness and major operations.

What is interesting here is not only that it shows a BMI of 18-25 may not be a healthy objective, but it calls into question what “overweight” really means. Isn’t the weight that confers the longest longevity the “ideal weight” and that weights under and over that ideal are in fact “underweight” and “overweight”?

Or have we confused sexy with ideal?

Although it is assumed that we are naturally attracted to whatever/whoever is healthiest, this is not necessarily the case. Creatures often find characteristics sexy which confer little health benefit. A peacock’s tail is no doubt a hit with the peahens but it is also a bit of a drag if he needs to make a run for it.

It doesn’t take much imagination to see that humans have preferred for a number of traits which, through the generations, have made us into very odd looking apes – naked, big breasts, long head hair… None of which seem to do much in the fitness department other than to signal sexual fitness. So have these preferences hijacked scientific thinking about what is ideal for health?

Stress & Famine

In a recent symposium, scientists reported what we already know – that once the diet is over the body works overtime to put the fat back on…

[Researchers] suggested that the physiological processes which drive all of us to seek and ingest food and limit energy expenditure during periods of negative energy balance provide an irresistible drive to regain lost adipose stores in weight-reduced obese individuals. This provides a potential basis for the well-recognized difficulty of maintaining weight loss.

But it gets worse! Granted our bodies are designed to conserve energy and store fat during periods of caloric deprivation. But could stress be triggering those same processes?

[Researchers] reported that conditions of reduced food allowance and chronic stress excite central neural networks that may lead toward abdominal obesity. This provides a potential link between stress and obesity.

Time to add some yoga to your weight-loss regime. More.

Calcium key nutrient for weight loss

Calcium could be the key nutrient needed to help you lose weight, according to a growing consensus of new research examining the mineral. Calcium not only helps with hypertension, the research shows: it also appears to support healthy physiology in a way that results in the loss of excess body fat. More

Specifically, one study reported that fat-free yogurt has a strongtly positive impact on weight loss programs. The prescription of 3 servings of fat-free yogurt increased weight loss especially around the abdomen.

For 12 weeks, the first group ate three 6-ounce servings of fat-free yogurt providing about 1,100 milligrams of calcium per day; the other group ate only one serving of dairy providing 400-500 milligrams of calcium per day. Both groups ate a controlled diet that contained 500 fewer calories than normal to stimulate weight loss.

As expected, all of the participants lost weight as a result of the calorie restriction. But the study showed that both weight and fat loss were significantly greater in the yogurt group.

For example, those on the low-calcium diet lost an average of 11 pounds, but those on the high-calcium yogurt diet lost an average of more than 14 pounds.

Participants on the yogurt diet also lost 81% more fat in the stomach area, which is the most dangerous type of fat. Excess fat in the midsection has been linked to an increased risk of heart disease, diabetes, stroke, and some forms of cancer.