Category Archives: Zone Diet

Lights off for weight loss

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I have often said that weight loss is a lot more complicated than simply “eating less and exercising more”. New research indicates how much more complicated weight gain is due to circadian rhythms. Our brain and virtually all of our cells are programmed to run on a 24-hour cycle to help us optimize future events (like sleep and eating) that are essential for life. In fact, even fungi have these biological clocks. There is a central clock in the brain that responds to light and dark by releasing the hormone melatonin. Melatonin, as well as other hormones, prepares the individual cells in different organs for an anticipated stimulus that allows those organs to rapidly respond with the greatest efficiency. The adipose tissue is one of those organs. This is why the uptake and release of fatty acids by the adipose tissue has a strong circadian rhythm (1). One hormone that is exclusively released by the fat cells is leptin. Both leptin and ghrelin (the hunger hormone released from the gut) are also under circadian control (2).

The bottom line is that as our light/dark cycles are becoming more distorted, the hormones that affect our appetite are also being adversely affected. It is known that sleep-deprived individuals are more inflamed (3) as well as have abnormalities in glucose metabolism (4).

New research indicates that increased light during the normal sleeping cycle for mice increases their weight and their fat mass (5). Most disturbing is that you only need a very dim light on during their normal sleep cycle to increase weight gain in the animals. The more intense the light during their normal sleep cycle, the greater the weight gain.

This is also true for humans, as discussed in an online pre-publication release that will be published in the March 2011 issue of the Journal of Endocrinology and Metabolism (6). In this study, subjects were exposed to dim lighting (about one-half the intensity of a typical office light) for eight hours prior to bedtime; then the release of melatonin would be completely suppressed for about 90 minutes after they started sleeping. Just like the mice, if the light was on, even dimly, while they were sleeping, their melatonin levels were depressed by about 50 percent. The less melatonin you release during sleep, the more body fat you accumulate.

This leads to an interesting thought. It is known that increased television viewing and prolonged computer use leads to increased weight gain. It has always been assumed that this was because the person was not exercising. This new data strongly suggests it is not a lack of physical activity that is the problem, but the disturbances in circadian rhythms that may be the underlying problem. It’s hard to exercise in the dark, but you sure can sleep better and get thinner in the process if you keep the lights off.

References

1. Bray MS and Young ME. “Circadian rhythms in the development of obesity: potential role for the circadian clock within the adipocyte.” Obesity Rev 8: 169-181 (2006)

2. Karla SP, Bagnasco M, Otukonyong EE, Dube MG, and Kalra PS. Rhythmic, reciprocal ghrelin and leptin signaling: new insight in the development of obesity.” Regulatory Peptides 111: 1-11 (2003)

3. Vgontzas AN, Papanicolaou DA, Bixler EO, Kales A, Tyson K, and Chrousos GP. “Elevation of plasma cytokines in disorders of excessive daytime sleepiness.” J Clin Endocrinol Metab 82: 1313-1316 (1997)

4. Spiegel K, Leproult R, and Van Cauter E. “Impact of sleep debt on metabolic and endocrine function.” Lancet 354: 1435-1439 (1999)

5. Fonken LK, Workman, JL, Walton JC, Weil ZM, Morris JS, Haim A, and Nelson RJ. “Light at night increases body mass by shifting the time of food intake.” Proc Natl Acad Sci USA 107: 18664-18669 (2010)

6. Gooley JJ, Chamberlain K, Smith KA, Shalsa SBS, Rajaatnam SMW, van Reen E, Zeitzer JM, Czeisler CA, and Lockley SW. “Exposure to room light before bedtime suppresses melatonin onset and shortens melatonin duration in humans.” J Clin Endocrino Metabol doi:10.1210/jc.2010-2098

Nothing contained in this blog is intended to be instructional for medial diagnosis or treatment. If you have a medical concern or issue, please consult your personal physician immediately.

Another good reason to eat your fruits and vegetables

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Your grandmother always told you, you couldn’t leave the table until you ate all your vegetables. She was giving you the essence of reducing your chances of dying from cardiovascular disease.

The trouble with testing any dietary hypothesis (even Grandma’s advice on vegetables) is the complexity of understanding nutrition. Unlike drugs, which are based on linear thinking (one drug affects one enzyme and that treats you), nutrition is based on non-linear thinking. That means nutrition is more like a three-dimensional chess match. Whenever you change one component (i.e. amount of fat) in the diet, there will be unintended changes as something else is automatically changed as a consequence (like either an increase in dietary protein or carbohydrate to make up the difference of the reduction of dietary fat). This secondary dietary change may totally obscure what you are trying to study. This explains why so many dietary studies appear to produce such wishy-washy results. To try to get around this constant dilemma, investigators often do extremely large epidemiological studies, using people who are initially disease-free and ask how an exposure to some dietary variable affects the development of a particular disease or more importantly death from a particular disease. These are called prospective cohort studies.

As you might imagine, there are very few of these studies since they require a very large number of subjects, and if the outcome is death, then they have to be followed for a very long time. This also means that these studies are extremely expensive. In a soon-to-be-published article in the European Heart Journal is a massive prospective cohort study (with more than 300,000 subjects and based upon an average of eight years of follow-up) that suggested if you ate more fruits and vegetables, your likelihood of dying of heart disease was reduced by 22 percent (1).

How much is more fruits and vegetables? It is about eight servings per day, and it appeared to be a dose-response effect. For each serving of fruits or vegetables, the risk of death from heart disease goes down by 4 percent. Bottom line, the more fruits and vegetables you eat, the greater the reduction in cardiovascular death.

Since you have to eat, why not eat right if your goal is reducing the risk of death from heart disease. If you are eating more fruits and vegetables, then something must be removed from the diet if the calories are to remain constant. The most logical choice would be reducing grains and starches as you increase fruits and vegetables. In the process, you reduce the glycemic load of the diet and reduce production of insulin. This will not only reduce your risk of dying from heart disease, but also help you lose excess body fat (2)

Notice that I keep emphasizing the words death and dying. The prevailing “wisdom” in the cardiovascular community is that it doesn’t matter what you eat as long as you reduce cholesterol levels. And since increased fruits and vegetables consumption has little impact on cholesterol levels, we are told that if you really want to reduce the risk of dying from heart disease, it’s imperative that you must take a statin drug for the rest of your life. Unfortunately, the research data doesn’t support such optimism. For example, if subjects are studied who have no heart disease (these are called primary prevention studies), then taking statin drugs has no impact on reducing their all-cause mortality (3). In other words, any reduction in cardiovascular death was offset by increases of death from other causes. Not such a good deal if your goal is reducing death whatever the cause. Another group of researchers came to the conclusion after analyzing a number of published trials using statin drugs for the primary prevention of developing heart disease, that there was no compelling reason for their use (4). Since the vast majority of the people taking statin drugs have no established heart disease, this would mean the continued prescription of these drugs comes close to health-care fraud.

But what if you already have heart disease? What is the best way to reduce the risk of dying from it? To answer that question, you undertake secondary prevention studies using death (it’s very easy to measure) as your clinical endpoint. In secondary prevention studies, statins will reduce cardiovascular mortality by about 20 percent in people who already have established heart disease. But if you really want to reduce the likelihood of dying from existing heart disease (like by 70 percent), then you not only have to have the patients increase their intake of fruits and vegetables, but also remove much of the omega-6 fatty acids from the diet and replace them with omega-3 fats (5).

If you do both of these dietary changes (replace grains and starches with more fruits and vegetables as well as replace omega-6 fats with omega-3 fats), then you are essentially following the anti inflammatory diet. That’s how you live longer whether you have heart disease or not.

References

1. Crowe FL, Roddam AW, Key TJ, et al. “Fruit and vegetable intake and mortality form ischaemic heart disease.” Eur Heart Journal 32: doi 10.1093 (2011)

2. Sears B. “The Zone.” Regan Books. New York, NY (1995)

3. Ray KK, Seshsai SRK, Erqou S, Sever P, Jukema JW, Ford I, and Sattar NS. “Statins and all-cause morality in high-risk primary prevention.” Arch Intern Med 170: 1024-1031 (2010)

4. Taylor F, Ward K, Moore THM, Burke M, Davey-Smith G, Casas JP, and Ebrahim S. “Statins for the primary prevention of cardiovascular disease.” The Cochrane Library Issue 1 (2011)

5. de Lorgeril M, Renaud S, Mamelle N, Salen P, Martin JL, Monjaud I, Guidollet J, Touboul P, and Delaye J. “Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease.” Lancet 343: 1454-1459 (1994)

Nothing contained in this blog is intended to be instructional for medial diagnosis or treatment. If you have a medical concern or issue, please consult your personal physician immediately.

Increased satiety: The real secret to weight loss

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Satiety is defined as lack of hunger. If you aren’t hungry, then cutting back calories is easy. Unfortunately, Americans seem to be hungrier than ever. This is not caused by a lack of willpower but due to hormonal imbalances in the hypothalamus that tell the brain to either seek more food or spend time on more productive activities. So the real question is not what is the best diet for weight loss, but what is the best diet for satiety?

the anti inflammatory diet has been clinically shown to burn fat faster than standard, recommended diets (1-3) as well as decreasing hunger compared to standard, recommended diets (4,5). But then whoever said that standard, recommended diets (like the USDA Food Pyramid) are good? A better comparison might be the anti inflammatory diet versus a Mediterranean diet.

I have often said that the anti inflammatory diet should be considered as the evolution of the Mediterranean diet because of its enhanced hormonal control. So where is the data for my contention?

The first randomized controlled research appeared in 2007 using patients with existing heart disease (6). In this study, while both groups lost weight, it was only the group on a Paleolithic diet that had any benefits in glucose reduction. So what’s a Paleolithic diet? In this study it was one that supplied 40 percent of the calories as low-glycemic-load carbohydrates, 28 percent of the calories as low-fat protein, and 28 percent from fat (the remaining calories came from alcohol, which didn’t exist in Paleolithic times). That sounds exactly like the anti inflammatory diet to me, so I will simply call it that. On the other hand, the Mediterranean diet was lower in protein (20 percent) and higher in carbohydrates (50 percent) as well as containing far more cereals and dairy products than the anti inflammatory diet.

The interesting thing that came out of this initial study was that patients on the anti inflammatory diet were apparently eating fewer calories, but with greater satiety. So they repeated the study again with another set of cardiovascular patients, except they measured leptin levels this time. The results were exactly the same (7), that is the anti inflammatory diet was more satiating per calorie, and there was also a greater reduction in leptin levels. This makes perfect sense since improved glycemic control seen in the first comparison study (6) would have been a consequence of reducing insulin resistance. The decrease in the leptin levels in the second study (7) would have been a consequence of the reduction of leptin resistance. The most likely cause of this hormone resistance would be the anti-inflammatory benefits of the anti inflammatory diet because it decreases cellular inflammation. It’s cellular inflammation that disrupts hormonal signaling efficiency and causes hormone resistance.

So here we have two randomized controlled studies (6,7) that indicate the superiority of the anti inflammatory diet compared to Mediterranean diet relative to reducing hormone resistance as well providing greater satiety with fewer calories, just as demonstrated in earlier studies when the anti inflammatory diet was compared to standard recommended diets (4,5). It is increased satiety that is ultimately how you lose weight and keep it off. The anti inflammatory diet appears the easiest way to reach that goal.

References

1. Layman DK, Boileau RA, Erickson DJ, Painter JE, Shiue H, Sather C, and Christou DD. “A reduced ratio of dietary carbohydrate to protein improves body composition and blood lipid profiles during weight loss in adult women.” J Nutr 133: 411-417 (2003)

2. Lasker DA, Evans EM, and Layman DK, “Moderate-carbohydrate, moderate-protein weight-loss diet reduces cardiovascular disease risk compared to high-carbohydrate, low-protein diet in obese adults. A randomized clinical trial.” Nutrition and Metabolism 5: 30 (2008)

3. Fontani G, Corradeschi F, Felici A, Alfatti F, Bugarini R, Fiaschi AI, Cerretani D, Montorfano G, Rizzo AM and Berra B. “Blood profiles, body fat and mood state in healthy subjects on different diets supplemented with omega-3 polyunsaturated fatty acids.” Eur J Clin Invest 35: 499-507 (2005)

4. Ludwig DS, Majzoub JA, Al-Zahrani A, Dallal GE, Blanco I, and Roberts SB. “High glycemic-index foods, overeating, and obesity.” Pediatrics 103:e26 (1999)

5. Agus MSD, Swain JF, Larson CL, Eckert E, and Ludwig DS. “Dietary composition and physiological adaptations to energy restriction.” Am J Clin Nutr 71: 901-907 (2000)

6. Lindberg S, Jonsson T, Granfeldt Y, Borgstrand E, Soffman J, Sjostrom K and Ahren B. “A Paleolithic diet improves glucose tolerance more than a Mediterrean-like diet in individuals with ischaemic heart disease.” Diabetologia 50: 1795-1807 (2007)

7. Jonsson T, Granfeldt Y, Erlanson-Albertsson, Ahren B, and Lindeber S. “A Paleolithic diet is more satiating per calorie than a Mediterrean-like diet in individuals with ischemic heart disease.” Nutrition & Metabolism 7:85 (2010)

Nothing contained in this blog is intended to be instructional for medial diagnosis or treatment. If you have a medical concern or issue, please consult your personal physician immediately.

Why the Atkins diet doesn’t work and never will

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The goal of any diet is to help you lose excess weight and keep it off. The first part is relatively easy to achieve; the second part is incredibly difficult to maintain. Any diet that restricts calories will do the first part, but invariably the lost weight returns. This is definitely the situation for the Atkins diet. I knew Bob Atkins well, and the only answer he had as to why people regain weight on his diet was that they are addicted to carbohydrates. Frankly, I never bought into that explanation from Bob any more than I believed the reasoning of the advocates for low-fat diets saying the failure to maintain weight loss is because people are addicted to fat. To paraphrase former President Clinton, “It’s the hormones, stupid.”

In most cases what really causes weight regain is cellular inflammation induced by hormonal imbalance. This is why any diet that uses the word “low” or “high” to describe itself will induce hormonal imbalance, and therefore ultimately fail. Low-fat diets are generally high-carbohydrate diets. High levels of carbohydrates will increase the production of insulin, which is the hormone that makes you fat and keeps you fat. This increase in insulin will generate increased cellular inflammation that increases the likelihood for weight regain (1). On the other hand, the Atkins diet is a low-carbohydrate diet that is also a high-fat diet. If those fats on the Atkins diet are rich in saturated and omega-6 fats (which they usually are), then their presence will also increase cellular inflammation (1). This increase in cellular inflammation (by either type of diet) disrupts hormonal signaling patterns (especially for insulin signaling) that generate increased insulin resistance. This was shown in one of my earlier research articles that demonstrated that under carefully controlled clinical conditions, following the Atkins diet shows significant increases in cellular inflammation compared to those subjects following the Zone Diet (2). In addition, there was decreased endurance capacity of the subjects on the Atkins diet compared to those on the Zone Diet (3).

The differences are probably due to the fact that the  anti inflammatory diet is a diet that is moderate in protein, carbohydrate and fat. It’s this type of dietary moderation of macronutrients that generates hormonal balance.Now new data from Yale Medical School indicates that a ketogenic (i.e. Atkins) diet may even have worse health implications than simply weight regain (4). In this study, it was demonstrated that although indicators of insulin resistance in the blood may be decreased on a ketogenic diet, insulin resistance in the liver was dramatically increased. Since the liver is the central processing organ for controlling metabolism, this would suggest that long-term use of the Atkins diet would cause metabolic problems leading to accumulation of excess fat. Adding even more fuel to this hormonal fire is another study that demonstrated that a ketogenic diet leads to increased production of cortisol (another hormone that makes you fat and keeps you fat) in the fat cells (5). Any increase in cortisol increases insulin resistance in that particular organ.

So it appears that ketogenic diets (like the Atkins diet) may initially reduce insulin levels in the blood, but increase insulin resistance in organs, such as the liver and the adipose tissue. The bottom line: Any initial weight loss with the Atkins diet is a false hope since it causes insulin resistance in various organs that ultimately cause the regain of any lost weight as excess fat. That’s a very bad prescription.

References:
1. Sears B. “Toxic Fat.” Thomas Nelson. Nashville, TN (2008)
2. Johnston CS, Tjonn SL, Swan PD, White A, Hutchins H, and Sears B. “Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets.” Am J Clin Nutr 83: 1055-1061 (2006)
3. White AM, Johnston CS, Swan PD, Tjonn SL, and Sears B. “Blood ketones are directly related to fatigue and perceived effort during exercise in overweight adults adhering to low-carbohydrate diets for weight loss: a pilot study.” J Am Diet Assoc 107: 1792-1796 (2007)

4. Jornayvaz FR, Jurczak MJ, Lee HY, Birkenfeld AL, Frederick DW, Zhang D, Zhang XM, Samuel VT, and Shulman GI. “A high-fat, ketogenic diet causes hepatic insulin resistance in mice, despite increasing energy expenditure and preventing weight gain.” Am J Physiol Endocrinol Metab 299: E808-815 (2010)
5. Stimson RH, Johnstone AM, Homer NZ, Wake DJ, Morton NM, Andrew R, Lobley GE, and Walker BR. “Dietary macronutrient content alters cortisol metabolism independently of body weight changes in obese men.” J Clin Endocrinol Metab 92: 4480-4484 (2007)

Nothing contained in this blog is intended to be instructional for medial diagnosis or treatment. If you have a medical concern or issue, please consult your personal physician immediately.

Want to lose Weight? Eat like our Paleolithic ancestors

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A recent article appeared in the British Journal of Nutrition that gives an updated estimate of what diet (i.e. Paleolithic) our ancestors may have eaten during the time from their first appearance in Africa some 200,000 years ago until they started leaving Africa 100,000 years later (1). This is important because this type of diet until 10,000 years ago (with the advent of agriculture) was the nutritional foundation through which our genes evolved. Since our diet and gene expression are intimately tied together (2), understanding the dietary forces that molded how our genes respond to diet is important. This is particularly true since nutritional science has many conflicting interactions that make the study of a single nutrient often result in conflicting data. One such example is the study of insulin responses induced by the diet without studying the impact of fatty acid composition on insulin secretion and vice versa. This is why the study of Paleolithic nutrition provides a template to ask questions to optimize our current diet. In fact, I actually I stated this on page 99 of my first book, “The Zone” (3).

So what are the newest updates on the composition of the Paleolithic diet of our African ancestors? It appears the protein content was between 25 and 29 percent, the carbohydrates were about 40 percent and the total fat was about 30-36 percent. If that sounds familiar to the 30 percent protein, 40 percent carbohydrate, and 30 percent fat ratio in the anti inflammatory diet, it should. Essentially the newest estimate of the Paleolithic diet of our human ancestors in Africa is the anti inflammatory diet.

Equally important, it was estimated that the intake of long-chain omega-3 fatty acids (EPA and DHA) was about 6 grams per day. This is similar to my recommendations in “The OmegaRx Zone,” published in 2002 (4). The dietary ratio of arachidonic acid (AA) to EPA was also estimated in this article and was found to be about 2. Since the dietary intake of these fatty acids would be reflected in the blood, then we can assume the AA/EPA ratio in Paleolithic man was about 2. This AA/EPA ratio is again strikingly similar to the recommendations in my various books about what the best AA/EPA ratio should be for optimal control of the cellular inflammation, which leads to the acceleration of chronic disease (4-6).

When you follow the Paleolithic diet (a.k.a. the anti inflammatory diet), you find almost instantaneous changes in hormonal responses (7, 8) and improved glycemic control (8,9) before there is any weight loss. And if you continue to follow it, you not only lose weight, but also burn fat faster (11-14).

Was I just taking lucky guesses on my recommendations for the anti inflammatory diet over the past 15 years? I would like to think they were not lucky guesses, but based on insight coming from my background in drug delivery technology that strives for a therapeutic zone for optimal results. The lucky part was having the perseverance to stay true to those insights. On the other hand, it is always nice to get validation even 15 years after the fact.

References
1. Kuipers RS, Luxwolda MF, Dijck-Brouwer DJA, Eaton SB, Crawford, MA, Cordain L, and Muskiet FAJ. “Estimate macronutrient and fatty acid intakes from an East African paleolithic diet.” British J Nutr 104: 1666-1687 (2010)
2. Sears B and Ricordi C. “Anti-Inflammatory nutrition as a pharmacological approach to treat obesity.” J Obesity published online September 30, 2010. doi: 10.1155/2011/431985. (2010)
3. Sears B. “The Zone.” Regan Books. New York, NY (1995)
4. Sears B. “The OmegaRx Zone.” Regan Books. New York, NY (2002)
5. Sears B. “The Anti-Inflammation Zone.” Regan Books. New York, NY (2005)
6. Sears B. “Toxic Fat.” Nelson Publishing. Nashville, TN (2008)
7. Ludwig DS, Majzoub JA, Al-Zahrani A, Dallal GE, Blanco I, and Roberts SB. “High-glycemic-index foods, overeating, and obesity.” Pediatrics 103: E26 (1999)
8. Markovic TP, Jenkins AB, Campbell LV, Furler SM, Kragen EW, and Chisholm DJ. “The determinants of glycemic responses to diet restriction and weight loss in obesity and NIDDM.” Diabetes Care 21: 687-694 (1998)
9. Lindberg S, Jonsson T, Granfeldt Y, Borgstrand E, Soffman J, Sjorstrom K, and Ahren B. “A Paleolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease.” Diabetologia 50: 1795-1807 (2007)
10. Frassetto LA, Schloetter M, Mietus-Synder M, Morris RC, and Sebastian A. “Metabolic and physiologic improvements from consuming a Paleolithic, hunter-gatherer type diet.” Eur J Clin Nutr 63: 947-955 (2009)
11. Osterdahl M. Kocturk T. Koochek A, and Wandell PE. “Effects of a short-term intervention with a Paleolithic diet in healthy volunteers.” Eur J Clin Nutr 62: 682-685 (2008)
12. Layman DK, Boileau RA, Erickson DJ, Painter JE, Shiue H, Sather C, and Christou DD. “A reduced ratio of dietary carbohydrate to protein improves body composition and blood lipid profiles during weight loss in adult women.” J Nutr 133: 411-417 (2003)
13. Lasker DA, Evans EM, and Layman DK, “Moderate carbohydrate, moderate protein weight loss diet reduces cardiovascular disease risk compared to high-carbohydrate, low-protein diet in obese adults. A randomized clinical trial.” Nutrition and Metabolism 5: 30 (2008)
14. Fontani G, Corradeschi F, Felici A, Alfatti F, Bugarini R, Fiaschi AI, Cerretani D, Montorfano G, Rizzo AM and Berra B. “Blood profiles, body fat and mood state in healthy subjects on different diets supplemented with omega-3 polyunsaturated fatty acids.” Eur J Clin Invest 35: 499-507 (2005)

Nothing contained in this blog is intended to be instructional for medial diagnosis or treatment. If you have a medical concern or issue, please consult your personal physician immediately.

Weight loss or fat loss? It makes a difference

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With the New Year comes the guaranteed resolution for most people to lose weight. Invariably that resolution is usually abandoned some time in February. Part of the reason is that we really don’t know what we are talking about when it comes to weight loss. Weight loss is composed of three separate components: water loss, muscle loss, and fat loss. If you restrict calories, you are going to lose weight. What that weight loss might consist of (water, muscle, or fat) is a very different question.

There are no health benefits to water loss (i.e. dehydration) or muscle loss (i.e. protein deprivation), but there is something magical about fat loss. If you can lose excess body fat, then you are virtually guaranteed to lower blood sugar levels, blood lipid levels, and blood pressure. Not surprisingly, drugs used to reduce blood sugar, blood lipids and blood pressure are the biggest sellers in the country.

Considering the continuing outcry to reverse our obesity epidemic, no one seems to bother to measure fat loss in any clinical trials. This is why you see a lot of research studies published stating it doesn’t matter what diet you follow because if you restrict calories, you will lose weight. I agree with that statement. But if you want better health (not to mention looking better in a swimsuit), then you want to make sure that you are losing fat at the fastest possible rate while conserving muscle mass at the same time. The published clinical studies that have looked at fat loss make it very clear that the anti inflammatory diet is the best dietary strategy to burn fat faster (1-3).

If the moderate-carbohydrate anti inflammatory diet is good, then shouldn’t an even lower-carbohydrate diet like the Atkins diet be better? Not so fast. The published studies comparing the anti inflammatory diet to the Atkins diet make it clear that there are no benefits to consuming a lower-carbohydrate diet that generates ketosis, but there are plenty of negative consequences, such as increased cellular inflammation and decreased capacity for exercise (4,5).

But losing weight is relatively easy compared to keeping it off. That’s why the recent DIOGENES study is so important (6). This study makes it very clear that if you want to keep lost weight off, then your best choice is maintaining a diet that has at least 25 percent of the calories coming from protein, and about 40 percent of the calories coming from low-glycemic carbohydrates. That’s the anti inflammatory diet.

So if your New Year’s resolution is to lose weight (and really lose fat) and keep it off, then the anti inflammatory diet should be your only choice.

References

1. Layman DK, Boileau RA, Erickson DJ, Painter JE, Shiue H, Sather C, and Christou DD. “A reduced ratio of dietary carbohydrate to protein improves body composition and blood lipid profiles during weight loss in adult women.” J Nutr 133: 411-417 (2003)
2. Lasker DA, Evans EM, and Layman DK, “Moderate-carbohydrate, moderate-protein weight-loss diet reduces cardiovascular disease risk compared to high-carbohydrate, low-protein diet in obese adults. A randomized clinical trial.” Nutrition and Metabolism 5: 30 (2008)
3. Fontani G, Corradeschi F, Felici A, Alfatti F, Bugarini R, Fiaschi AI, Cerretani D, Montorfano G, Rizzo AM and Berra B. “Blood profiles, body fat and mood state in healthy subjects on different diets supplemented with omega-3 polyunsaturated fatty acids.” Eur J Clin Invest 35: 499-507 (2005)
4. Johnston CS, Tjonn SL, Swan PD, White A, Hutchins H, and Sears B. “Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets.” Am J Clin Nutr 83: 1055-1061 (2006)
5. White AM, Johnston CS, Swan PD, Tjonn SL, and Sears B. “Blood ketones are directly related to fatigue and perceived effort during exercise in overweight adults adhering to low-carbohydrate diets for weight loss: a pilot study.” J Am
Diet Assoc 107:1792-1796 (2007)
6. Larsen TM, Dalskov SM, van Baak M, Jebb SA, Papadaki A, Pfeiffer AF, Martinez JA, Handjieva-Darlenska T, Kunesova M, Pihlsgard M, Stender S, Holst C, Saris WH, and Astrup A. “Diets with high or low protein content and glycemic index for weight-loss maintenance.” N Engl J Med 363: 2102-2113 (2010)

Nothing contained in this blog is intended to be instructional for medial diagnosis or treatment. If you have a medical concern or issue, please consult your personal physician immediately.

Diet important in weight-loss maintenance

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Losing weight is easy. The challenge lies in keeping the weight from coming back. Weight maintenance is difficult due to either psychological (motivation begins to decline over time) or physiological (an increase in hunger that often accompanies weight loss) reasons (1). But as virtually everyone knows, regain of lost weight is usually certain. Against this background of gloom comes new hope, according to a recent study in the New England Journal of Medicine that demonstrates the superiority of a low-glycemic, moderate-protein diet as an effective strategy for maintenance of initial weight loss (2).

The study took place in eight European countries. The first phase of the trial involved participants who were placed on a low-calorie diet consisting of 800-1,000 calories for eight weeks through which they lost on average 22 pounds of body weight (and who knows how much muscle mass). After the weight-loss phase, the individuals were randomly assigned to one of five different diets and instructed to maintain their weight loss, although further weight reduction was allowed as well. Of the five groups, the one assigned to the low-protein and high glycemic-index diet regained their lost weight. This is the typical type of dietary advice that is usually recommended to everyone.

On the other hand, the higher-protein, low glycemic-index group lost an additional 5 percent of their body weight. In addition, they were less likely to drop out and had a higher rate of weight-loss maintenance. The other diets were between these extremes.

The authors’ conclusion was that the use of a higher-protein and lower glycemic-index diet was the most beneficial dietary strategy for both weight-loss maintenance and adherence. Furthermore, this type of diet may serve as an effective strategy for those whose barrier to weight-loss maintenance in the past has been physiological rather than psychological (2).

Maybe they just should have recommended the subjects read “The Zone,” which made the same dietary recommendations 15 years ago (3).

References
1. Ludwig DS and Ebbeling CB. “Weight-loss maintenance–mind over matter?” N Engl J Med. 363: 2159-2161 (2010)
2. Larsen TM, Dalskov SM, van Baak M, Jebb SA, Papadaki A, Pfeiffer AF, Martinez JA, Handjieva-Darlenska T, Kunešová M, Pihlsgård M, Stender S, Holst C, Saris WH, and Astrup A. “Diet, Obesity, and Genes (Diogenes) Project. Diets with high or low protein content and glycemic index for weight-loss maintenance.” N Engl J Med 363: 2102-2113 (2010)
3. Sears B. “The Zone.” Regan Books. New York, NY (1995)

Nothing contained in this blog is intended to be instructional for medial diagnosis or treatment. If you have a medical concern or issue, please consult your personal physician immediately.

Does eating fat make you fat?

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The 1990s brought with it an era of people fearing fat. After all, “if no fat touches my lips, then no fat reaches my hips”. Harvard took charge of this debate and declared war against fat, especially saturated fat. Manufacturers created everything from fat-free yogurt to cookies. Overall, fat intake did decrease nationwide during this time, but the waist lines of the U.S. population continued to expand. Despite recent reports about the Mediterranean diet and the benefits of monounsaturated fats, the low-fat craze still has many hardwired to think that eating higher-fat foods will make them fat. Although calorically speaking, fat is more energy dense than carbohydrates and protein, a recent study may help to ease people’s preconceived notions on the role of fat and weight gain.

There have been inconsistent findings in the literature on whether the type of fat consumed influences weight change. Even studies in which poly and monounsaturated fats have been substituted for saturated fat to lower cardiovascular disease were equally wishy-washy (1). In fact, a recent study published in the American Journal of Clinical Nutrition questions whether dietary fat played a role in future weight gain (2). Of the more than 89,000 men and women studied, overall fat consumption ranged from 31.5 percent to 36.5 percent. No matter the total fat intake or the type of fat consumed, there was no effect on weight gain over the long term in either men or women. Maybe fat doesn’t make you fat.

This only proves you can always tell a Harvard man, you just can’t tell him very much.

1) Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Saturated fat, carbohydrate, and cardiovascular disease. Am J Clin Nutr. 2010 Jan 20.

2) Forouhi NG, Sharp SJ, Du H, van der A DL, Halkjaer J, Schulze MB, Tjønneland A, Overvad K, Jakobsen MU, Boeing H, Buijsse B, Palli D, Masala G, Feskens EJ, Sørensen TI, Wareham NJ. Dietary fat intake and subsequent weight change in adults: results from the European Prospective Investigation into Cancer and Nutrition cohorts. Am J Clin Nutr. 2009 Dec;90(6):1632-41.

Nothing contained in this blog is intended to be instructional for medial diagnosis or treatment. If you have a medical concern or issue, please consult your personal physician immediately.

Time to get your Zzzzzzzzzzz’s

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You shouldn’t have to wait until daylight savings ends to get that long-awaited extra hour of sleep, and a new study sheds light as to why you may wish to hit the hay a little sooner each night. A study just published in the Annals of Internal Medicine randomized 10 overweight or obese individuals to receive either 8.5 hours of sleep or 5.5 hours over a 14-day period of time (1). Each group consumed a moderate calorie-restricted diet. Although the duration and the number of individuals in the study was short and small, those who received 5.5 hours of sleep were 55 percent less likely to have any weight they lost coming from stored fat and 60 percent more likely to lose muscle mass. In addition, lack of sleep led to increased hunger and changes in metabolism. This makes perfect sense since it is known from previous studies that sleep deprivation increases both insulin levels (making it difficult to access stored body fat) and cortisol levels (that leads to breakdown of muscle mass). Who wouldn’t want a prescription to get more sleep, and wouldn’t it be a shame to work so hard to reduce your calorie intake only to find out you were cannibalizing your muscles rather than losing your stored body fat? So here’s to getting those Zzzzzzzzzzz’s.

1. Nedeltcheva, A.V, J.M. Kilkus , J. Imperial, D.A. Schoeller, P.D. Penev. Insufficient Sleep Undermines Dietary Efforts to Reduce Adiposity. Ann Intern Med 153:435-441 (2010)

Nothing contained in this blog is intended to be instructional for medial diagnosis or treatment. If you have a medical concern or issue, please consult your personal physician immediately.

For losing weight, exercise is good; diet is better

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Here’s standard quote: “Losing weight can improve health and reduce many of the risk factors related to diabetes and heart disease.” Unfortunately, that’s not true. The correct statement is “losing excess body fat can improve health and reduce many of the risk factors related to diabetes and heart disease.”

It may seem like a minor difference, but it makes a world of difference. Weight loss could be due to water loss or cannibalization of lean body mass (muscles and organs), neither of which will lead to any health benefits.

If you want to reduce excess body fat, you have to lower insulin levels. How do you control that on a consistent basis? Remember the 80/20 rule. That means 80 percent of your insulin control will come from following a strict anti inflammatory diet, and 20 percent will come from increased physical activity.

This means the best exercise program can be undone by the wrong diet. Physical exercise has many important benefits, such as reducing the likelihood of diabetes and heart disease, improving sense of self-worth and hanging out with like-minded individuals.

Unfortunately, initial weight loss is not one of those benefits since research has demonstrated that exercise increases one’s appetite. This is why following a strict anti inflammatory diet is imperative if you are trying to lose weight by increasing your exercise. Another helpful hint is to increase your high purity omega-3 oil intake, as it has been demonstrated that fat loss is significantly increased when high purity omega-3 oil is used in combination with exercise.

On the other hand, after you reach your weight goals, the balance of diet and exercise to maintain your weight shifts to a 50/50 balance. Now exercise becomes an ideal way to maintain your weight as long as you continue to control insulin through the anti inflammatory diet.

Nothing contained in this blog is intended to be instructional for medial diagnosis or treatment. If you have a medical concern or issue, please consult your personal physician immediately.