Tag Archives: healthy eating

The diet wars continue

If you are confused or frustrated by the conflicting claims about whether a low-fat or low-carbohydrate diet is the best, you are forgiven. First we were told that eating a low-fat diet was the best way to lose weight and improve heart health. Then, research suggested that low-carbohydrate diets were better. And back and forth it has gone for years.

During this time, the prevailing recommendations have suggested that a diet low in fat and high in carbohydrates was best. But more and more research has supported the notion that cutting carbohydrates, not fat, would lead to greater weight loss. Although this has been supported by some research, critics pointed out that eating more fat would raise blood cholesterol and other risks for heart disease.

According to a recent study, though, low-carbohydrate diets seem to have benefits for promoting weight loss and improving some indicators of heart health over low-fat diets. But you should hold off on shunning fruits and vegetables in favor of cheeseburgers! Here is a practical interpretation of the research and some common sense recommendations, taken from my Health & Fitness column in the Aiken Standard this week.

The study, published last week in the Annals of Internal Medicine, reported on 150 men and women who either restricted the amount of carbohydrates or fat they ate. After one year, the group that ate a low carbohydrate diet lost over 7 pounds more than the subjects on the low-fat diet. Additionally, the low-carbohydrate diet promoted greater improvements in blood lipids than the low-fat diet.

This is important for two reasons. First, this wasn’t a weight loss study; the researchers were simply following the subjects to see what would happen as they followed either diet. The fact that the low-carbohydrate group lost more weight suggests that it is relatively easier to cut calories following this type of diet.

This is consistent with other research showing that eating more carbohydrates, especially refined carbohydrates and sugar, can actually make people feel hungrier and eat more. Indeed, other studies have shown low-carbohydrate diets to be more effective for weight loss than low-fat diets (although a more recent study suggests there isn’t such a difference).

Second, the greater decrease in triglycerides and “bad” LDL cholesterol and increase in “good” HDL cholesterol in the low-carbohydrate group were different from what might be expected. Conventional wisdom holds that a low-fat diet should have a greater effect on blood lipids. Since weight loss can have a big effect on blood lipids, the improvement in the low-carbohydrate group may be due to losing more weight, not a direct effect of the diet.

It is important to note that the low-fat diet also led to weight loss in this and numerous other studies. The critical component of any weight loss diet is that it is relatively low in calories, regardless of what nutrients supply those calories. Really, almost any diet will lead to weight loss as long as it contains less energy than what is expended, but a low-carbohydrate diet may be more effective for weight loss than the traditional low-fat diet.

The bottom line is that the best diet is one that emphasizes eating wholesome foods, not on cutting carbohydrates or fat. That said, limiting carbohydrates in the form of refined grains and added sugar is an excellent way to reduce calorie intake and improve the overall nutritional value of what you eat. And shifting toward more monounsaturated fats (think olive oil and nuts) rather than worrying about the total amount of fat you eat is also a good idea.

Being mindful of eating habits, according to Shannon.

I had an interesting conversation with my friend Shannon earlier this week that fit with the topic of being mindful of health habits. (I have written about Shannon previously, but not for some time) 

She was telling me that one recent evening she drove to three fast food restaurants to get dinner for her family. Apparently, she wanted food from a different place than her husband, neither of which worked for her kids. As they sat down at the dinner table she became mindful of how ridiculous this was.

First, she spent almost an hour driving to fetch the food. This was time she could have spent doing any number of things, including actually preparing a meal for her family. Second was the cost, including the food itself and the gas required to drive to three different restaurants. Third, looking at the food they were eating made her realize that it wasn’t healthy. In fact, their meal included no fruits or vegetables (beyond french fries) at all!

What struck me was that the quality of the food they were eating was the last thing Shannon mentioned to me, almost as a afterthought. What got her attention was the time and money she sent on the food. Cooking at home could have taken less time and certainly would have cost less. It would have been healthier, too.

At least they ate dinner together

 

Being mindful of eating habits, according to Shannon.

I had an interesting conversation with my friend Shannon earlier this week that fit with the topic of being mindful of health habits. (I have written about Shannon previously, but not for some time) 

She was telling me that one recent evening she drove to three fast food restaurants to get dinner for her family. Apparently, she wanted food from a different place than her husband, neither of which worked for her kids. As they sat down at the dinner table she became mindful of how ridiculous this was.

First, she spent almost an hour driving to fetch the food. This was time she could have spent doing any number of things, including actually preparing a meal for her family. Second was the cost, including the food itself and the gas required to drive to three different restaurants. Third, looking at the food they were eating made her realize that it wasn’t healthy. In fact, their meal included no fruits or vegetables (beyond french fries) at all!

What struck me was that the quality of the food they were eating was the last thing Shannon mentioned to me, almost as a afterthought. What got her attention was the time and money she sent on the food. Cooking at home could have taken less time and certainly would have cost less. It would have been healthier, too.

At least they ate dinner together

 

Mindfulness matters for health.

According to a TIME magazine cover article from earlier this year, we are in the midst of a “mindful revolution.” Beyond being a trendy topic, mindfulness is important for making meaningful and lasting health behavior changes. This is the topic of my Health & Fitness column in the Aiken Standard this week. 


Mindfulness can be described as an awareness of thoughts, feelings, bodily sensations, and the surrounding environment. This is most commonly explored through mindful meditation, a practice that is credited with improving physical and mental health. Beyond meditation, being mindful can help to improve attention and focus in nearly every aspect of life.

 

Thinking about your actions and the effect they have on your health and the health of others can be good for you and those around you. It turns out that we engage in many health behaviors that are driven more by habit than conscious decision-making. This includes what, when, and how much we eat as well as how active we are, two of the most important determinants of health.

 

When was the last time you thought about what you were eating? Not just which restaurant to go to or what time to eat, but really thought about what and how much you ate? Chances are, at least some of the time you eat when you aren’t hungry or keep eating even when you are full. You probably also eat foods you know you shouldn’t or don’t intend to, sometimes without even realizing it.

 

This concept was explored in depth by Brian Wansink in the 2006 book, Mindless Eating. Based on his research, this book helped to explain the hidden reasons behind what, why, and how much we eat, often without being aware of it. This includes marketing tricks as well as environmental factors, many of which operate outside of our consciousness, that drive our food choices and prompt us to eat. 

 

This is where mindfulness comes in. By making an effort to be cognizant about your own thoughts and sensations as well as the environment you are in, you can prevent overeating and poor food choices.

 

Furthermore, we should be aware of how our food choices influence others around us. Research shows that children of parents who eat more fruits and vegetables tend to eat more of these foods than kids without such influence. Mindful eating includes accounting for how our actions and choices can influence the decisions of other family members and friends.

 

 

The same is true for how active or sedentary we are. Being active is a choice, sometimes a difficult one, that is influenced by other people and the environment. Most people spend the majority of the day sitting at work and at home, often without thinking about it. This sedentary lifestyle has been linked to an increased risk of obesity and heart disease, so it is relevant.

 

 

Sure, it feels good to sit on the couch to watch television. Think about it: is that really the best way to spend your time? At work, taking short breaks to get up from your desk and move can make you feel more alert and energized. Isn’t that worth it?

 

 

Similar to eating, our activity choices can influence the actions of those around us. A suggestion to walk to lunch can increase your own activity and that of your friends. Planning to go for a walk or bike ride with your family after dinner is a great way to share the benefits of activity.

 

 

When it comes to health, mindfulness matters. Being mindful about what you eat and make a choice to be more active allows you to have a positive effect on your health and the health of those around you.

 

 

My kids will be thrilled to learn that they don’t have to eat vegetables anymore!

According to this video from SCI CODE’s Coma Niddy (via The Kid Should See This), there is no such thing as vegetables.  What we think of as vegetables are really fruits, roots, stems, and leaves.

That said, these formerly-known-as-vegetables are still really good for us and we should eat them.

While my kids will thrilled to learn that they don’t need to eat “vegetables” anymore, I suspect they will be less amused by a plate full of tubers and legumes.

To make your diet healthier, add exercise.

The American diet is frequently blamed for the poor health of Americans and, increasingly, other countries. The quest for the healthiest way to eat can literally take people around the world to find the right foods eat.

Unfortunately, diets and supplements that include these “super foods” are rarely the answer to good health on their own. It turns out that the key getting the optimal health benefits from your diet isn’t the food itself—it’s exercise!

This is the topic of my Health & Fitness column in the Aiken Standard this week. It’s not to say that what you eat isn’t important (it is!). The point is that healthy eating will only get you part of the way to the goal of good health.

For decades scientists have tried to isolate the types of foods or individual nutrients that lead to good health by studying what healthy and unhealthy people eat around the world. In some studies eating more of a certain nutrient or food, like saturated fat or red meat, was associated with a higher risk of heart disease and people who ate more fish had better heart health.

This is how we arrived at the common guidelines that encourage us to eat more fish and less red meat. The assumption was that the saturated fat in red meat was the cause of more heart attacks in Americans while the beneficial oils in fish protected the Japanese from heart disease.

But these studies, or at least the interpretation of these studies, didn’t take into account the fact that the populations that had the higher heart attack risk were also less active than their healthier counterparts. Perhaps it was the physical activity that made the difference in health.

A good example of this is the popular Mediterranean diet, which is often touted as the healthiest diet in the world. It’s true that people in the Mediterranean region historically tended to have a lower risk of heart disease. This was thought to be due to their diet which emphasizes healthy fats from olive oil along with vegetables, whole grains, seafood instead of red meat, and red wine in moderation.

Unfortunately, eating more olive oil or drinking more red wine, both recommendations based on the Mediterranean diet, won’t necessarily make you any healthier. This is because health benefits are due to a complex interaction of what we eat and other lifestyle factors, including activity. And people in the Mediterranean region move a lot more than we do, a key to realizing the benefits of the local diet.

Another example is the Ornish diet, a low-fat, semi-vegetarian diet that has been credited with improving blood lipids and even reversing the process that clogs arteries in heart disease. This is part of the reason for the recommendation to avoid foods high in saturated fat and cholesterol and eat more vegetables. It’s true that this diet has been shown to improve heart health, but the subjects in the studies also exercised regularly. Achieving the full benefits of this diet requires exercise, too.

Even the typical American diet won’t necessarily be unhealthy when combined with enough exercise. The Olympic swimmer Michael Phelps famously revealed what he ate on a typically day. The amount and type of foods he consumed were not what you would expect from someone so fit and healthy! Without the hours of training he engaged in each day that diet would almost certainly have resulted in obesity and poor health.

So, as you work toward improving your diet, don’t forget about the importance of daily exercise or other activity in maximizing the health benefits. And when people ask your secret, you can tell them that the real key to a healthy diet is exercise.

Don’t go into (health) debt!

We are all aware of the hazards of being in debt. Too many individuals and families have gotten themselves in a poor financial situation by spending too much and not saving enough. For most, this debt has developed over several years and will have an impact lasting years into the future.

Unfortunately, this is not the only debt we face. Many of us are also in a health debt crisis. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Poor eating habits and increasingly sedentary lifestyles have led to an obesity epidemic. This is important since the three leading causes of death among adults (heart disease, stroke, and cancer) are directly linked to poor diet, inactivity, and obesity.

Obesity, diabetes, heart disease, and cancer are among the conditions that make up our health debt. Even if we have not been diagnosed with these or other health conditions, our lifestyle has put us on that path.

Whether our doctors have told us or not, many of us are in poor health. And our overall health and potential complications get worse each year, so the longer we are overweight and inactive, the worse our health is likely to be in the future. That is our health debt crisis.

Another example of a health debt is smoking, the cause of nearly 90% of lung cancer cases. Lung cancer doesn’t develop after the first cigarette; it takes years of smoking to cause cancer. One estimate suggests that there is a 20 year time lag between smoking and lung cancer diagnosis.

During this time smoking is causing damage to the lungs that leads to cancer, but it is usually undetectable. The cancer process is underway long before it causes symptoms, and since smokers are unaware of it, they continue to smoke. Quitting smoking begins to erase this debt but former smokers suffer poor health even after they quit. In some cases, the debt can’t be completely paid back.

Aside from poor health and reduced quality of life, health debt carries a financial cost. The medical costs attributed to obesity alone are estimated to be $147 billion per year, and a typical obese patient spends over $1,000 more per year on their own medical care than someone at a healthy body weight. The financial burden is both collective and individual, meaning we all pay for it.

Just as financial debt is due to an difference between the money we save and what we spend, much of our health debt is due to an imbalance between the energy (calories) we save and spend.

We have been spending too little energy through activity and saving too much of the energy we eat in the form of fat. Each day we consume more calories than we burn, we store that extra energy as fat. Even a small difference each day adds up over time.

Putting it in these terms, the pathway out of health debt is clear—spend more energy by being more active and cutting back on the calories we eat. Like a financial debt, even though the solution is easy to identify, putting it into place requires making some difficult choices.

But it doesn’t have to be a painful process. Even small changes in activity and diet can lead to weight loss and improved health over time. Make it a priority to be active every day and try to spend less time sitting. Pass on second servings at meals and skip desert once in a while.

Remember, the health debt wasn’t created overnight. It was the result of small changes over time, some of which we may not have noticed. Fixing it will take time, too.

Are fat-free and sugar-free foods healthy? Maybe not!

Have you ever felt confused by the health claims made about some foods? If so, you are not alone. Nutrition is isn’t always easy to understand and, unfortunately, misleading information on food labels only makes it worse.

There are a great many foods that seem as though they would be healthy choices for weight loss or good health in general. Surprisingly, some of these low-fat and low-sugar alternatives aren’t as healthy as you might think.

This is because, in many cases, the claims on the label only tell part of the story. This isn’t to say that the information is false, but it does require some interpretation to understand whether these foods are really a healthy choice.

My Health & Fitness column in the Aiken Standard this week includes two examples of label language that seems to indicate a healthier option, but may not necessarily be the case:

1. Fat-free

Cutting back on fat intake is a good way to reduce calories and is typically recommended for weight loss. It is also a major part of traditional recommendations to lower cholesterol and prevent heart disease, although recent research suggests this may not be so important.

In order to meet a demand for lower fat and lower calorie foods, manufacturers have long offered fat-free versions of popular items. Cookies, snack foods, and salad dressings are among the most popular fat-free foods, especially for people who are trying to lose weight.

However, the number of calories in the fat-free foods may be the same as the full-fat versions because manufacturers often add sugar to make these lower fat foods taste as good. This is often the case for cookies, cakes, and other fat-free baked goods.

In the end, these fat-free foods may not really be lower in calories. And common sense tells us that the best way to reduce calories is to eat fewer of these snack foods and dressings in the first place.

 2. Sugar-free

Reducing sugar intake is also a popular way to limit calories in many foods and beverages. Currently, sugar is viewed as a major contributor to obesity and poor health in general, so this also makes some foods appear to be healthier than they really are.

While it is true that sugar-free versions of desserts and snack foods do usually contain fewer calories, the alternative sweeteners used instead raise some concerns. While there is no good evidence that these sweeteners are harmful, they certainly don’t make these foods any healthier.

It is important to note that the concern is with foods that have added sugar, such as packaged or prepared desserts, baked goods, and snacks. Foods with naturally occurring sugars like fruits, fruit juices, milk, and some vegetables are not worth worrying about.

Again, the most reasonable approach to creating a healthy diet is to eat fewer foods with added sugar, not looking for foods that replace added sugar with artificial sweeteners.

The Bottom Line

The problem for most people isn’t that they are eating cookies with too much sugar or salad dressing with too much fat, it’s that they are eating too many cookies and using too much dressing in the first place. Lowering fat or sugar in these foods does little to make people healthier.

The only way to do that would be to limit the intake of these processed foods in favor of more “real” food. Indeed, fruits, vegetables, nuts, and natural oils (like olive oil) are widely thought to be healthful, certainly better than processed and modified alternatives.

Calories Still Count!

The debate about whether diet and exercise are the cause of or good treatments for obesity has been going for some time. A familiar point of argument is the role of total calories vs. the source of those calories.A new model of how obesity illustrates how calories in, calories out may not be the initial step in the cascade of physiological and behavioral factors that lead to significant fat gain. But this doesn’t change the fact modifying eating and activity behaviors are a key step in the development of obesity—and the key to weight loss.This is the topic of my Health & Fitness column in the Aiken Standard this week.


Eat less, exercise more. Calories in, calories out.

These phrases are probably familiar to you if you have tried to lose weight. This is because these concepts make up the traditional explanation for why people gain weight and the most common method of losing weight.

More and more research suggests that gaining and losing weight might involve more that the simple math of counting calories. It may be that the source of the calories matters as much as the total amount that you eat.

However, this doesn’t mean that you can ignore the calories you eat and expend through exercise and other activity. While it may be true that the quality of the food we eat is important, calories still count.

A recent article in the Journal of the American Medical Association proposes an alternative to the classic model of how weight gain occurs. Traditionally, an imbalance between calories in and calories out causes obesity. According to this model, eating too much and not being active enough results in increased fat storage.

The new model suggests that diet quality, especially the type and amount of carbohydrates, combined with genetics and lifestyle factors including getting enough sleep and excessive stress leads to fat accumulation. The excess fat alters levels of hormones and other factors that stimulate hunger and inhibit energy expenditure, including physical activity.

In the new model, increasing fat mass comes first and excessive food intake and inadequate activity follows. The end result is the same, though: a small increase in body fat turns into obesity.

This seems to suggest that carbohydrate intake, especially from refined grains and sugars, is the main culprit. This is good news for people who follow and promote low-carb diets! It also gives the impression that exercise isn’t as important as previously believed.

But a closer look at the new model shows that obesity—storage of excessive body fat—really is the result of too many calories in and too few calories out. The difference is that the eating and activity behaviors is driven by other factors.

The fact of the matter is that diet quality, genetics, and factors such as stress and sleep do play a role weight gain. Changes in hormones, sugars, and fats in the blood are real and powerful physiological signals that certainly contribute to obesity.

But so do changes in how much we eat and how active we are. It would be wrong to disregard these behavioral factors and the important role they play not only in body weight regulation, but in health in general.

Furthermore, the traditional calories in, calories out model of weight gain leads to a sensible treatment for obesity: Eat less, exercise more. Even though these simple recommendations can be challenging to implement, certainly in the long term, people who follow this advice do lose weight.

Even in the new model, calories in must be greater than calories out to lead to the significant fat gain that characterizes obesity. Additionally, the focus on the food quality is also consistent with this idea. People who get more of their calories from refined grains and sugars tend to consume more total calories.

As of now, the only treatments we have for obesity focus on changing energy intake and energy expenditure. This almost always involves altering eating and activity behaviors and frequently includes other lifestyle changes including stress management and getting enough sleep.

Given this new model of obesity, the best way to lose or maintain weight is not new at all: Eat less, move more, chill out!

When normal isn’t normal.

The typical American is overweight, doesn’t get enough exercise, eats too few vegetables and fruits, too much sugar, and too many calories. Unfortunately, we have come to consider this combination as “normal.” While this situation may be common, it is definitely not normal. This is the topic of my Health & Fitness column in the Aiken Standard this week.

For most measures of health, a normal value is consistent with good health. A “normal” blood pressure is in a range that is associated with a low risk of stroke, for example. Someone with LDL (bad) cholesterol that is considered “above normal” has a greater risk of heart attack than a person with a normal LDL value.

But for many health indicators, having a normal value is not the norm. According to the most recent recommendations, a normal blood pressure is less than 120/80 mmHg. However, nearly 60% of adults have a blood pressure that is above normal, meaning they have hypertension or prehypertension.

A person who has a body mass index (BMI) in the normal range, between 18.5 and 24.9 kg/m2, is considered to be at a healthy body weight. But two-thirds of adults are overweight, with a BMI above the normal range. Similarly, participating in regular exercise should be considered normal. But it’s not, since fewer than half of adults meet minimum recommendations for physical activity.

The problem is that the term “normal” is frequently used to refer to what is typical, rather than what is healthy. Obesity is so common that a person who is at a healthy weight may look out-of-place. So many people look for ways to avoid physical activity that a person who walks instead of drives is considered abnormal. The person who comes away from a buffet with a less-than-full plate or who has a salad for dinner often gets strange looks. One of the reasons that people get noticed for doing these things is because they stand out from the crowd.

In reality, though, many of the health behaviors we consider to be abnormal—regular exercise, a healthy diet, or a lean physique—are, historically, completely normal. Until relatively recently, most everyone was active much of the day and spent little time being sedentary. Likewise, the consumption of the processed foods that are such a big part of our current diet was rare even a few decades ago.

It is likely that, by considering unhealthy behaviors to be normal, we have created a situation that discourages people from adopting a healthy lifestyle. As anyone who has tried to change their health habits knows, it can be a challenge, especially if everyone else maintains their typical eating and activity pattern. It’s not easy to be “the one” who only eats healthy food or who takes time to exercise every day.

Maybe we need to redefine normal health behaviors to reflect what is healthy rather than what is most common. When walking or biking rather than driving becomes the norm there will be greater incentive to provide safe places for pedestrians and cyclists to travel. When a healthy diet is considered normal it is more likely that restaurants will offer more nutritious options.

In the end, we would all benefit from changing our definition of normal. And a normal diet and activity pattern will go a long way to promoting a normal BMI, blood pressure, and cholesterol.