Thursday, July 13, 2017

Is Coconut Oil Healthy?

This subject perfectly illustrates the deep chasm between nutrition research and the general public’s views of nutrition. They are very often not aligned. I’m not sure when or how it started, but a few years back, the idea that coconut oil was health promoting began to build momentum.

The answer is no, coconut oil is not the best oil to use. It is not even close to being the best oil to use. In fact, it is probably the one you most want to avoid using.

Coconut oil is extremely high in saturated fat. Almost 90% of the fat in coconut oil is saturated. For comparisons sake, butter contains 64% saturated fat and beef contains 40% saturated fat. 

The saturated fat in coconut oil raises LDL cholesterol, which increases risk of heart disease and stroke. In fact, the American Heart Association recently released a report advising against use of coconut oil, citing a review of 7 randomized trials showing that coconut oil increased LDL cholesterol in all 7 studies!

Oils with high amounts of mono and polyunsaturated fats, such as olive oil and canola oil, have the exact opposite effect. They lower LDL cholesterol and have been associated with reduced risk of heart disease and stroke. These are the oils you should be using.

Prebiotic supplementation and weight loss in children

The Study
Prebiotics are a non-digestible carbohydrate that promote the growth of healthy bacteria in the gut. The role of prebiotic supplementation in weight loss is controversial. In this randomized trial, 42 overweight boys and girls between the ages of 7-12 were assigned 8 grams of oligofructose-enriched inulin (a prebiotic) each day or placebo for 16 weeks. After the intervention, a variety of measures were taken and an all you can eat breakfast buffet was offered to the subjects. 

After 16 weeks of supplementation, there were no significant differences in the amount of food the subjects were consuming on a daily basis. There were no significant differences in body mass index between the two groups. When all subjects were included, there were no significant differences in the amount of food consumed at the all you can eat breakfast buffet. American Journal of Clinical Nutrition 2017; 105:790-99.

Take Home Message
It appears that prebiotic supplementation is not effective as a weight loss strategy. It is interesting to note that when the analysis was restricted to just 11-12 year old subjects, there was a significantly lower consumption of food at the breakfast buffet at the end of the intervention for those in the prebiotic group. 

However, when all of the data was looked at together, there was no significant difference in daily energy consumption or BMI after 16 weeks of supplementation. It will take some more research to fully answer this question, but right now it does not look like prebiotics will do much to aid in the weight loss process.  

Can whole grains increase metabolism?

The Study
The impact of whole grains on body weight remains a controversial topic. In this randomized controlled trial, 81 men and women were put on a 6 week diet. The diets were identical except for the fact that one group received 207 grams of whole grain and 40 grams of fiber each day, while the other received refined grains and only 21 grams of fiber. The goal of this intervention was to maintain weight and observe any metabolic differences between the two groups. By the end of follow-up, the whole grain group had a significant increase in resting metabolic rate and a higher stool energy content than the refined grain group. The combined difference between the two groups amounted to 92 calories per day. American Journal of Clinical Nutrition 2017; 105:589-99.

Take Home Message
In the last few years, several fad diets have attempted to demonize whole grains as unhealthy and an obstacle to weight loss. The research does not support this view. The literature is replete with studies associating whole grains with a reduced risk of heart disease, stroke, diabetes, inflammatory disease and cancer. This study is a great example of some emerging evidence that it can help maintain body weight as well.

There are several potential mechanisms to explain the relationship between whole grains and a lower weight. Whole grains are thought to suppress appetite, improve glycemic control, improve insulin sensitivity and are also thought to positively alter gut-microbiota. The 92 calorie per day difference found in this study does not sound like a lot but it adds up. In a year’s time, this difference equates to a weight loss of about 6 pounds. 

Don’t listen to those that tell you to avoid whole grains. They are a very important part of a healthy diet and may actually help you lose weight. Shoot for 1-2 servings per day. Great choices are oatmeal, brown rice, and quinoa.

Book Review: Blast The Sugar Out

Next up for review is Blast the Sugar Out. The author, Dr. Ian Smith, is a medical doctor who used to be a co-host of the television show, The Doctors. He has written several other bestselling health, fitness and weight loss books.

This book presents a 5 week weight loss strategy packed with recipes, meal plans and snack ideas. It has a particular focus on reducing blood sugar levels for those who are diabetic or prediabetic. The author mentions that the book was also written for anyone who wants to lose weight or reduce their sugar consumption. The book is 240 pages long. It is well written and I truly enjoyed reading it.

5 Things I Really Liked About Blast the Sugar Out
1) I like how the primary focus of this book is to reduce refined sugar consumption. After trans fat, I rate sugar as the worst thing that we can eat. The number of problems that refined sugar causes is staggering. I treat it like a drug, because to me that is what it is. 

2) I really like that the book emphasizes cardiovascular exercise as a big part of the program. It needs to be a major focus if weight loss is your goal.

3) I like the recommendation to drink a lot of water. It is essential not only for weight loss, but for overall health and quality of life.

4) The recipes and meal plans are well organized and very well done.

5) I really liked the Sugar Swap in the back of the book (Appendix 1). In this section, the author lists a much healthier alternative for every kind of sugary treat that you may be tempted by. This is a very practical little section.

5 Things I Didn’t Agree With In Blast the Sugar Out
1) A lot of high glycemic load carbs are allowed on this program. All of the following are regulars in the meal plans: cold cereals, dried fruit, smoothies, French toast with maple syrup, French fries, lots of bread (even whole grain bread can spike blood sugar), onion rings, pizza, popcorn, fruit juice, pancakes, crackers, rice cakes, pita bread, animal crackers, vanilla wafers, pretzels, etc.  When it comes to spikes in blood sugar, increased hunger and cravings, many of these foods are as damaging as sugar.

2) This book is very big on snacking. In addition to 3 meals, the plan calls for 2 or even 3 snacks per day. In my experience, this can lead to overeating and really slow down rate of weight loss. If the average woman needs to be close to 1,200 calories/day to effectively lose weight, each meal/snack needs to be around 200 calories. This is not a lot of food! If she goes over by even 50 calories per meal or snack, she is looking at 300 extra calories per day or 9,000 extra calories per month. Further, if you are eating in a way that stabilizes blood sugar, you will not need to eat every 2 or 3 hours. You simply won’t be hungry.

3) Allows late night snacking. In the section on snacking, the book mentions that it is OK to have a snack at 8:30 PM or later. I have found that late night eating is a really bad idea for those trying to lose weight. I have seen it completely prevent weight loss in past clients and I actually use it as a strategy to gain weight for the rare client that works with me in an effort to increase their weight.

4) A lot of the meals are really low in fat. Fat is actually a very good thing in your diet, if you choose it carefully. Vegetable based fats like olive oil, canola oil, nuts, and avocados have a positive impact on risk of chronic disease. They also help to stabilize the blood sugar, decrease insulin spikes and keep you full longer than meals without fat. The research literature has also shown that low fat diets are not effective for long term weight loss.

5) The book could focus a bit more on resistance training. While a good amount of time is spent on cardio, strength training is mentioned only briefly. I believe that weight training is the secret ingredient to lasting weight loss. Sparing lean tissue during the weight loss process is the absolute key to keeping the weight off.

Is Blast the Sugar Out Worth Reading?
Absolutely. This book gets a lot right. As a nation, we all need to be eating a lot less sugar. It is far more damaging to our health than most people realize. This book will help you to do that. I would just make a few additions to this program. I would be a little stricter with the high glycemic carbs, cut down on the snacking (especially at night), add in a bit more healthy vegetable fat and add a whole bunch of strength training.

Saturday, May 13, 2017

Visual cues and subsequent energy intake

The Study
Larger portion sizes have been shown to increase energy intake in the research literature. A recently published study attempts to explain why. Thirty-six children between the ages of 7 and 10 were shown a variety of pictures while undergoing a brain MRI scan. Some of the pictures were of large portion sizes, some were of small portion sizes. Some of the pictures where of high energy density junk foods (like chicken nuggets, French fries and cookies) and some were of low energy density healthy foods (like grilled chicken, green beans and blueberries).

The results were fascinating. When the children were shown pictures of foods with large portion sizes, there was a decrease in activity in the region of the brain called the inferior frontal gyrus. This region is important for inhibition. When the children were shown pictures of the high energy density junk food, there was an increased activation in the insula, caudate and cingulate. These parts of the brain deal with reward and taste processing. American Journal of Clinical Nutrition 2017; 105:295-305.

Take Home Message
This is a really interesting study. Just seeing pictures of foods that were large in portions or energy dense changed the brain in a way that increased the desire to overeat. When I first started studying nutrition and weight loss in the early 2000’s, the prevailing wisdom was that losing weight was simply about eating less and exercising more. 

It is now clear that there is a lot more going on. There are a multitude of factors that impact our food choices and cravings. The results of this study add simple visual cues to the growing and complex list of body systems that impact what we eat and how much we eat. We are learning a lot but still have a ways to go. If you find yourself in the presence of tempting foods that you do not want to eat, look away! J

Changes in skeletal muscle and organ size after weight loss

The Study
Most people who lose weight have a really hard time keeping it off. This is largely due to a drop in resting energy expenditure after weight loss. The goal of this study was to learn more about the root cause of the metabolic decrease that accompanies weight loss. For this investigation, 53 men and 39 women with type 2 diabetes were randomly assigned to one of two groups. The first group had an intensive diet and exercise intervention to help them lose weight. The second group had diabetes support and education, but did not lose weight. MRI scans were performed on all subjects at the end of one year and then again at the end of the second year.

The results were very interesting. By the end of 1 year, only the diet and exercise group lost weight (14.5 pounds on average). The diet and exercise group lost a bit more muscle during the first year (about ½ a pound), but also had significant reductions in the size of their spleen and liver when compared to the control group. American Journal of Clinical Nutrition 2017; 105:78-84.

Take Home Message
This is a pretty cool study. The intervention that helped these subjects lose weight was really heavy on exercise, which is why they maintained a lot of their muscle. The fact that their organs decreased in size is fascinating. Organs like the liver, spleen, heart, and kidneys burn a lot of calories. The fact that they may get smaller after weight loss may explain a lot of the decrease in metabolic rate seen after weight loss. 

The take home message is the following: lift weights at least twice per week when trying to lose weight. This will minimize the loss of lean muscle tissue and make it much easier to keep the weight you lose off permanently. We need to learn more about the decrease in organ size and how this may impact our ability to keep weight off. Stay tuned.

Product Review: Bodylastics Resistance Bands

When I was in college and even grad school, there always seemed to be plenty of time to get to the gym and enjoy a leisurely workout. Now that I’m older, time is definitely more limited. I’ve noticed the same thing with the majority of my clients over the years. At the end of the day, it is just not realistic for most people to get the gym on a daily basis. It is for this reason that I am a huge proponent of working out at home.

You do not need a lot of space or equipment to successfully exercise at home. An inexpensive piece of cardio equipment (such as the Gazelle Edge), a flat bench and some dumbbells will get the job done quite well for most people. However, working out your back can be a bit more challenging in the home environment. There are a few dumbbell exercises that focus on the back, but to really get the variety you want, you’ll need to bring in some other equipment. I figured I’d use this post to introduce one such piece of equipment: Bodylastics Resistance Bands.  

Bodylastics Resistance Bands are a stackable and adjustable resistance system. The version that I purchased has 96 pounds of resistance, but they also sell versions with more or less resistance. The system comes with 4 different colored bands of varying thickness that you can combine to produce the exact resistance you need for any exercise.

In addition to the stackable resistance bands, the system comes with hand and ankle handles, as well as a door anchor. The door anchor is the absolute key. It allows you to attach the system to any door that closes in your home. If you put it up high, you can simulate high pulley exercises, like lat pull downs. If you keep the anchor a bit lower, you can simulate low pulley exercises, like seated rows. This adds a completely new element to how you can work your back at home. Let’s take a quick look at the pros and cons of the Bodylastics system.

1) Extremely Well Made And Durable: I’ve had my bands for 6 years and they are showing no signs of wear and tear.

2) Serious Resistance: I’ve historically been a bit down on resistance bands in general. I never felt like I was getting the type of resistance that I needed. Not so with the Bodylastics system. These feel a lot tighter than other bands I’ve used. I get a great workout with these.

3) Comes With A Door Anchor: Great for working the back with simulated high and low pulley exercises.

4) Very Portable: The system comes with a carrying case that can easily fit in your luggage for when you need to bring your workout on the road.

5) Very Secure Door Anchor: Door anchors tend to make me nervous. Not this one. It is solid and it’s going no where, so feel free to workout with confidence.

1) The only con that I can come up with is the price. They are a bit more expensive than other resistance bands. They retail for $54.95, but as of this writing, has them on sale for $29.95, which is a great price while it lasts.

Do I Recommend Bodylastics Resistance Bands?
Absolutely. These are a great addition to any home gym and will allow you to be much more creative with your workouts. While they cost a bit more than other bands on the market, the quality of this product easily makes it worth the extra investment. To learn more about these bands or to pick them up, check out their amazon page (here).

Disclosure: I am not affiliated with the company that makes these bands and make no money if you buy them.  I just think they are great and want to let you know.