Wednesday, November 24, 2010

Question And Answer: Breakfast

          I’ve been working in the fields of exercise and nutrition for over 15 years.  I see many of my own private clients each day and a number of doctors in Boston send me out to meet with their patients for weight loss and disease risk reduction.  I’ve noticed that certain questions tend to come up time and time again and I thought it would be a nice feature to answer some of them for you on this Blog.  Today’s topic is breakfast.

Question:  Skipping breakfast is a good way to decrease the day’s calories and lose weight, right?

Answer: Absolutely not!  When you skip breakfast you switch on a mechanism that will increase weight gain, not weight loss.    You must remember that we evolved in times of famine and food scarcity.  To survive, humans had to develop ways around these tough times in our evolution.  If you finish dinner at 7:00 PM and then wake up, skip breakfast and eat lunch at noon, you have gone 17 hours without eating.  This tells the body that there is a lack of food around and the body makes 2 relevant adjustments.  1) It slows down your metabolism. 2) It preserves your body fat and will burn muscle for energy.  Neither of these will help you lose weight.  Eat a nice sized breakfast every single day.

Question: I’m just not hungry in the morning, doesn’t that mean that I don’t need to eat?

Answer: Not at all.  You will develop a hunger for breakfast once you get into the routine.  If you have to force yourself at first, so be it.

Question: Is it alright to drink coffee in the morning?

Answer: Absolutely.  Feel free to drink a cup or 2 of coffee each day, regular or decaf.  Recent research suggests that coffee drinkers have a slightly reduced risk of cardiovascular disease and type 2 diabetes, so it may actually be good for you.   However, make sure you don’t add sugar or artificial sweetener to your coffee (a little milk or cream is ok).

Question: Can I do smoothies for breakfast?

Answer: I’m not a huge fan.  #1) I like real food in general, I don’t like powders or supplements for protein.  #2) Most smoothies include adding whole fruits and blending them to a puree.  This separates the sugar in the fruit from the fiber and will cause a greater spike in blood sugar and insulin than if you ate the whole fruit as nature intended.  This will have a negative effect on subsequent hunger and body weight.  A simple breakfast like nuts, fruit and a few slices of turkey breast takes no more time to make than a smoothie and will better stabilize your blood sugar.

Question: I do my cardio in the morning, should I eat before or after?

Answer:  This depends entirely on you.  Some people can workout on an empty stomach and feel fine (like me).  I don’t eat before my cardio if I do it first thing in the morning.  If you feel really hungry and weak without breakfast, I would suggest splitting your breakfast in two parts and eat half before your workout and the other half after.  I don’t think it is a good idea to workout on a full stomach.


Sunday, November 14, 2010

Book Review: The Paleo Solution by Rob Wolf

           Another regular feature of my Blog will be book reviews.  I’ll take a look at popular books on Diet, Exercise, Weight Loss and Health and let you know what I think.  I have only 2 criteria for reviewing a book.

1) It must be a Nutrition/Weight loss top 20 best seller on Amazon.  I want to review books that you all have heard of and may like to read.

2) The author must have credentials.  I need to see some level of education.  In other words, I need to see proof that the author has at least a peripheral understanding of nutrition science and research.  I am more than tired of celebrities who are selling diet and weight loss books without ever opening a book on the subject.

            The Paleo Solution by Robb Wolf meets both criteria nicely.   It is a best seller on in the category of weight loss and the author has a degree in biochemistry, a field closely correlated with nutrition.

            The book is based on the theory that the diet we ate during the Paleolithic or “hunter-gatherer” era of our evolution is the most health promoting.  The book is really well written and quite humorous at times.  The author and I have a lot in common.  In our youth we were both trying to be healthy and followed a low fat, high carb diet that made us sick.  We eventually learned about the right way to eat, fell in love with the field of nutrition and got a degree in the field.  The book spends a lot of time going over the biochemistry of digestion, presents a detailed 30 day meal plan and spends a good amount of time discussing exercise.   It’s a fairly long book (320 pages) but it reads quick because it is interesting and well written.

5 Things I really like about The Paleo Solution
1) The idea of studying human evolution to figure out what we should eat.  Anyone who has worked with me or read my book knows that my nutrition philosophy is heavily influenced by studying the original human diet.

2) The emphasis on the biochemistry of digestion.  The author does a great job explaining the hormonal consequences of eating different foods.  This is very important information if you want to truly understand the health effects of the foods we eat.

3) Emphasizes the importance of adequate sleep.  This is huge for both general health as well as weight loss.

4) Stresses that exercising too much is not good for you.  I like the moderate approach he takes to increasing physical activity.

5) Focuses on just 3 meals a day.  I totally agree with this philosophy.  With a stable blood sugar, there is no need to graze.

5 Things I disagreed with in The Paleo Solution
1) One thing that I found a bit tough to take is how the author kept blasting the nutritional research as quackery and non-scientific.   I feel that the research we do at Harvard is extremely relevant and our methods are tried and true.  There are a lot of problems with nutrition science for sure but to make such a blank statement was a bit rough.

2) The author believes that all grains are unhealthy.  I don’t agree with this.  There is very well designed research that points to the beneficial effects of whole grains on risk of heart disease, diabetes and even some cancers. 

3) The author also doesn’t differentiate cereal fiber from other forms of fiber.  He mentions that you get lots of fiber on his diet, which is true, but none of it is cereal fiber.  In our research at Harvard, cereal fiber had the most protective effects regarding disease risk reduction.

4) The meal plan was a little heavy on the red meat.  One of his sample days had red meat at all 3 meals and even for the snack.   This is not a good idea.

5) The nutrient composition of a sample day on his plan was: Fat 39%, Carb 23%, Protein 38% and cholesterol 461 mg.  This is a bit high on the protein.  I did a review paper on high protein diets and I feel this amount of protein may put a stress on the kidneys of sensitive individuals.  I’m also not crazy about the amount of cholesterol ingested on this day.

Is it worth reading?
        I think The Paleo Solution is definitely worth reading.  I learned a lot about how our early ancestors lived and ate and this is extremely relevant when asking questions about the lifestyle we were designed to live.   However, I think to follow the diet literally isn’t the best idea.   There is a lot of really good research out there that has improved our knowledge of the health effects of our food and that must be taken into account in addition to our native diet. 

        One last thought: Our early ancestors lived for only 30-35 years.  Who knows what long term health affects this native diet would have had on risk of heart disease, stroke, diabetes and cancer if they lived to their mid 70’s like we do?

Thursday, November 4, 2010

Research Update

As many of you may already know, I read the nutrition literature monthly to keep up to date on the latest research.  I will regularly post summaries of some of the studies that I find particularly relevant.  Here is the latest:

Red Meat And All Cause Mortality
Archives of Internal Medicine vol 169, pp 562-71, 2009

These results came from the National Institutes of Health-AARP Study and included approximately 500,000 participants.  Those who ate the most red meat (5 oz per day) were 30% more likely to die over the next ten years than those that ate the least (2/3 oz per day).  For the purposes of this study, red meat included beef, veal, lamb and pork products.

Take Home Message: This is not the first time we’ve seen such results regarding red meat consumption.  It is high in saturated fat, often contains nitrates and sulfates, and when cooked converts carcinogenic heterocyclic amines.  Focus on chicken, turkey, fish, eggs and legumes for your protein choices and let red meat be an occasional treat.

Micronutrients And Fad Diets
American Journal of Clinical Nutrition vol 92, pp 304-12, 2010

This study looked at 4 distinct dietary approaches to weight loss and measured their nutrient quality.  73 overweight or obese women were put on each diet for a period of 8 weeks.   The diets tested were the Atkin diet (extremely low carb), the Zone (moderate carb, Mediterranean), Ornish (extremely low fat) and LEARN (based on the US Food Pyramid).   The results were very interesting.  The Atkins group was deficient in Thiamin, Folate, Vitamin C, Iron and Magnesium.  The Ornish group was deficient in Vitamin E, B-12 and Zinc.  The Learn group was deficient in Vitamin E, Thiamin and Magnesium.  The Zone intervention resulted in no deficiencies and in fact was associated with a significantly decreased risk of deficiency for Vitamins A, E, K and C.

Take Home Message: This study provides more evidence of the healthful nature of a Mediterranean style of eating.  Moderate low glycemic carbs, a good amount of healthy fats and lean sources of protein are the hallmarks of this dietary strategy.  If you’ve read my book, worked with me or read this Blog this is old news for you!!! :)

Omega 3 And Fish Consumption And Risk Of Age Related Hearing Loss
American Journal of Clinical Nutrition Vol 92, pp 416-21, 2010

This was a cohort study of 2,956 men and women in Australia.  Diet was measured by means of a food frequency questionnaire and then hearing was measured at 5 and 10 year follow-up visits.   Subjects that consumed fish greater than or equal to twice a week had a 42% reduced risk of age related hearing loss compared to those that ate fish less than once a week.

Take home message:  This study provides even more evidence of the benefits of fish consumption.  Make sure you include seafood in your protein choices at least twice a week but limit consumption of the high mercury varieties- including Swordfish, King Mackerel and Tilefish.