Saturday, March 14, 2020

Does weight gain change your brain’s response to high sugar/high fat foods?

The Study
In this fascinating study, 67 subjects were given milkshakes containing varying amounts of fat and sugar while undergoing a brain MRI. Thirty-six of these subjects had a 10% or greater increase in their BMI in the previous 2 years. Thirty-one of these subjects were weight stable in the previous 2 years. The subjects who had gained weight showed a decreased responsivity in brain regions associated with taste and reward processing when consuming milkshakes high in fat and sugar. This would make them more likely to want to keep eating these unhealthy foods. American Journal of Clinical Nutrition 2019; 110:1275-86.  

Take Home Message
This study provides further evidence that there is an addictive component to eating unhealthy foods. I have noticed this with my clients for years. Although the mechanisms are not quite clear, it appears that the more high sugar and high fat food you eat, the more you want.

Egg consumption and dementia

The Study
Moderate egg consumption has been associated with improved cognitive function in the research literature. This may be due to the high content of phosphatidylcholine in eggs. This study examined the association between phosphatidylcholine and risk of dementia in 2,497 middle-aged men from Finland. After 21 years of follow-up, men who consumed the most phosphatidylcholine had a 28% lower risk of dementia when compared to men who consumed the least. Even more impressive was that in a subset of the study, men who consumed the most phosphatidylcholine performed significantly better in tests of memory and verbal fluency. American Journal of Clinical Nutrition 2019;110:1416-1423.

Take Home Message
This is a very interesting study. For years, eggs were vilified because of their high cholesterol content. While you don’t want to go overboard with eggs, I tell my clients that up to 6 yolks a week are fine. Eggs yolks contain a lot of healthy nutrients. This study adds to that list of healthy nutrients. Just one note- if you have diabetes, it is a good idea to limit egg yolk consumption. Some research has shown an increased risk of heart disease in diabetics who consumed a lot of egg yolks.

Friday, March 13, 2020

Is intermittent fasting the best way to eat for our weight and health?

Intermittent fasting has been the subject of a lot of research and intense conversation of late. A recent review article in The New England Journal of Medicine adds fuel to the debate. What are the pro’s and con’s of intermittent fasting? Is it the easiest way to lose weight? Is it the best strategy for health and longevity? I don’t know if we totally have the answers to these questions just yet, but some conclusions can be drawn from the data we have so far.

The Article 
The article was published in late December in The New England Journal of Medicine by two researchers from John’s Hopkins University School of Medicine (Reference 1). The main thrust of the article is to present the health benefits of intermittent fasting. The authors argue that fasting turns on adaptive cellular responses that improve glucose regulation, increases stress resistance and suppresses inflammation. 

The article discusses the three most studied fasting protocols:
-Alternate day fasting.

-5:2 intermittent fasting, where you fast for 2 days each week.

-Daily time restricted feeding.

The article goes on to describe research that found benefits of intermittent fasting on aging and a wide variety of disease processes, including: cognitive function, obesity, diabetes, cardiovascular disease and cancer.

Conclusions And Recommendations
1) This article presents some very interesting research concerning the health effects of intermittent fasting. This is a well written and well researched article published in the top medical journal in the world. The researchers make some compelling arguments about how fasting can improve health. I think the research in this area is in a really early stage and we need to do a lot more before we have any definitive answers.

2) Having said that, most of the research has been on animals. This can be a problem because animals have a very different physiology compared to humans and many times animal research does not translate to humans much at all. The authors mention this in the conclusion: “Animal models show that intermittent fasting improves health throughout the life span, whereas clinical studies have mainly involved relatively short-term interventions, over a period of months. It remains to be determined whether people can maintain intermittent fasting for years and potentially accrue the benefits seen in animal models” (Reference 1).

3) When it comes to weight loss strategies, I am not at all convinced that intermittent fasting is the way to go. I feel this way for several reasons:

-In most of the studies that I have seen, there is no greater weight loss when comparing fasting and a more standard continuous calories restriction. I researched two of the weight loss studies cited in this review (References 2 and 3). These studies compared continuous calorie restriction to intermittent fasting. In both of these investigations, the amount of weight loss was the same whether fasting was used or continuous calorie restriction was used as a method of weight loss. 

-While there were some benefits to those who fasted, including improved fasting insulin and insulin resistance, there were some negatives as well. Several other research investigations that I have covered in my blog showed negative outcomes with diets using intermittent fasting. These include: an increased LDL cholesterol, glucose dysregulation, increased inflammation, increased hunger, a decreased physical activity level and a decreased energy expenditure. If you want to reference these studies, please refer to this older blog post (click here).

-There can be some real side effects to intermittent fasting. This was apparent in both of the weight loss studies that I downloaded from the review. In the British Journal of Nutrition article, subjects in the intermittent fasting group were more likely to report constipation, headache, feeling light-headed and being preoccupied with food as side effects (Reference 2). Furthermore, the subjects fasting were more likely to have deficiencies in important nutrients such as magnesium, zinc, selenium and fiber.
In the International Journal of Obesity article, subjects fasting were more likely to report negative side effects such as lack of energy, headache, constipation, lack of concentration and hunger (Reference 3).

-Another major issue for me is the nutritional composition of the diet. If you are seriously restricting your food intake several days each week, there is no way that you will be getting enough vitamins, minerals, fiber, antioxidants, fruits, vegetables, etc. Supplementing with vitamins is just not the same.

In conclusion, this article on fasting in The New England Journal of Medicine is very interesting.  There appears to be some real health benefits for animals. It remains to be seen if these benefits translate to humans over the long term. As a weight loss strategy, it is my opinion that fasting is not the easiest or most effective strategy.

1) de Cabo R, et al. Effects of intermittent fasting on health, aging and disease. New England Journal of Medicine 2019; 381:2541-51.

2) Harvie M, et al. The effect of intermittent energy and carbohydrate restriction v daily energy restriction on weight loss and metabolic disease risk markers in overweight women. British Journal of Nutrition 2013; 110:1534-47.

3) Harvie M, et al. The effects of intermittent or continuous energy restriction on weight loss and metabolic disease risk markers: a randomized trial in young overweight women. International Journal of Obesity 2011; 35:714-27.

Monday, January 13, 2020

Glycemic load and inflammatory metabolites

The Study
The glycemic load is a measure of how your diet impacts your blood sugar. A high glycemic load diet causes a lot of dramatic spikes in blood sugar, while a low glycemic load diet has a much easier effect on blood sugar. In this study, 80 subjects consumed a high glycemic load diet for 28 days followed by a low glycemic load diet for 28 days. A variety of metabolic functions were tested after both dietary periods. After the low glycemic load diet, subjects had a significant improvement in metabolites involved with inflammation. American Journal of Clinical Nutrition 2019; 110:984-92.

Take Home Message
This study provides further evidence that dramatic swings in blood sugar can be harmful to our health. Focus on low glycemic load sources of carbohydrate such as fruits, vegetables, legumes and whole grains and be sure to strictly limit refined carbohydrate foods such as bread, pasta, white rice and sugar.

Mediterranean diet and risk of skin cancer

The Study
In this French study, 98,995 women had their diet monitored for a period of 15 years. Each subject was given a score that reflected how well they followed a Mediterranean diet. The score was based on intakes of fruits, vegetables, legumes, cereal products, olive oil, fish, dairy products, meat products and alcohol. Women who most closely followed a Mediterranean diet had a 17% lower risk of skin cancer when compared to women who did not follow a Mediterranean diet. American Journal of Clinical Nutrition 2019;110:993-1002. 

Take Home Message
This is a really interesting study. It is the first I have seen that links a healthy diet to a reduced risk of skin cancer. One potential mechanism is that the Mediterranean diet contains high levels of antioxidant nutrients like beta carotene, retinol, vitamin C and E, folate and vitamin D. These antioxidants may act to reduce damage to DNA. Another potential mechanism is that subjects consuming a Mediterranean diet consume healthier fats like omega 3 fatty acids and monounsaturated fat. These fats may reduce inflammation and in turn, reduce risk of skin cancer. Either way, this study provides more evidence that a Mediterranean diet is a very healthy way to eat.

Akonza Lat Machine Review

Working out at home is a great strategy for anyone who is too busy to get to the gym consistently. You don’t really need all that much equipment, as most body parts can be worked well with a simple pair of adjustable dumbbells. The back is the one body part that is a bit harder to target at home. A machine that focuses on the back is a great idea for any home gym.

That is why the Akonza lat machine is next up for review. This is a lat pull down machine designed for the home gym that has both a high and low pulley. It is available on with free delivery for Prime Members.

1) This machine is very well built: I have had mine for over 3 years and it looks and works like it did when it was brand new.

2) Not too tall: This is important as some of the machines I looked at were too big for my basement. The Akonza Lat pull down machine is 6 feet, 4.5 inches tall and will fit in most any room in your home.

3) Inexpensive: Currently this machine is on sale at at the very attractive price of $149.97, which includes shipping for Prime Members.

4) Versatile: The machine comes with both a high and low pulley and two attachments. This allows you to add a bunch of exercises for your back, triceps, shoulders and biceps. You can do even more if you add other attachments, which are quite inexpensive.

5) You can put it together by yourself. The directions were not at all complicated, it just took a little time.

1) The seat is a bit on the small side. This is not a major problem, it just could have been a little bigger.

2) When using the lower pulley for upright rows or bicep curls, the machine is not quite stable and seems like it could tilt backward. This is easily fixed by simply putting one foot on the base of the machine during the upward phase of the exercise. Admittedly, the machine is not designed for these types of exercises, I just like to do them. When using the high and low pulley as intended, the machine is completely stable. 

Do I Recommend the Akonza Lat Machine?
Absolutely. This little gem will turn your basement weight room into a bona fide home gym. The price is right, it is versatile and is built very well. If you are busy, working out at home is critical to working out consistently. Adding just a few pieces of equipment, such as this lat machine, will allow you to replicate the gym experience in the comfort of your own home.

Disclosure: I am not affiliated with the company that makes the Akonza Lat Machine and make no money if you buy it.