What Are Sources Of Saturated Fat And How Much Should I Be Eating?

Saturated fats are fats that contain no double bonds, all of their carbons are saturated with hydrogen. They are mostly found in animal products like steak, hamburger, bacon, butter, ice cream and cheese. There are just a few vegetable sources of saturated fat, such as coconut oil and palm oil. 

Several fad diets are promoting saturated fats such as butter and coconut oil as health promoting and even as weight loss aids. This recommendation is not based on solid evidence. The research shows that saturated fats increase risk of heart disease and diabetes. I have my clients shoot for no more than 7% of calories as saturated fat. Instead of saturated fats, focus on the health promoting unsaturated fats, such as olive oil, canola oil, avocados, nuts and nut butters.

Why Are Some Of Us Resistant To Weight Loss?

The Study

In this interesting study, 39 subjects completed a 28 day low calorie diet. By the end of follow up, 23 of the subjects lost the expected amount of weight, while 16 did not, despite following the diet well. These subjects were compared:

-Subjects who did not hit their goal weight had a significantly lower drop in metabolic rate. The successful losers dropped an average of 80 calories a day in metabolic rate. The less successful subjects had a 175 calorie drop.

-There was a dysregulation in fat oxidation metabolites in the unsuccessful subjects. This lead the researchers to believe that they were not as efficient at oxidizing fat as the successful subjects. American Journal of Clinical Nutrition 2021; 114:267-80

Take Home Message

This is a fascinating study to me. It looks like our genes may influence our ability to lose weight. Some people will do better following a weight loss program than others. Lifting weights during the weight lost process can spare lean body mass, which will blunt the reduction in metabolic rate that comes with weight loss.

The inefficient fat oxidation is very interesting. We need more research in order to understand this better and to come up with a potential fix. Perhaps a medication could be developed to help here.

Processed Red Meat And Risk Of Dementia

The Study

Over 490,000 subjects from the British UK Biobank cohort study had their processed red meat consumption measured and were followed for the development of dementia.  By the end of the 8-year follow up, subjects consuming processed red meat 5 or more times per week had a 67% higher risk of dementia when compared to subjects who rarely consumed processed red meat. American Journal of Clinical Nutrition 2021 114: 175-84.

Take Home Message

The authors believed that the nitrates used in processed red meats could cause oxidative stress that contributes to the development of dementia. Other possible mechanisms include the high sodium and saturated fat content of processed red meat. Strictly limit bacon, sausage, pepperoni and other processed red meats. Focus on lean meats like chicken and turkey, seafood, nuts and legumes for your protein choices.

 

Book Review: Sugar Proof

Next up for review is Sugar Proof, by Dr. Michael Goran and Dr. Emily Ventura. Dr. Goran is a pediatric professor at USC Medical School and Dr. Ventura is a nutrition educator and cook.

Introduction

As the name suggests, this book is all about sugar. It describes all of the dangers of feeding sugar to our children and has several programs designed to reduce sugar intake. The book contains 368 pages. It is well written and I really enjoyed reading it.

5 Things I Really Liked About Sugar Proof

1) I think the authors did a good job detailing all of the potential harms of consuming sugar. The mood swings, fatigue and difficulty concentrating associated with high sugar consumption can make our kid’s lives much more difficult. There is also a significant long-term increase in risk of chronic disease associated with sugar consumption.

2) I like the chart that has all of the different names that manufacturers use on food ingredient lists for sugar. This makes it much easier for the reader to identify the sources of sugar in a product.

3) Similarly, there is a very useful chart that has the amounts of sugar in everyday foods. Many readers will be surprised at how much sugar is added to commonly consumed foods.

4) I like the section where the authors detail the addictive aspects of sugar. The research is beginning to show that sugar addiction is real.

5) I also like that the authors mention that sugar changes kid’s palates. When a lot of sugar is consumed, kids don’t want to eat healthy foods like proteins, fruits and vegetables. I have seen this with my client’s kids for years.

5 Things I Didn’t Agree With in Sugar Proof

1) I did not understand how the authors handled references in this book. There were no reference markers in the text whatsoever. In other words, the authors would describe a study, but there was no way to find out what study they were talking about.

2) Similar to point #1, there were no citations at the end of the chapter or the back of the book. There was a link to a separate website that had the references. This is very unusual for a research-based book and highly inconvenient.

3) There were some very curious claims in this book, particularly about non-nutritive sweeteners:

For example, on page 11, the authors are talking about non-nutritive sweeteners and mention: “These compounds can cause symptoms ranging from acute gastrointestinal distress to long term effects on the brain, contributing to cognitive decline later in life”. 

There is no reference given for this claim in the text, at the back of the book or even when I searched on their website under Chapter 1 references. Saying that artificial sweeteners cause cognitive decline is quite a serious claim. Not providing a reference to support this claim really undermines the validity of the book in general.

Another example is on page 19: “Dramatic new research shows that their developing bodies are uniquely vulnerable to the effects of too much sugar. In fact, sugar can disrupt the normal growth of the heart, brain, liver, gut and more.”  Again, no references are given anywhere to support this claim. 

Now I am no advocate for sugar consumption. But to say that it stops the development of a growing heart, brain and liver without providing references is just surprising from a research based book.

4) The authors go to great lengths to mention that sugar is extremely addictive. I couldn’t agree more and increasingly, the research literature backs this idea up. However, the author permits up to 24 grams of sugar per day for older children. For the vast majority of my clients, having sugar at all doesn’t work. It is so addictive that if you have it even a few times a week, you want it all the time. It sounds ironic, but giving up sugar 100% is far easier than giving it up 75%. After a few weeks of withdrawal, my clients don’t really miss it at all. Would you tell an alcoholic that 1 or 2 drinks a day are OK? Would you tell a smoker that 3 or 4 cigarettes a day are fine? With addictive substances, the answer is to give it up. I know it is not easy at first, but it is really the only way.

5) Some of the substitutions the authors recommend for sugar will cause as many problems as sugar itself. Replacing sugar with rice crackers, popcorn, dried fruits, fruit smoothies and pita bread will cause a very similar spike in blood sugar and insulin. The real key is to eliminate sugar and replace it with low glycemic load carbs like fruits, vegetables, legumes and whole grains.

Is Sugar Proof Worth Reading?

Absolutely! The main message of this book is to reduce sugar in our children’s diet, which is very important. I do not think that many people realize the damage it does to their quality of life today and their risk of long-term disease tomorrow. 

Having said that, the book’s handling of the research literature could be a little more organized. My only other complaint is when you eliminate the sugar from your child’s diet, don’t replace it with other high glycemic load carbohydrates.

 

 

 

What Is The Best Exercise To Get Rid Of Belly Fat

I get this question quite a bit from my clients. Losing weight from a particular body part, such as your belly, is called “spot reducing” and it does not work. Our bodies are not built that way. Doing crunches, for example, works your ab muscles, but does not have an impact on abdominal fat. 

When you lose weight, you lose it proportionally from your entire body. Therefore, the best way to lose belly fat is the best way to lose fat in general, which is a combination of a good diet, lots of cardio and resistance training.

So, at the end of the day, the only exercise to get rid of belly fat is push-away’s. Push away from the dinner table. Push-away from the vending machine. Push away from the ice cream, etc. 😊

Are Vegan Diets A Good Choice For Children?

The Study

Several popular books and documentaries recommend vegan diets to improve health and performance. It is unknown how these diets impact the health of young children. A really interesting cross-sectional study was recently published that sheds some light on this topic. Fifty-two vegan and 72 matched omnivore controls between the ages of 5 and 10 had their diet measured by means of a food frequency questionnaire. A variety of health outcomes were measured for comparison.

Here are some of the most pertinent results:

-Vegan children had lower body fat compared to omnivores.

-Vegan children had lower LDL cholesterol and C-reactive protein than omnivores.

-Vegans were shorter in stature.

-Vegans had less bone mineral content.

-Vegans had lower HDL cholesterol and higher homocysteine levels.

-Vegans had lower levels of Vitamin B-12, iron and Vitamin D. In fact, vegans were more likely to have a deficiency of B-12 and iron. American Journal of Clinical Nutrition 2021; 113:1165-77.  

Take Home Message

This is a really interesting and important study. It appears that a vegan diet is not particularly healthy for young, growing children. The impact of a vegan diet on cardiovascular risk factors were mixed. Lower body fat, LDL and C-reactive protein is beneficial, but lower HDL and higher homocysteine certainly is not.

Of even more concern are the negative impacts of the vegan diet on growth, bone mineral content and risk of deficiency of several very important nutrients. If you are avoiding animal products for moral or ethical reasons, I am not going to argue with that decision. However, if you are vegan because you think it is healthier for your children, you may want to reconsider.

Sugar-sweetened Beverage Consumption And Early Onset Colorectal Cancer.

The Study

Early onset colon cancer is increasing at an alarming rate. In fact, several organizations are now recommending colonoscopy screening starting at age 45 instead of 50. Sugar sweetened beverages were examined in this investigation for a potential association with early onset colon cancer. Over 95,000 women in the Nurses Health Study II were followed for 24 years. Here are some of the results of this important study:

-Women consuming 2 or more servings per day of sugar sweetened beverages had over twice the risk of early colon cancer when compared to women who had less than one serving per week.

-Each serving of a sugar sweetened beverage was associated with a 16% higher risk of early onset colon cancer.

-Replacing each serving per day of a sugar sweetened beverage with a diet soda, coffee or milk was associated with a reduced risk of early colon cancer of between 17 and 36 percent. Gut 2021: doi: 10.1136/gutjnl-2020-323450 

Take Home Message

The take home message here is really simple.  Strictly limit or completely eliminate sugar sweetened beverages.

 

Intermittent Fasting: New Evidence From A Top Journal

Intermittent Fasting has become a very popular dietary strategy for those trying to lose weight. What does the research say? Is it safe? Does it work? What are the side effects? A very well designed randomized trial in JAMA Internal Medicine was recently published. The results may be quite surprising to you. (Reference 1).

The Study

In this interesting study, 116 subjects were randomized into 1 of two groups:

-Half of the subjects were put into a group instructed to eat 3 meals per day.

-The other half followed an intermittent fasting protocol, where they could only eat between noon and 8:00 PM each day.

Subjects were followed for 12 weeks.

Here are some of the results of this important investigation:

-By the end of the 12 week follow-up, there were no significant differences in weight loss between the fasting group and the conventional dieting group.

-By the end of the 12 week follow-up, there were no significant differences in any metabolic measures between the groups. These variables included fasting insulin, glucose, hemoglobin A1C, triglycerides, total cholesterol, HDL cholesterol and LDL cholesterol.

-Measures of daily physical activity were significantly lower in the fasting group when compared to the conventional 3 meal a day group.

-Sleep efficiency was significantly lower in the fasting group when compared to the conventional 3 meal a day group.

-Adherence was higher in the conventional diet group. In other words, it was harder to stick to the intermittent fasting plan.

-In the fasting group, 65% of weight loss was muscle. This is a really big number. Normally, when we lose weight, 20-30% of the weight loss is muscle. This finding led the researchers to warn that intermittent fasting could lead to increased risk of sarcopenia (muscles loss). This is not good for your health or the long term ability to keep the weight off.

Conclusions And Recommendations

This is an interesting and important study that does not support intermittent fasting as a successful strategy for weight loss or health improvement.

To summarize:

-Fasting did not improve rate of weight loss.

-Fasting did not improve health.

-It was harder to stay on this diet than a conventional 3 meal a day plan.

-There were several negative side effects seen only in the intermittent fasting group. Most notably, a decrease in sleep quality, physical activity and an increased loss of muscle mass.  

I know that there are a lot of popular and convincing books about fasting out there, but at the end of the day, the research should guide us when it comes to evaluating any weight loss strategy. Although this is a well designed study in a top journal, it is only one study and is not definitive by any means.

Having said that, this is not the first study to show negative outcomes with intermittent fasting. Several other research investigations that I have previously covered in my blog showed numerous side effects to 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).

If you are trying to lose weight and improve your health, intermittent fasting does not look like the way to go.

References

1) Lowe DA, et al, Effects of time restricted eating on weight loss and other metabolic parameters in women and men with overweight and obesity. JAMA Internal Medicine; 2020; 180:1491-99.

Relation of fat mass and muscle mass to risk of all cause mortality

The Study

Subjects from 7 different prospective cohort studies had their body composition measured and were followed for an average of 14 years. Over 16,000 subjects were included in this investigation.

Here is what the researchers found:

-When compared to subjects with the lowest body fat, those with the highest body fat had a 56% increased risk of dying from any cause.

-When compared to subjects with the least muscle mass, those with the highest muscle mass had a 30% lower risk of dying from any cause.

-The BMI of the subjects correlated extremely well with their body fat (r = .813).

-The BMI of the subjects also correlated very well with their muscle mass (r = .710).

American Journal of Clinical Nutrition 2021; 113:639-46.  

Take Home Message

This study shows us the importance of not only maintaining a healthy weight, but of preserving our lean body mass. We start to lose muscle after the age of 25. If we don’t actively work on maintaining our muscle, this loss can have a seriously negative impact on our health and ability to function as we age. Hit the weights at least twice per week to prevent the loss and even add to your lean body mass. 

One other interesting note from this study: body mass index was highly correlated with both body fat and lean body mass in this large population. There are many who think it is not an important measure. This study shows that it truly is.

Can supplementing with protein improve muscle mass and strength?

The Study

Age related loss of muscle results in a decrease in quality of life and ability to function. It has been theorized that protein supplementation may slow down this loss of muscle that is a normal part of aging. In this interesting 1 year randomized trial, 208 healthy adults over the age of 65 were randomized into 1 of 5 groups:

1) Carbohydrate supplementation- 30 grams per day.

2) Collagen protein supplementation- 20 grams per day.

3) Whey protein supplementation- 20 grams per day.

4) Light resistance training with bands- 3 times per week.

5) Heavy resistance training with weights- 3 times per week.

By the end of the year, the following results were found:

- The protein supplement groups had no improvements in measures of strength or muscle size.

- The resistance groups had improvements in muscle strength and size.

- The groups supplemented with protein and carbohydrate had an increase in percentage of body fat. American Journal of Clinical Nutrition 2021; 113:790-800.

Take Home Message

Don’t expect a protein supplement to improve your strength or muscle size on its own.  Weight training is how you make that happen. Hit the weights at least twice per week with a full body workout. Three times is even better!

 

Product Review: Tanita Ironman Scale

When deciding on which products to review for this newsletter, I always ask myself two questions: 1) Will this product make it easier for my clients to succeed in attaining their health and fitness goals?  2) Am I asked about this type of product on a regular basis? An accurate, reliable scale answers both of these questions with a resounding “Yes”. Therefore, it is time to review the Tanita Ironman BC554.

When your goal is to lose weight, you need an honest, consistent and objective measure of your progress.  If what you are doing is working, keep going with it!  If not, you need to make some changes. If you are not weighing yourself regularly, you will not be able to tell what is working and what is not. To do this, you need an accurate and reliable scale. I have been a huge fan of Tanita Ironman scales for years. I currently have the Ironman BC554.

Pros

1) Accuracy. I consider the Tanita Ironman line research quality. Knowing you have an accurate measurement is, for obvious reasons, pivotal.

2) Durability. My last model lasted me for almost 10 years.

3) Long battery life. I am amazed at how long the batteries last in these scales. You go years without having to replace them.

4) Measures body fat. If you are lifting weights while you are losing weight, a time may come where you will be building muscle and losing body fat at largely the same rate. This can become a bit frustrating as the number on the scale stops going down. At this point, your percent body fat is a better indicator of progress than your weight. Tanita Ironman scales come with a bioelectrical impedance analyzer to measure body fat. When used correctly, these scales provide an accurate measure of body composition which can become a very useful measure of progress toward your goals. Studies have shown that bioelectrical impedance with a Tanita scale has a high and significant correlation with DEXA, which is the gold standard of body fat analysis (Reference 1-2).

Cons

1) A bit pricey. The BC554 currently lists on Amazon for $172.99. This is a lot for a scale.

Would I Recommend Tanita Ironman Scales?

Without a doubt. These scales can be a bit on the pricey side, but they last forever, are highly accurate, and allow you to measure your body fat. Overall, they are a great investment in your health. 

To learn more about Tanita scales, visit Tanita.com. If you want to buy one, you can pick it up on Amazon.com.  If you want more information about the proper way to weigh yourself, check out this previous post.

Disclosure: I have no relationship with the Tanita company and make no money if you buy their products.

References

1) Rubiano F, et al. Validity of consumer model bioimpedance analysis system with established dual x-ray absorptiometry (DEXA). Presented at ACSM 46th annual meeting. Poster.

2) Rubiano F, et al. Comparison of body composition techniques. Presented at The International Symposium Of Invivo Body Composition Studies 1999. Poster.

Beyond Meat Plant Protein Vs. Animal Protein

The Study

Plant based meat substitutes are popping up everywhere these days. You can even get a plant based Whopper at Burger King! Are they any better for you than red meat? This study wanted to find out. In a crossover design, 36 subjects consumed 2 or more servings of Beyond Meat plant protein or animal meat each day for separate 8 week periods. A number of risk factors for cardiovascular disease were taken before and after each 8 week intervention. 

The results were interesting. After the Beyond Meat intervention, body weight was significantly lower (around 2 pounds in 8 weeks) and LDL cholesterol was significantly lower (around 10 mg/dl). There was no difference in other measures, including blood pressure, insulin level, glucose level, HDL cholesterol and triglyceride level. American Journal of Clinical Nutrition 2020; 112:1188-99.  

Take Home Message

The Beyond Meat vegetable protein had a nice impact on weight and LDL cholesterol in this trial. The fact that it is higher in fiber and lower in saturated fat explains these results. I’m surprised that it did not show more benefit, to be honest. The red meat chosen in this intervention was 80% fat, which is a lot of extra saturated fat. If they had chosen lean or very lean red meat, you may not have seen much of a difference in LDL cholesterol. 

There is no doubt that vegetable protein is a great protein choice. However, there is no reason to become a vegetarian, as chicken, turkey and seafood are excellent protein choices. Red meat should be an occasional treat (once a week max) and be sure to include vegetable proteins like beans, nuts, lentils and protein rich whole grains, such as quinoa, as often as possible.

Late Night Eating And Weight Loss

The Study

Does eating food late at night make it harder to lose weight? This cross-sectional study was designed to shed light on this hypothesis. Over 3,000 subjects from a weight loss program in Spain had the midpoint of the time between breakfast and dinner calculated. The group was divided into early eaters and late night eaters. The results were fascinating:

-For starters, there were no significant differences between late and early eaters in energy intake or physical activity.

=Late night eaters had a higher BMI, body fat and waist circumference than early eaters.

-Late night eater’s rate of weight loss was 80 grams less per week compared to the early eaters. This difference was statistically significant and added up to over 3 pounds less weight lost during the 5 month intervention.

-Late night eaters had higher triglycerides and lower insulin sensitivity when compared to early eaters. American Journal of Clinical Nutrition 2021 113:154-61.

Take Home Message

I have been telling my clients for years to stop eating after 8:00 PM if they are trying to lose weight. While I have found this to be anecdotally important, there is not a ton of research to back this up. This study, although a weaker form of research (cross-sectional studies lack temporality and cannot determine causation) does provide some evidence that there may be something to this. Some potential mechanisms include:

-Late eating simply adds extra calories.

-Our metabolism may slow down at night, so more of what we eat is converted to fat.

-The thermic effect of food is lower at night.

-Late night snacking is generally of poor nutritional quality. High glycemic carbs like chips and cookies promote weight gain through their impact on your blood sugar.

Either way, it is a good idea to stop eating by 8:00 PM if weight loss is your goal.

 

Book Review: The Pegan Diet

Next up for review is The Pegan Diet by Dr. Mark Hyman. Dr. Hyman is a medical doctor who is the Head of Strategy and Innovation at the Cleveland Clinic Center for Functional Medicine. 

Introduction

This book lays out 21 principles to improve your health. Dr. Hyman promotes a Pegan diet, which is a combination of Paleo and Vegan diet. The principles are quite thorough and focus on what one should eat and what one should avoid in order to attain peak health. The book is 253 pages. It is very well written. The author has a motivating style of writing and I enjoyed reading this book.

5 Things I Really Liked About The Pegan Diet

1) I really like that this book recommends the reader to strictly limit refined carbohydrates like bread, white rice, pasta and sugar. I strongly believe that a stable blood sugar is the path to weight loss and greater health. Avoiding these foods will make it much easier to maintain a stable blood sugar.

2) I really like the emphasis on the environmental impact of the foods we eat. This is an evolving field of nutrition research that is really important. I know that a lot of my professors at Harvard Nutrition are really locking into this idea in recent years.

3) This book spends a lot of time on the importance of sleep. I also think this is huge, especially during the stressful times that we find ourselves in with the Covid-19 pandemic. When you are sleeping well, just about every aspect of your physical and mental health will improve. 

4) The book has a lot of great cooking tips and healthy recipes. The author has a passion for cooking healthy foods and it shows. I also appreciated the emphasis on cooking most of your meals at home. It really is the only way to improve your diet in the long run.

5) I really appreciated the section on what to feed your children. Instilling healthy eating habits in your kids at a young age is of critical importance.

4 Things I Didn’t Agree With in The Pegan Diet

1) I don’t agree with his recommendation of beef as a protein source. While a burger or steak now and again is fine, I don’t recommend red meat to my clients as a go to protein. It has been shown to have a negative impact on risk of heart disease, cancer, diabetes and all-cause mortality in the research literature (References 1-3). In my opinion, the focus should be on lean animal protein sources such as chicken and turkey, low fat dairy, seafood and vegetable sources of protein such as beans and lentils.

2) Similarly, certain fats recommended in this book are not the best. Butter, coconut oil, tallow and palm oil are really high in saturated fat, which can raise cholesterol and risk of heart disease and all-cause mortality (References 4-5). It is far better to focus on unsaturated sources of fat such as avocados, olive oil, nuts and seeds. These have a positive impact on serum cholesterol and risk of cardiovascular disease.

3) Although this book says to avoid sugar, there is a fair amount of it in several of the recipes. While I am sure Dr. Hyman preaches moderation of sugar intake, I have found that complete avoidance of sugar to be easier than having it now and again. For people addicted to sugar (which is the majority of those trying to lose weight), having it now and again does not seem to work. I have had much better luck with total avoidance and occasional sugar free treats. This helps my clients and readers of my books stay on course over the long term.

4) I feel like the book is just a little bit under-referenced. As an epidemiologist, I’d like to see most any nutrition and health claim backed up with a study or 2 that we can look up. While 35 references are provided, I think this could have been a bit more comprehensive.

Is The Pegan Diet Worth Reading?

Absolutely! This book gets a lot right. If you follow the principles in this book you will improve your health for sure. It is a well written book and totally worth reading. I would just be a little pickier on some of the proteins and fats recommended, but otherwise this is all really sound advice.

References

1) Bernstein AM, et al. Major dietary protein sources and risk of coronary heart disease in women. Circulation 2010; 122: 876-83.

2) Pan A, et al. Red meat consumption and mortality: Results from 2 prospective cohort studies. Archives of Internal Medicine 2012; 172:555-63.

3) Pan A, et al. Red meat consumption and risk of type 2 diabetes: 3 cohorts of U.S. adults and an updated meta-analysis. American Journal of Clinical Nutrition 2011; 94:1088-96.

4) Wang, DD et al. Association of specific dietary fats with total and cause specific mortality. JAMA Internal Medicine 2016; 176:1134-45.

5) Hu FB, et al. Dietary fat intake and risk of coronary heart disease in women. New England Journal of Medicine 1997; 337:1491-99.

 

 

Physical Activity And Incident Diabetes

The Study

In this interesting study, 7,280 subjects aged 17-84 from the Hispanic Community Health Study wore an accelerometer for a period of 7 days and were followed for incidence of diabetes for 6 years. An accelerometer effectively measures total physical activity. By the end of follow-up, subjects over 50 that exercised the most had a 50% lower risk of developing type 2 diabetes when compared to subjects exercising the least.

American Journal of Clinical Nutrition 2020; 112:1318-27.  

Take Home Message

Diabetes is a terrible disease that ravages multiple systems of our body as it progresses. Prevention is key. Regular physical activity has a multitude of benefits. It reduces risk of not only diabetes, but heart disease, stroke, cancer and Alzheimers disease. It helps to reduce stress, improve energy, sleep and mood and even improves your appearance. During these challenging times, cardiovascular exercise is even more important. Try to shoot for at least 150 minutes per week of cardio. It can be whatever you like; walking, biking, elliptical trainer, etc. It is a time commitment, but well worth the investment.

 

Midlife Body Composition And Healthy Aging

The Study

In this interesting study, over 1,000 men had their body composition taken in midlife and were followed for 32 years to see the impact of muscle mass on quality of life and odds of reaching the age of 90. The results were fascinating. Subjects in the highest category of muscle mass had over twice the odds of reaching age 90 when compared to subjects with the lowest muscle mass. Furthermore, having more muscle increase quality of life dramatically, which included:

 -improved physical functioning.

 -decreased role limitations due to health problems.

 -improved social functioning.

 -improved general health.

 American Journal of Clinical Nutrition 2020 112:1287-94.

Take Home Message

Physical activity is imperative to healthy aging. How do you maintain your muscle mass as you age? You need to hit the weights 2-3 times a week with a full body program and engage in regular cardio. Exercise is like the fountain of youth. I hope you are all taking full advantage of it!

Added Sugar And Risk Of Cancer

Most of us realize that sugar is not the healthiest thing to include in our diet. For decades, we have known that sugar increases risk of cavities and is a source of nutritionally empty calories. However, added sugar has a much more sinister side. More recently, it has been associated with increases in risk of heart disease, type 2 diabetes and cancer. A study was recently published in a French cohort that examines the association between sugar consumption and risk of cancer (Reference 1).

The Article

In this interesting study, over 100,000 participants from the French Nutrinet-Sante cohort had their added sugar intake measured repeatedly and were followed for an average of 6 years for incidence of cancer. Sugar intake was assessed by means of multiple 24-hour dietary records that were repeated every 6 months to account for changes in diet. Here are some of the results of this important investigation:

 -Total sugar consumption was significantly associated with a 17% higher overall cancer risk when comparing those who consumed the most sugar with those who consumed the least.

 -Breast cancer was the cancer most significantly elevated, with a 51% increased risk when comparing those who consumed the most sugar to those who consumed the least.

 -These results remained significant when weight gain was adjusted for in statistical modeling.

Conclusions And Recommendations

This is an interesting and important study. Sugar consumption has already been associated with dental caries, heart disease, type 2 diabetes and obesity. It is becoming clear that we can add cancer to the list.

There are several potential mechanisms to explain the association between sugar consumption and risk of cancer:

1) A high intake of sugar can lead to excess calorie consumption and obesity. This can increase risk of cancer. However, keep in mind that these results persisted after adjusting for weight loss, so there is something more going on here.

2) Oxidative stress is theorized to increase with a high sugar consumption. This can also increase risk of cancer.

3) Sugar can also increase inflammation, which may increase risk of cancer.

4) Sugar is a very high glycemic load carbohydrate, and the glycemic load of the diet has been associated with an increased risk of cancer.

Limiting sugar consumption is complicated because it is so very addictive for most of us. It may seem counter-intuitive, but I have found with my clients that giving up sugar 100% is far easier than giving it up 75%. The best bet is to give up sugar entirely. After 2 weeks, you won’t even miss it.  Since we all want something sweet now and again, have a sugar free dessert once or twice a week. This is a strategy that I have found to be very successful with my clients.

References

1) Debra, C et al, Total and added sugar intakes, sugar types and cancer risk: Results from the prospective Nutri-Sante cohort. American Journal of Clinical Nutrition 2020; 112:1267-79.

What are some tips to get back on track with my diet after the holidays?

The time between Thanksgiving and New Years day presents some real challenges for those trying to eat healthy and lose weight. The holidays are great and it is a lot of fun to eat and drink a bit more during this time. Just about everyone puts on a few pounds by New Years Day. The Covid-19 pandemic, with it’s high levels of stress and social distancing, is adding to the problem this year.

However, for many of us, the unhealthy eating continues well into January and even February. This is mostly due to swings in blood sugar that result in increased hunger and cravings for refined carbohydrates, which were likely consumed in large amounts over the last several weeks. The more we eat bread, pasta, white rice and sugar, the more we want these foods.

A couple of extra cheat meals and a few pounds gained during the holiday season are not much of a problem. But if the disordered eating lasts for months, you will put on some serious weight. Even my most successful and dedicated clients will struggle during and after the holidays. Here are a few strategies that help them get back on track:

1) If you have eaten more refined carbohydrates during the holiday season, you will have an increase in cravings for them. You will also be more hungry in general. Step one is to mentally realize this. Tell yourself that you will be hungry for the wrong foods, but will not give into them. Getting your head right and understanding the origin of the cravings is very helpful.

2) Write down your food for 2 weeks. It adds a layer of accountability that gets you back on the right track.

3) Go to the grocery store and load up on all of the right foods. Make it easy to eat healthy. 

4) Plan your meals ahead of time. Think about what you will eat for breakfast, lunch and dinner for the next few days or even a week.

5) Try to limit eating out at restaurants for the first week or two. Although most of us are doing take out during Covid, restaurant meals usually have a lot more calories, fat, salt and sugar.

After a week or two of eating right, you will find that your blood sugar has stabilized and the hunger and cravings for the wrong foods will start to calm down.

 

Non-nutritive Sweeteners And Blood Sugar

The Study

Non-nutritive sweeteners can be a useful tool for those trying to eliminate sugar from their diet. However, some believe that despite being calorie free, they may still have a negative impact on blood sugar and insulin levels. The fear is that artificial sweeteners may stimulate the gut or initiate a systematic response due to their sweet taste. 

This investigation is a systematic review and meta-analysis of 26 trials examining the glucose and insulin raising effect after consuming a non-nutritive sweetener preload.  Over 450 subjects were included in these trials. The conclusion of this comprehensive study is that there is no negative impact on blood glucose or insulin levels after consuming non-nutritive sweeteners.  Interestingly, the non-nutritive sweeteners actually improved blood glucose levels in diabetic subjects. American Journal of Clinical Nutrition 2020; 112:1002-14.  

Take Home Message

Non-nutritive sweeteners, like Splenda and Equal have been shown to be quite safe in the research literature. This is particularly true when consumed in moderation. This study lends further support to this idea. The key here is moderation. Daily use of non-nutritive sweeteners is not a great idea. The big problem that I have found with them is that they can perpetuate cravings for sweets and refined carbs. However, when consumed just a few times per week, these sweeteners are great because they allow you to have a soda or dessert, yet stay away from sugar. 

Early Time Restricted Feeding And Insulin Sensitivity

The Study

There has been a lot of popular interest in intermittent fasting in the last few years. However, most of the research that I have seen paints a fairly negative picture of the benefits and health consequences of this dietary practice. This article uses a much gentler version of energy restriction. In this investigation, 16 healthy young men were assigned to one of 2 groups. Eight subjects had their energy restricted to the hours of 8:00 AM and 4:00 PM. The other 8 subjects could eat all day, but had a similar caloric restriction. After 2 weeks, weight loss was the same in the 2 groups, but the energy restricted group had a significant improvement in insulin sensitivity. American Journal of Clinical Nutrition 2020 112:1015-28.

Take Home Message

This is a very interesting study. Eating from 8:00 AM to 4:00 PM is a very mild form of energy restriction and appears to improve insulin sensitivity. This style of eating allows one to consume a breakfast, lunch and early dinner. I think that these three meals are important to ensure that blood sugar is stable and adequate nutrients are consumed. The researchers believe the benefit to insulin sensitivity was due to the fact that glucose tolerance is higher earlier in the day, when most food was consumed by the energy restriction group.

Fitbit Inspire Hr Heart Rate And Fitness Tracker Review

A fitness tracker can be a very useful tool when looking to lose weight, improve your fitness and improve your health. They can provide a lot of useful data and be quite motivating. Today I review the Fitbit Inspire HR Heart Rate And Fitness Tracker.

Pros

1) This heart rate monitor is comfortable to wear and not too big. This is a plus for me because I don’t like wearing big watches.

2) It has a touch screen and you can easily toggle through the different display options.

3) It measures steps, distance traveled and heart rate.

4) It also has a sleep tracker. I have not used this feature yet, but sleep is an important part of our health and it is useful to learn more about your sleep habits.

5) It is easy to charge this watch on your computer.

6) It has long battery life. A charge last for 5 days.

7) It has a really useful app for your phone that keeps track of everything.

8) It also has a stop watch and countdown timer which can come in handy.

Cons

1) The font on the watch is a little small, which can make it difficult to read for people who wear reading glasses.

2) It was not super easy to set up. It took a while for my phone and the Fitbit HR to link up. In fairness, this may have been an issue with my phone’s Bluetooth.

Do I Recommend the Fitbit Inspire HR Fitness Tracker?

Absolutely. This is a useful tool to help you analyze your steps, sleep and heart rate. Since increasing physical activity and losing weight is a major New Year’s resolution, this little gadget can come in handy right about now. You can pick one up for $79.95 on amazon.com. Here is the link for anyone interested.

Disclosure: I am not affiliated with the company that makes the Fitbit Inspire HR and make no money if you buy it.