Glycemic Index And Brain Function

The Study

In this interesting study, 25 type 2 diabetics consumed a high or low glycemic breakfast, lunch and dinner on 2 separate occasions. The glycemic index is a measure of how a carbohydrate food impacts your blood sugar. High glycemic foods cause a spike in glucose and insulin levels and low glycemic foods have a more modest impact on blood sugar and insulin. All subjects went through a battery of cognitive tests during each study day.

The subjects had a significant improvement in global cognitive and executive functioning when comparing the low glycemic day to the high glycemic day.

American Journal of Clinical Nutrition 2023; 117:859-69.
 
Take Home Message

It sounds funny saying this, but the way you eat can impact how smart you are. Your brain works better when you eat in a way that provides a stable blood sugar.

The authors proposed several potential mechanisms for the cognitive benefits seen in this study after the low-glycemic index meal plan:

-More energy on the low GI day was responsible for the improvements in cognitive function.

-A better mood on the low GI day was responsible for the improvements in cognitive function.

-Less hunger on the low GI day was responsible for the improvements in cognitive function.

-Improvements in cerebral blood flow may also be responsible.

When it comes to carbs, focus on fruits, vegetables, legumes and whole grains such as oatmeal, quinoa and brown rice. Strictly limit bread, pasta, white rice and sugar.

Gut Microbiome And Body Weight

The Study

Recent research has shown that our gut microbiome may influence energy balance. In this interesting crossover trial, 31 young and normal weight men and women consumed a Western Diet and a Microbiome Enhancing Diet for 23 days each. 

Both of these diets had the same number of calories and macronutrient break down. The Western Diet was a typical unhealthy American way of eating. The Microbiome Enhancer Diet was high in fiber, resistant starch, had a larger particle size and fewer processed foods.

After each dietary intervention, a variety of measurements were taken.

During the Microbiome Enhancing Diet protocol, subjects lost 116 calories per day in their feces.

Nature Communications 2023; 14:3161.

Take Home Message

This is a truly fascinating study. 116 calories may not sound like much, but in a year, it adds up to 12 lbs. lost. The gut microbiome is emerging as something of a control center for energy balance. How it does this is unclear, but there are a few theories:

 
1) It has an influence on the number of calories harvested from food.
 
2) It has an influence on gut hormones.
 
3) Signaling through microbiome metabolic byproducts such as SCFA’s (short chain fatty acids).

There are many reasons to eat a diet high in fiber and low in processed foods. You can potentially add enhancing your gut microbiome to the list.

Product Review: Cooper Complete Basic One Iron Free Multivitamin

Many of my clients ask me if I take a multivitamin and if I have one to recommend. The answer is yes to both questions. But before we get to that, just a bit of background. If you have worked with me or read any of my books, you likely know that I am not a supplement guy. There are several reasons why this is true:

-It is always better to get whatever nutrients you are looking for by eating healthy.

-Because of the 1994 Dietary Supplement Health And Education Act, there is virtually no regulation of the supplement industry. In other words, no one is testing if your supplement has what it says it does. And no one is testing whether anything else unsafe may be added to it. This has caused a ton of problems. Some supplements have been found to have prescription drugs like Prozac or Viagra when tested. Not good!

However, multivitamins have several benefits:

-Recently a Harvard study showed that taking a daily multivitamin improved memory and slowed cognitive decline in older adults (Reference 1).

-Most of us need to supplement vitamin D, particularly in the winter months. It is really hard to get enough from your food. You can find a multivitamin that includes Vitamin D to take care of this.

-A multivitamin can act as insurance for your healthy diet. Sometimes even the best diets lack certain nutrients. A multivitamin can make up this small difference.

I have for years been recommending a great multivitamin sold by Cooper Concepts. It is called Cooper Complete Basic One Iron Free. Dr. Kenneth Cooper is an amazing Physician, Researcher and Entrepreneur who has focused on exercise and preventative health for his entire career. One of his companies, Cooper Concepts, sells a one a day multivitamin that checks all my boxes.

Pro’s

1) Dr. Cooper consulted with leading nutrition researchers, including the Department of Nutrition at Harvard School of Public Health, to help him determine what nutrients to include in this multivitamin. 

2) This vitamin contains 2000 IU’s of Vitamin D.

3)Most importantly, Dr. Cooper has an independent lab test this multivitamin to be sure that it contains what it says it does and nothing else. This is huge!

Con's

1) This multivitamin is a bit more expensive than other brands. It is priced at $29.98 for 60 tablets.

What I Recommend To My Clients

If a client’s diet is otherwise good, I recommend taking this multivitamin 3 times per week as insurance and to make sure they are getting enough vitamin D. This is particularly important in the winter, when the sun is less strong (we make vitamin D through our skin from sun exposure).

This also brings the cost down quite a bit. At 12 pills a month, the bottle will last 5 months or so, which is $6 a month. Since each pill contains 2000 IU of Vitamin D, taking 3 a week averages just over 800 IU per day, which is a level I am comfortable with. For more information or to pick up this multivitamin, click here.

References

1) American Journal Of Clinical Nutrition 2023 118:273-82

Disclosure: I am not affiliated with the company that makes Cooper Complete supplements and make no money if you buy any of their products.

How Many Times A Week Should I Lift Weights?

Weight lifting, also known as resistance training, is a critical component of health and fitness no matter what your goals may be. There are two major reasons why:

-As we age, we start to lose muscle. This can have a significant negative impact on our metabolism, level of functioning and ability to manage our weight.

-Resistance training spares lean body mass during the weight loss process, which makes it much easier to keep the lost weight off for good.

Hit the weights 3 times per week on non-consecutive days. Monday, Wednesday and Friday or Tuesday, Thursday and Saturday. You need time for the muscles to rest and rebuild in between sessions.

If time is a serious issue, you can get away with 2 times a week. One last note, make sure to contact your Doctor whenever starting an exercise program to make sure it is safe for you to do so.

 

Sugar And Weight Gain

The Study

This study is a systematic review of 169 trials that examined the relationship between sugar consumption and weight gain. 

The results were pretty predictable:

In trials where sugar was added to the diet, subjects experienced statistically significant weight gain.

In trials where sugar was subtracted from the diet, subjects experienced statistically significant weight loss.

American Journal of Clinical Nutrition 2023; 117:741-65.

Take Home Message

Simple message here.  If you are trying to lose weight and keep it off, you need to be seriously concerned about the amount of sugar you are consuming.

Importance Of Carbohydrates In Weight Management

The Study

A recent weight loss trial (The Diet Fits Trial) compared a low-fat diet to a low-carb diet. The results showed that a lower carb diet increased weight loss at 3 and 6 months but that there was no difference after a year.

This study reanalyzed the data by creating a biomarker of carbohydrate intake (triglycerides/HDL cholesterol) and a biomarker of fat intake (LDL cholesterol + HDL cholesterol) and examined how these impacted weight loss in the Diet Fits subjects. The results were interesting:

-The carbohydrate biomarker predicted weight loss at all 3 time points.

-The fat biomarker did not predict weight loss.

-The reduction of the glycemic load drove most of the weight loss in these subjects.

American Journal of Clinical Nutrition 2023; 117:599-606.

Take Home Message

The message here is simple. If you are trying to lose weight, pay attention to your carbs. The glycemic load of the carbs you eat will have the biggest impact on your ability to lose weight. The research bears this out, as does my 20 years of experience working with weight loss clients.

Book Review: The Good Life

Next up for review is The Good Life, by Dr. Robert Waldinger and Dr. Marc Schulz. The authors are the directors of the Harvard Study of Adult Development.

Introduction

The main focus of this book is to report on the findings of the 84-year Harvard Study of Adult Development. In 1938, 268 sophomores at Harvard University and 456 inner city Boston 14-year-old boys initiated a lifelong study to learn what makes people healthy and happy. They were sent questionnaires and interviewed regularly throughout their lifespan. The study actually continues to this day for the offspring of the original members. The book has 351 pages. It is well written and I really enjoyed reading it.

5 Things I Really Liked About The Good Life

1) The main conclusion of this research is that the quality of our relationships is the most important factor determining our health and happiness throughout our lives. Most of us focus on making money, having career success and status in an effort to make us happy and it turns out they don’t matter that much at all. I found this fascinating.

2) Most of the research that I have conducted and read focuses on length of life and disease risk reduction. I like that this study also looked at happiness and quality of life, which is every bit as important as length of days.

3) The fact that this study has gone on for 84 years with 84% follow-up is amazing.

4) I like how the authors used participant’s interview question answers over the years to illustrate how relationships, good or bad, had a huge impact on their happiness.

5) I also like how the book invites us to review the relationships in our own life and offers suggestions to improve them in both in number and quality.

5 Things I Didn’t Agree With In The Good Life

1) I wish the book was not so laser focused on relationships. There was a lot of data on other lifestyle choices that impacted happiness and health that were mentioned very quickly. I wish they were fleshed out a bit.

2) As a quantitative researcher, I was looking for some numbers and statistics to back up the claims made by the authors. For example, there are objective surveys to determine happiness and quality of life. Were these administered for any part of the follow-up? If they were, the impact of distinct lifestyle habits could have been tested statistically.

3) Similar to point #1, the authors mention that exercise was very important for health and happiness but didn’t really go into it. I would have love to see a whole chapter on this topic.

4) Ditto for the impact of nutrition and body weight on our health and happiness.

5) The authors mention a bit about how money was not really associated with happiness. I found this fascinating and would have loved a whole chapter on the impact of money on health and happiness.

Is The Good Life Worth Reading?

Absolutely! This book covers some really important research regarding how our relationships impact our health and happiness. It provides the reader with an opportunity to evaluate the relationships in his or her life and offers tips on how to nurture them. Although I would have liked to see more data on other lifestyle choices, this is a really important book and definitely worth a look.

What Is The Best Cardio Machine For Weight Loss?

This one is easy to answer. The elliptical trainer is by far the best cardio machine for weight loss.

Here is why:

1) It is an upright form of exercise, so it burns a lot of calories. When using an elliptical trainer, you are supporting your own body weight. This burns more calories than if your weight is supported, as it is on a bicycle.

2) It is very low impact and easy on the joints. This is important for my older clients and those with orthopedic concerns.

3) There are inexpensive home models available. Exercising outdoors is great. I do it as much as possible. However, rain, snow and cold can sometimes keep you inside. Consistency is key when it comes to cardio. Having a home elliptical makes it easy to hit your cardio goals no matter what the weather is doing.

Sleep Deprivation And Energy Intake In Children

The Study

In this interesting study, 105 children between the ages of 8 and 12 went to bed 1 hour earlier for 7 days and then 1 hour later for 7 days. They had their food intake measured throughout the study period. 

Here is what they found:

-During sleep restriction, children consumed 86 more calories per day then when well slept. This does not sound like much, but if consumed over a full year, would result in 9 lbs. gained.

-During sleep restriction, children consumed significantly more total sugars, ultra-processed foods and sugar sweetened beverages.

American Journal of Clinical Nutrition 2023; 117:317-25.

Take Home Message

For the last several decades, the research on the importance of sleep in weight maintenance has really started to build.  There is evidence that sleep deprivation influences hormones that dictate appetite, such as leptin and ghrelin. There is also evidence that metabolism slows down and you burn fewer calories when under slept.

Proper sleep is also really important for your energy, mood and immune system. For adults, hit a minimum of 7 hours per night. The number varies for children. This study looked at 8-12 year old’s and the range for them is 8 to 11 hours per night.

Eating At Restaurants And Weight Gain

The Study

The average American consumes 3 meals per week at restaurants. These meals are usually nutritionally inferior to what would be cooked at home. In this investigation, nearly 100,000 U.S. adults from The American Cancer Society’s Cancer Prevention Cohort had their weight and restaurant visits measured over a 3 year period.

Here is what they found:

Subjects who maintained their number of fast food and full-service restaurant visits gained weight over the 3 years.

Subjects who reduced their level of fast food and full-service restaurant visits had a statistically significant weight loss over the 3 years.

American Journal of Clinical Nutrition 2023; 117:392-401.

Take Home Message

This is a really simple study with a powerful message: Eat out less if you are trying to lose weight.

Restaurant meals are almost always higher in fat, sugar, salt and calories than food prepared at home. Keep in mind that a chef’s goal is to make food taste good, not to make it as healthy as possible.

I give my clients 2 cheat meals a week to go off their diets. A great strategy is to save your restaurant trips for these splurge meals. The rest of the time, cook healthy meals at home. You’ll be surprised how much this can influence your rate of weight loss.

Diet And COVID-19 Severity

The Study

The association between eating a healthy diet and risk of COVID-19 outcomes was examined in almost 43,000 subjects from Harvard’s Nurses’ Health Study and the Health Professional Follow-up Study. A healthy diet score was created to see how closely subjects followed a Mediterranean diet. The results were interesting:

-Subjects who most closely followed a Mediterranean diet had a 22% lower chance of contracting the virus when compared to those who followed it the least.

-When they did contract COVID-19, subjects who most closely followed a Mediterranean diet had less severe infections and were less likely to be hospitalized.

American Journal of Clinical Nutrition 2022; 116:1672-81.

Take Home Message

I know that most people are tired of thinking about COVID-19. I am too. However, it appears that it will continue to be a part of our lives, at least for the immediate future. It has taken some time for good quality research to be conducted on COVID-19 and it is now being published in large amounts.

This study suggests that you can protect yourself from catching COVID-19 and/or a bad case of the virus by eating right.

The authors believe that a healthy diet improved immune function and decreased inflammation in their subjects. This is the most likely reason for the benefit seen here.

Dietary Trends In Fat And Sugar Intake

The Study

Every few years, the government conducts the NHANES (National Health And Nutrition Examination Survey) survey to examine the health of the U.S. population. This cross-sectional, geographically and ethnically representative survey gives a snapshot view of what we are all eating. 

This current study looked at the added sugar and saturated fat consumption of 2-18 year olds. The results were not good. Saturated fat and added sugar accounted for 30% of energy intake. The goal is under 15%.

The top 3 sources of food for our children were:

1) Sweet bakery foods

2) Savory snacks (like potato chips)

3) Pizza

American Journal of Clinical Nutrition 2022; 116:1779-89.

Take Home Message

These results are disturbing to me for at least 4 reasons:

1) Our children are not getting the nutrients they need to promote healthy growing bodies and brains.

2) This style of eating will dramatically increase risk of weight gain, which is now epidemic among our children.

3) Diets this high in sugar and saturated fat will substantially increase risk of obesity, heart disease, diabetes, stroke and certain cancers. There has also been an association found between eating this way and negative mental health outcomes, like anxiety and depression.

4) We are instilling bad eating habits in our kids which most certainly will be carried on into adulthood.

We need to do a lot better with what we are feeding our children.

App Review: MyNetDiary

 

If you are trying to make positive changes in your diet to lose weight and/or improve your health, it is very useful to keep track of the foods you eat. It provides accountability and allows you to spot trends in your eating patterns. 

With smartphones, it is now easier than ever to log your food intake. There are a lot of food tracking apps out there. Today, I will review one of them; MyNetDiary. This app is available for download on both Android and iPhones. There is a free version, as well as a paid premium version.

Pro’s

1) As mentioned, the basic version is free. I still don’t know why these apps are mostly free, but they are and we won’t complain!

2) You don’t have to set up an account with MyNetDiary. It is always a pain to sign up for an account with these apps. Then you get blasted with emails about upgrades and offers. You don’t have to do this with MyNetDiary, you just download it and are ready to go.

3) It has a very easy interface. It took me just a couple of minutes to figure out how to log my foods.

4) It has a bar code reader, so you can scan in your food items. This is a really cool feature.

5) There are tons of foods in the database. Every brand I looked up, I found.

6) There is a nice, simple nutrient report, along with a pie chart showing fat, protein and carb percentages. You can see this for each meal and for the whole day. This is very useful.

7) You can store commonly eaten foods, so once you search for a food, you can easily access it for a future meal.

Con’s

1) There are just a few too many notifications suggesting things to try out on the app.  This can be mildly annoying.

2) The dashboard is a bit cluttered with options you don’t really need and likely will never use.

Would I Recommend MyNetDiary?

Absolutely! This free and handy little app will be a real asset to anyone trying to track changes in their diet. I always have new clients write down their food for the first few weeks we work together. It is a powerful tool that takes just minutes a day.

Disclosure: I am not affiliated with the company that makes the MyNetDiary and make no money if you buy the premium version.

How Do I Get Back On Track With My Diet After The Holidays?

The time between Thanksgiving and New Year’s 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 Year’s Day.

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. A great free app to help you do this is MyFitness Pal.

3) Go to the grocery store and load up on all of the right foods. Make it easy to eat healthy. Similarly, get all of the unhealthy foods out of your house. 

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. 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.

 

  

Physical Activity And COVID Outcomes

The Study

The association between physical activity and COVID outcomes was examined in a cohort of 194,191 COVID positive adults. Subjects were categorized into different fitness levels based on self-reported exercise habits at doctor’s visits. The results were very interesting:

 -When compared to subjects who were physically active 150 minutes per week or more, subject active less than 10 minutes per week had a 91% increased risk of COVID related hospitalization.

- When compared to subjects who were physically active 150 minutes per week or more, subject active less than 10 minutes per week had a 391% increased risk of dying from COVID.

American Journal of Preventive Medicine 2022 https://doi.org/10.1016/j.amepre.2022.10.007

Take Home Message

There are several potential mechanisms for the association between exercise and COVID outcomes seen in this investigation. Regular exercise decreases the risk of heart disease, stroke and diabetes, which are risk factors for adverse outcomes with COVID. Exercise also improves immune function and decreases inflammation. These could also explain the association.

Exercise is one of the best weapons to fight virtually every disease, including viruses such as COVID. Get moving and stay active.

Dietary Choices And Sleep Quality

The Study

The association between diet and sleep quality was investigated by a research team at Columbia University. Twenty-six subjects slept 5 nights in a research lab. Four of those days they ate a controlled diet, and the fifth they could eat whatever they wanted. The results were very interesting:

-Fiber was associated with better quality sleep (more slow wave sleep).

-Saturated fat was associated with worse quality sleep (less slow wave sleep).

-Sugar and low fiber carbs were associated with worse quality sleep (more arousals).

Journal of Clinical Sleep Medicine 2016; 12:19-24.

Take Home Message

Quality sleep is critically important for both our physical and mental health. This study shows that what you eat can have a real impact on your sleep. The researchers theorized that our food choices can have an impact on our circadian rhythm and melatonin production.

There are lots of reasons to limit saturated fat, sugar and refined carbs and make sure you are getting enough fiber. Now we have one more.

Book Review: Glucose Revolution

Next up for review is Glucose Revolution, by Jesse Inchauspe. The author holds a Master’s Degree in Biochemistry and is the founder of @GlucoseGoddess, a popular nutrition Instagram account.

Introduction

The main focus of this book is the importance of keeping a stable blood sugar. It contains 10 “Diet Hacks” to help the reader avoid swings in blood sugar and insulin levels. The book is 224 pages. It is very well written and I enjoyed reading it.

5 Things I Really Liked About Glucose Revolution

1) I like the focus on blood sugar stability. I have been using a blood sugar stabilizing diet for my clients for over 15 years with really good weight loss and health improvement results.

2) I also like how exercise is stressed. It is hugely important for just about any health or weight loss goal.

3) The author recommends limiting fruit juices and smoothies due to their high glycemic impact. I couldn’t agree more.

4) I really like the way the author describes reactive hypoglycemia, which is when swings in blood sugar leave you tired, hungry and moody. I have seen this in the vast majority of my clients over the years.

5) Combining carbs with fat and protein is recommended to keep blood sugar stable. This is a very important strategy that I recommend to each and every client I work with.

5 Things I Didn’t Agree With In Glucose Revolution

1) Finding the cited research was a real challenge in this book. When mentioning a study, it is common practice to number the references and list them sequentially at the end of the chapter or book. The author did not do this but would highlight part of the text and then list any references in the back of the book. This is a bit clumsy and makes it quite difficult to identify the research.

2) I feel like the authors interpretation of the research literature was a bit off at times. For example, one of the dietary strategies described is to eat your protein and fat before your carbohydrates at each meal to stabilize blood sugar. Three studies are cited as evidence that this reduces peak blood glucose. I looked them all up.

-The study by Shukla included only 11 diabetic subjects. They waited 15 minutes between eating the different macronutrients.

-The study by Nishino was in a very obscure Japanese journal I never heard of. Subjects were told to bite each food 20 times before swallowing.

-The study by Trico was on 20 type 2 diabetics who were free living. In other words, no one supervised how they ate their food. This was a trial that was not controlled very well.

The fact that most of these studies were in diabetics with very unusual eating conditions makes it hard to generalize that eating your protein and fat right before your carb will have a major impact on your blood sugar. It may, but these studies don’t really prove that.

3) The author allows regular consumption of sugar. She just recommends trying to limit its impact on blood glucose with “Diet Hacks”.  However, sugar has been shown to be addictive in the research literature. It sounds funny, but it is far easier to give up sugar 100%, then 75%. After a few weeks pass, you don’t even miss it. Having it all the time will result in sugar cravings and increased hunger in general. I have had much more success with eliminating sugar entirely from my client’s diet and allowing an occasional sugar free treat to satisfy any minor residual dessert cravings.

4) Similar to #3, the author allows snacking and has strategies to deal with carb cravings. If you are craving sugar and refined carbs all the time and need to eat in between meals, there is something wrong with your diet.

5) Much of the nutrition advice in this book is questionable. The author recommends all of the following foods as parts of meals and snacks: toast, ham, cheese, butter, coconut oil, cream, rice, potatoes, bagels, crackers, sausage and bacon.  These foods are high in red meat, saturated fat and refined carbohydrates and are not a good choice if you are trying to reduce your risk of chronic disease.

Is Glucose Revolution Worth Reading?

Absolutely! A major goal of my work with clients is to stabilize their blood sugar. I find the best and easiest way is to eliminate sugar and strictly limit refined carbohydrate foods. After a few weeks, the cravings for these foods virtually disappear and my clients develop an entirely new relationship with food.

I would also be careful following some of the nutrition advice here. Including lots of red meat, saturated fat, sugar and refined carbs in your meal choices is not a good idea.