Do You Have Any Tips To Stay On Track With My Diet During The Holidays?

The holidays are a real challenge for those trying to lose weight and eat right. There are tons of opportunities for poor eating. Here are just a few quick tips to help you stay on track:

1) I love the concept of having 2 cheat meals each week when you are allowed to go off your diet a bit. Use these strategically around the holidays so you can have a few days where you can pretty much eat what you want.

2) Keep up your exercise habits. Even though we are all busy during the holidays, keep exercise a priority. Daily cardio and twice per week weight training will do a lot to keep your weight where you want it to be on the other end of the holiday season.

3) Strictly limit sugar. I have seen it completely derail weight loss progress. It not only increases hunger due to its negative impact on blood sugar, it also has a powerful addictive component. 

Go with sugar free desserts, like fresh berries and whipped cream. Another strategy is to make sure you have a dessert on hand made with non-nutritive sweeteners. For example, at Thanksgiving, we simply substitute Splenda for sugar in our pumpkin pie recipe. 

The Mediterranean Diet And Hearing Loss

The Study

Hearing loss in the elderly is closely associated with a decrease in function. In this interesting study, 882 older participants of the Baltimore Longitudinal Study had their diet monitored for 8 years and had their hearing examined by pure-tone audiometry. 

Subjects most closely following a Mediterranean diet had a significantly lower risk of hearing loss by the end of follow-up.

American Journal of Clinical Nutrition 2024; 119:1338-45

Take Home Message

This is the first article I have ever seen that looked at diet and hearing and is yet another reason to consider the Mediterranean diet. The research literature consistently shows that it has a powerful impact on our physical and mental health.

There are several potential mechanisms at play here:

-This diet includes an abundance of vitamins, carotenoids and specific fatty acids that have a positive impact on inner ear health.

-The Mediterranean diet reduces inflammation and oxidative damage.

-This way of eating may improve cochlear blood flow.

Ultra Processed Foods And Risk Of Cardiovascular Disease

The Study

Ultra-processed foods are food products that contain extra ingredients that add palatability and extend shelf life. The research literature has recently shown that they are quite detrimental to our health. 

In this interesting study, ultra-processed foods were combined into categories to examine their long-term impact on risk of cardiovascular disease.

This study included over 200,000 subjects from 3 different Harvard cohort studies. Subjects had their ultra-processed food consumption monitored for over 30 years and were watched for incidence of heart disease and stroke. 

Among the findings:

-Total ultra-processed foods were significantly associated with cardiovascular disease risk.

-Among food groups, both processed meats and sugar sweetened beverages were associated with an increased risk of cardiovascular disease.

https://doi.org/10.1016/j.lana.2024.100859

Take Home Message

Processed meats include bacon, sausage, hot dogs and preserved deli meats like salami and pepperoni. Strictly limit these in your diet along with sodas and other sugary beverages.

Protein Choices And Healthy Aging

Although nutrition is a very popular topic in the media, the majority of the conversation focuses on sources of dietary fat and carbohydrate. Protein tends to be a lot less trendy. However, the amount and type of protein we choose to put into our bodies is important. Really important.

Harvard University’s Department of Nutrition recently published an impressive study examining the impact of different types of protein foods on healthy aging over a 30-year follow-up.

The Study 

In this investigation, 48,762 women over the age of 60 from Harvard’s Nurses’ Health Study were followed for 30 years (Reference 1). The purpose of this study was to see how different types of protein influenced healthy aging.

Healthy aging was considered:

1) Being free from 11 major chronic diseases such as cancer, type 2 diabetes and heart disease.

2) Good mental health.

3) No cognitive impairment.

4) No impairment of physical functioning.

The results were very interesting:

-A 3% increase in total protein increased the odds of healthy aging by 3%.

-A 3% increase in animal protein increased the odds of healthy aging by 7%.

-A 3% increase in dairy protein increased the odds of healthy aging by 14%.

-A 3% increase in plant protein increased the odds of healthy aging by 38%.

Conclusions And Recommendations

There are really 2 important messages here:

1) Protein is critical for healthy aging. All types of protein were associated with healthy aging.

2) The type of protein really matters. While all were beneficial, plant and dairy protein seemed to help the most.

I have my clients shoot for about 20% of their diet as protein and make sure they get a serving at each and every meal.

Good sources of dairy protein are plain non-fat yogurt, low fat milk, low fat cottage cheese and low fat cheese.

Good sources of animal protein are fish and shellfish, turkey and chicken, eggs and egg whites.

Good sources of plant protein are whole grains (such as quinoa and protein pasta), beans, lentils, nuts and seeds.

References

1) Korat A, et al. Dietary protein intake in midlife in relation to healthy aging- results from the prospective Nurses’ Health Study cohort. American Journal of Clinical Nutrition 2024; 119:271-82.

On Food Labels, What Is The Difference Between “Total Sugars” And “Added Sugars”?

Many who are trying to manage their weight or improve their health are looking to reduce sugar in their diet. Food labels are a bit confusing, because they have two categories for sugars: Total Sugar and Added Sugars.

Total Sugars are all sugars in the product. This includes naturally occurring and those added in the manufacturing process.

Added Sugars just includes those added in the manufacturing process.

Total sugars can be a bit misleading. For example, a glass of plain low-fat milk has 12 grams of total sugars. However, this is all lactose, a naturally occurring sugar that does not have much of an effect on blood sugar. Added sugars are 0.

When looking at food labels, focus on the Added Sugars column. Keep this at 0 or close to 0 if you are trying to limit refined sugar.

Nut Consumption And Brain Insulin Sensitivity

The Study

Improvements in brain insulin sensitivity may prevent cognitive decline and reduce risk of Alzheimer’s disease. In this randomized crossover study, 28 healthy overweight adults consumed 60 grams (359 calories) of mixed nuts for 16 weeks and then no nuts for 16 weeks. 

Brain insulin sensitivity was measured by MRI. Other risk factors for cardiovascular disease were also taken.

After consuming the nuts, subjects showed statistically significant improvements in brain insulin sensitivity. These subjects also had improvements in triglycerides, systolic blood pressure and LDL cholesterol.

American Journal of Clinical Nutrition 2024; 119:314-23

Take Home Message

Nuts are a nutrition powerhouse that have previously been associated with reductions in risk of heart disease, stroke, type 2 diabetes and obesity. They may also have a nice impact on cognition and reduce risk of cognitive decline.

The researchers were not sure of the potential mechanisms at play here, so more research is needed in this area. I try to have nuts with breakfast and lunch just about every day and recommend my clients do the same.

How Variety And Portion Size Can Influence Food Consumption

The Study

In this interesting crossover trial, 42 women ate a lunch once per week for 4 weeks that varied in 2 properties:

Low Variety: Consisting of 3 bowls of their favorite dish.

High Variety: Consisting of 3 different main dishes.

Small Portion: 450 grams

Large Portion: 600 grams

The results were interesting:

-When women ate the high variety lunch, they consumed significantly more food (15 more grams per meal).

-When women ate the large portion size lunch, they also consumed a significantly higher amount of food (57 more grams per meal).

https://doi.org/10.1016/j.appet.2023.107089

Take Home Message

If you are trying to cut calories, don’t include too many kinds of food in your meals. Keep it simple.

It is also a good idea to serve yourself a reasonable portion in your kitchen and bring it out to your table rather than having a huge serving dish right in front of you.

Book Review: The Longevity Diet

Next up for review is The Longevity Diet, by Valter Longo, PhD. The author is the Director of the Longevity Institute at University of Southern California. I recently heard him give a talk at the Harvard School of Public Health and was so impressed that I went out and bought his book.

Introduction

The main focus of this book is about increasing longevity. It contains nutrition, exercise and modified fasting tips based on the author’s research. The book is 317 pages. It is very well written and I enjoyed reading it.

5 Things I Really Liked About The Longevity Diet

1) In an effort to reduce conflict of interest, the author donates all of the proceeds of this book to charity. I think this is terrific.

2) The author does not promote fasting because of the side effects, including an increased risk of heart disease. I could not agree more. The research literature has shown some serious problems with fasting and our health.

3) I really like the discussion on glycemic index and glycemic load. He mentions that glycemic load is the more important of the two and I totally agree with this.

4) There is a really good section on the health and longevity benefits of cardiovascular exercise. This part of the book is really well done.

5) His longevity diet is largely based on a nice Mediterranean diet. The research has consistently shown that this is the best diet to reduce risk of chronic disease.

5 Things I Didn’t Agree With In The Longevity Diet

1) A major issue I have, and one the author freely admits, is that most of his research is in mice. There needs to be randomized trials in humans before you can really have confidence in a lot of these recommendations.

2) There were a few references in the text that did not lead to any searchable citations. For example, on page 67, the author cites his own study showing an increased risk of mortality with higher protein intakes. When you click on the reference, it just says “Levine et al and Longo, Low Protein Intake”. This happens several times throughout the text. I was hoping to find a full citation in a peer reviewed journal so I could read this study.

3) The author mentions that all protein increases risk of disease. I fully agree that red meat, full fat dairy and processed meat promote a variety of chronic diseases. However, seafood, chicken, turkey, and vegetable proteins like beans, nuts, and legumes have not been shown to increase risk of disease and don’t really need to be reduced in our diets. I have my clients shoot for about 20% of their diet to come from these healthy protein sources.

4) I thought the section on resistant training was a little light. This is a really important part of aging well and I think the recommendation could have been a bit more comprehensive.

5) In the text, the author mentions some really sound dietary recommendations very similar to the Mediterranean diet. At the end of the book there are some meal plans and things go a bit sideways.  The meals have an abundance of high glycemic load carbs, including: bread, jam, pasta, dried fruit, smoothies, bagels, potatoes, honey and pizza. 

Is The Longevity Diet Worth Reading?

Absolutely! This book provides a lot of solid and research-based advice to increase the odds that you will live longer and better. 

I think we need to see a bit more data on humans before the merits of modified fasting are confirmed, but this is definitely an interesting line of research.

I like most of the dietary recommendation in this book, I just think we should be a bit tighter on the high glycemic load carbs and that healthy source of protein don’t have to be quite as restricted.

 

Can I Have Butter Again?

Several popular fad diets are spreading the idea that saturated fats are not harmful and butter is a perfectly fine food to be included in your diet every day, if not every meal.

Is this a good idea? In a word, no! The idea that saturated fats are harmless is not based on solid nutrition research.

The nutrition literature has always shown, and continues to show, that saturated fat increases risk of heart disease and stroke, especially when compared to other more healthy options.

For example, in a large well designed cohort study out of Harvard that included over 125,000 men and women, replacing saturated fat with either polyunsaturated fat, monounsaturated fat or whole grains significantly reduce risk of heart disease (Reference 1).

In conclusion, don’t believe the hype. Vegetable sources of fat such as olive oil, canola oil, nuts, nut butters and avocados are a much healthier choice than butter.

References

1) Journal of the American College of Cardiology 2015 66:1538-48

Mediterranean Diet And Mortality

The Study

The research literature consistently shows that the Mediterranean diet is the most effective diet for reducing risk of chronic disease. In this interesting study, 25,315 women from the Women’s Health Study had their diet measured and were watched for 25 years.

Subjects following a Mediterranean diet had an 11% lower risk of dying from any cause when compared to subjects not following a Mediterranean diet.

JAMA Network Open. 2024;7(5):e2414322

Take Home Message

The fact that the Mediterranean diet reduced mortality in this investigation is really not a surprise, many studies have shown this. What makes this study special is that the researchers took 33 biomarkers from each subject at baseline in order to get some insight into just why this diet is so effective at reducing disease.

The biomarkers that were most different for those strictly following a Mediterranean diet showed a reduced insulin resistance, body mass index, triglycerides and inflammatory markers. These are likely the ways that a Mediterranean diet offers protection from chronic disease. 

A Mediterranean diet is high in fruits, vegetable, legumes, whole grains, poultry, seafood and nuts and low in refined carbs, sugar, red meat and processed meats. This is a great way to eat for your health.

 

Can Statins Prevent Cancer?

The Study

Chronic inflammation is known to be a major cause of cancer. A groundbreaking study out of Massachusetts General Hospital in Boston was recently published that used both an animal model and an epidemiological study to show that statin drugs may block this inflammation and reduce the risk of developing cancer.

-In mice, a statin drug called Pitavastatin suppressed externally caused inflammation in the skin and pancreas and prevented inflammation dependent cancers.

-In humans, subjects taking Pitavastatin had a statistically significant reduced risk of pancreatic cancer. 

doi.org/10.1038/s41467-024-48441-8

Take Home Message

Tens of millions of Americans are taking statins to lower their cholesterol and reduce their risk of heart disease and stroke. A surprising and beneficial side effect of these meds may be that they help reduce the risk of cancer. More research is needed here, but this is exciting news.

Can multivitamins slow cognitive decline?

The Study

Recent evidence suggests that multivitamin use may delay cognitive aging and decrease risk of age-related dementia. The COSMOS randomized controlled trial conducted by Harvard Medical School put this hypothesis to the test.

In this study, 5,203 subjects over the age of 60 took a daily multivitamin for 2 years and took a battery of memory tests. Compared to the placebo group, the subjects taking a multivitamin had a statistically significant improvement in global cognition and episodic memory. The researchers estimated that taking the multivitamin was equivalent to reducing cognitive aging by 2 years.

American Journal of Clinical Nutrition 2024; 119:692-701

Take Home Message

The evidence is beginning to mount that taking a multivitamin has a positive impact on cognitive aging. Considering that they are inexpensive and have no negative side effects, it is not a bad idea to consider taking a multivitamin if you are older than 60.

Does being physically active attenuate the negative impact of sugar consumption?

The Study

Sugar sweetened beverages are known to have an adverse impact on cardiovascular health. A group of researchers at Harvard University wondered if being physically active reduced these negative effects. 

In this investigation, 65,730 women from the Nurses’ Health Study and 39,418 men from the Health Professional Follow-up Study had their sugar consumption and physical activity levels followed for 30 years.

The results were interesting:

-When looking at all subjects, those that consumed 2 or more sugar sweetened beverages per day had a 21% higher risk of cardiovascular disease when compared to those that never drank them.

-There was no association between diet beverage consumption and risk of cardiovascular disease.

-Participants meeting physical activity guidelines (greater than 7.5 MET hours per week) had no reduced risk when compared to subjects that did not meet physical activity guidelines (less than 7.5 MET hours per week).

American Journal Of Clinical Nutrition 2024; 119:669-681

Take Home Message

Whether you are physically active or not, it is a good idea to strictly limit sugar sweetened beverages.

Carbohydrates And Body Weight

In the 80’s and 90’s, dietary fat was the major focus of most weight loss strategies. Starting in the early 2000’s, the research literature started to show that carbohydrates were also important in weight maintenance. Most current fad diets manipulate the amount or type of carbohydrate permitted in some way. 

Harvard University’s Department of Nutrition recently published an impressive study examining the weight loss impact of different type of carbohydrate foods over a 24 year follow-up.

The Study

In this investigation, 136,432 men and women from Harvard’s Nurses’ Health Study, Nurses’ Health Study 2 and Health Professional Follow-up study had their 4 year weight change and diet measured for 24 years (Reference 1). 

The results were very interesting: (As a reference, 100 grams is just less than ½ of a cup)

-An increase in glycemic index and glycemic load were positively associated with weight gain.

-A 100 gram per day increase in added sugar resulted in a 4 year weight gain of 2 lbs.

-A 100 gram per day increase in refined grains resulted in a 4 year weight gain of 1.8 lbs.

-A 100 gram per day increase in potatoes and other starchy vegetables resulted in a 4 year weight gain of 5.7 lbs.

-A 100 gram per day increase in whole grains resulted in a 4 year weight loss of .9 lbs.

-A 100 gram per day increase in fruit resulted in a 4 year weight loss of 3.5 lbs.

-A 100 gram per day increase in non-starchy vegetable resulted in a 4 year weight loss of 6.6 lbs.

Conclusions And Recommendations

If you are trying to control your weight, you need to pay close attention to the type of carbs on your plate. However, there is no need to completely eliminate them. Carbohydrate foods are our best sources of fiber, vitamins, minerals and cancer fighting phytochemicals.

Focus on fruits, vegetables, legumes (beans and lentils) and whole grains (brown rice, quinoa and oatmeal).

Limit sugar, potatoes and refined grains like white rice, bread and pasta.

References

1) Wan Y, et al. Association between changes in carbohydrate intake and long-term weight changes: Prospective cohort study. British Medical Journal 2023; 382:e073939.

 

Exercise And Risk Of Depression

The Study

Recent evidence suggests that cardiovascular exercise is associated with a reduced risk of depression. In this interesting study, 4,016 subjects from the Irish Longitudinal Study On Aging cohort had their physical activity and levels of depression measured for 10 years.

By the end of follow-up, subjects who completed 400-600 METS per week had a 43% lower odds of depression.

JAMA Network Open 2023; 6:e2322489

Take Home Message

Since one minute of brisk walking is equal to 4 METS, the level of exercise found to reduce the odds of depression in this study is equivalent to only 100 minutes of brisk walking per week.

Cardiovascular exercise is not just important for our physical health, but our mental health as well. Do your very best to make it a priority in your life.

 

Fruit Juice And Weight Gain

The Study

100% fruit juice has historically been considered part of a healthy breakfast. Recent research suggests that it may be associated with weight gain. In this study, a comprehensive review and meta-analysis of the research literature was conducted to answer this question. Forty-two studies were included. 

Here is what the researchers found when combining all of the data:

-Among children, each additional serving of fruit juice was associated with a statistically significant increase in body mass index.

-In adults, studies that did not adjust for total energy consumption showed a statistically significant weight gain with 100% fruit juice consumption.

Journal of the American Medical Association Pediatrics doi:10.1001/jamapediatrics.2023.6124

Take Home Message

There are a few potential explanations for these results:

1) Drinking fruit juice may increase cravings for sweet foods.

2) Liquid calories are not registered in the same way as solid calories, so we tend to overeat when consuming liquid calories.

3) There is less fiber in fruit juice which results in a more rapid absorption of the sugar found in juice.

Always eat fruit in it’s whole and natural form. For example, have an orange instead of orange juice. Have an apple instead of apple juice. When it comes to our food, the less processing, the better.

How To Get Back On Track With Your 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.

 

Mediterranean Diet And PTSD

The Study

The association between diet and mental health has been an area of increasing interest in the research literature. In this interesting study, 191 women who had traumatic exposure and PTSD symptoms had their diet evaluated.

The researchers found that higher PTSD symptoms were associated with less adherence to a Mediterranean diet.

Nature Mental Health 2023; 1:900

Take Home Message

Diets that are easy on our blood sugar seem to have a positive impact on mood and mental health. A Mediterranean diet is a great example. This type of diet focuses on fruits, vegetables, whole grains, beans, nuts, olive oil, seafood and chicken. 

It limits refined grains, sugars, red meat and saturated fat. It is a great way to eat for both your physical and mental health.

Protein Timing After A Workout

The Study

It has long been theorized that consuming protein just after a resistance training session will maximize gains in muscular strength and growth. The thought here is that there is an anabolic “window of opportunity” for protein uptake and muscle synthesis that can be taken advantage of with supplementation. What does the research say?  

A review published in the Journal of the International Society of Sports Nutrition examined this question. After summarizing the 6 most influential studies on this subject, the researchers concluded that there was no definitive evidence that supplementing protein after a workout improves results.

Journal of the International Society of Sports Nutrition 2013; 10:5

Take Home Message

As long as you are getting adequate protein at all 3 meals, there is no reason to load up on protein after a workout.

Is Organic Produce Worth The Extra Expense?

At first glance, the idea that organically grown produce is healthier than conventionally grown makes a lot of sense. If organic products cost the same amount of money as conventionally grown, it would be a pretty easy decision for most of us. However, this is not the case. Organic produce can cost twice as much as conventionally grown. This begs the question: Is it worth the extra money? Let’s look at what the research says:

Study #1

Stanford University conducted a review of the research literature that included 240 studies on organically grown foods (Reference 1). The Authors concluded that there was no convincing evidence that organic produce was more nutritious or would result in significantly improved health outcomes.

Study #2

A research group from a British medical school conducted a similar investigation (Reference 2). This review included a variety of outcomes and 12 separate influential studies. The researchers concluded that evidence was lacking for any nutrition related health effects of organically grown food.

Study #3

In 2021, the USDA conducted its annual testing of pesticide residues on foods available for sale in the U.S. (Reference 3). This included 2.7 million analyses.

-24% of foods tested had no detectable residues. 

-99% of foods were below the EPA’s tolerance levels. These levels are conservatively set at 1/100^th of an exposure that caused no toxicity in laboratory animals.

Conclusions And Recommendations

These studies may be surprising to many and even a bit controversial. However, in the field of nutrition, many commonly held beliefs by the public are not supported by the research literature. 

Organic produce is much more expensive than conventionally grown, often two times as much money. Most buyers of organic foods spend this extra money for one of two reasons:

-They think there are more nutrients in organic foods.

-They believe that organic foods will have a more positive effect on their health than conventionally grown food.

Up to this point, the research indicates that neither are true. If you like to buy organic produce and can easily afford to do so, by all means continue. However, if you are buying organic produce because you think it is more nutritious or will result in improved health, there is very little evidence that this is true.

References

1) Smith-Spangler C, et al. Are organic foods safer or healthier than conventional alternative? A systematic review. Annals of Internal Medicine 2012; 157:348-66.

2) Dangour AD, et al. Nutrition related health effects of organic foods: A systematic review. American Journal of Clinical Nutrition 2010; 92:203-10.

3) https://www.ams.usda.gov/reports/pdp-annual-summary-reports