Changing carb quality improves risk factors for heart disease

The Study 

The quality of carbohydrates we eat has been a very hot topic in nutrition research for some time. In this fascinating study, over 5,000 overweight Spanish adults worked to improve their carbohydrate choices from less healthy sources (such as refined cereals, sugar and soda) to more healthy sources (such as fruits, vegetables, legumes and whole grains). The results were impressive. After 6 months of these changes, body weight, waist circumference, blood pressure, fasting glucose, glycated hemoglobin, and triglyceride levels all improved significantly. After 12 months, HDL cholesterol also improved. American Journal of Clinical Nutrition 2020; 111:291-306. 

Take Home Message

The carbohydrates you choose can have a major impact on your weight, energy, mood and health. Shoot for healthy sources like fruits, vegetables, whole grains, beans and other legumes. Limit bread, pasta, white rice and sugar. It is also a good idea to have a moderate percentage of carbs in your diet. Somewhere around 40-50% is a nice goal, especially if you round out the difference with 20-25% lean proteins and 30-35% healthy vegetable based fats.

Three Popular Diets Compared

The Study

This interesting study examined adherence, dietary composition, weight loss and health effects for three popular weight loss diets: intermittent fasting, paleo and Mediterranean. A total of 250 overweight adults were allowed to choose which diet they wanted to try and were followed for 1 year. Here are some of the results:

-Weight loss was slightly higher on the Intermittent Fasting diet at 8.8 lbs. by the end of the year. The Mediterranean diet was a close second at 6.2 lbs. The Paleo group only lost 4 pounds by the end of follow up. However, the Mediterranean group lost more body fat, visceral fat and had a greater drop in waist circumference than the other groups.

-The Mediterranean diet was the easiest to stick to with 57% of subjects sticking with the diet by the end of 1 year. The Intermittent fasting group was a close second with 54% of subjects staying on the diet by the end of 1 year. Only 35% of the Paleo subjects were still on their diet by the end of the year.

-The Mediterranean group had a significantly lower blood pressure and HbA1c compared to the other groups and also ended up with a lower c-reactive protein, which is a measure of body wide inflammation.

-The intermittent fasting subjects had the highest consumption of processed foods and lowest fiber and calcium intakes by the end of 12 months. American Journal of Clinical Nutrition 2020; 111:503-14.

Take Home Message

This is a really interesting study. When you are choosing a weight loss diet, you need to look at the whole picture. Will the diet work? Can you stay on it? How will it impact your long-term health? For me, the Mediterranean diet is the clear winner here. It provides the right combination of helping you lose weight, being the easiest to stay on and it has the best impact on your health. I have been recommending this type of diet for over 20 years with amazing results. If you want to learn more about it, check out the Healthy Eating Pyramid from the Harvard School of Public Health here.

Book Review: The Weight Loss Triad, 2nd Edition

As many of my blog and newsletter readers know, I like to review books from time to time. Well today it is my pleasure to introduce my own new book, The Weight Loss Triad, 2nd Edition. Many of you may be familiar with my first book, The Weight Loss Triad, which was published in 2009. I can’t believe it was over 10 years ago! There are a few reasons why I figured it was time to update this book:

-There has been a lot of new nutrition and weight loss research in the past 10 years that has influenced my recommendations. While the majority of my program is exactly the same as it was 10 years ago, there have been a few important changes that needed attention.

-I have had 10 more years of experience working with clients, which has taught me a lot about how to make this program work for people regardless of any obstacles they may be facing.

-The 1st Edition was written for the general population. I didn’t include a lot of the research that guides my recommendations because I did not want to make things too complicated. In the 2nd Edition, I want to let the reader know where they can find the studies that I have used to formulate my recommendations and to provide a summary of this research.

My new book, similar to the 1st Edition, presents a comprehensive weight loss strategy broken down into 3 key areas: Diet, Cardiovascular Exercise and Resistance Training. It also includes chapters on lifestyle factors and frequently asked questions to help the reader incorporate the principles of this program into their daily routine no matter what life throws their way.

In these crazy and stressful times, we all need to do what we can to take care of ourselves. If your diet and exercise programs need a little tweaking and you want to drop a couple of pounds, this book could be a great help to you.

You can pick it up on Amazon.com in either a print or kindle version. (Click Here)

Diet And Arthritis

The Study

The relationship between diet and arthritis progression was examined in 2,757 subjects with existing knee arthritis. Subjects in this study tended to eat two different types of diets. The Western Dietary pattern was high in French fries, red and processed meats, sugar, refined grains and pizza. The Prudent Dietary pattern was high in fruits, vegetables, legumes, fish and whole grains. After 6 years of follow-up, subjects consuming the Western diet had a significant progression of their arthritis. Subjects consuming the Prudent diet had a significant decreased progression of knee arthritis. American Journal of Clinical Nutrition 2020; 111:667-676.  

Take Home Message

This is a fascinating study. The idea that your diet can impact something like arthritis progression is powerful stuff. There are two potential mechanisms. One is that eating the unhealthy Western diet promoted weight gain, which speeds up arthritis progression. This is not the only mechanism because when body weight was controlled for, the relationships persisted. It is also possible that the Western diet promoted inflammation while the Prudent diet decreased it. There are about 1,000 reasons to eat a healthy diet. It looks like we can add improving orthopedic health to the list.

Muscle Loss And Weight Regain

The Study

In this interesting trial, 209 subjects went on an 8-week low calorie diet and lost at least 8% of their initial body weight. At the end of their weight loss, body composition was measured via DEXA scan. Over 30% of lost weight was muscle in these subjects. The amount of muscle lost was a borderline significant predictor of weight regain (p-value of .055). American Journal of Clinical Nutrition 2020; 111:536-44.

Take Home Message

It is very common to regain lost weight. A big reason why this happens is that we lose muscle when we lose weight without resistance training. Muscle burns 3 times as many calories as fat and muscle loss can have a negative and significant impact on metabolic rate. 

This study shows that the amount of muscle lost during the weight loss process tended to predict weight regain. The good news is that there is a highly effective way to limit the amount of muscle lost as you lose weight. You simply lift weights 2-3 times a week. Weight lifting is often overlooked by those attempting to lose weight but is essential if you want to keep the weight you lose off for good.

Are You Weighing Yourself Correctly?

If you are trying to lose weight, it is imperative that you weigh yourself consistently and with accuracy. Since I often get questions from clients about the best way to do this, I thought it would make a nice feature article for readers of my blog and newsletter.

Why is it so important to weigh yourself each week?

There are two reasons why it is critically important to weigh yourself each and every week:

-The first reason is simply to find out what is going on. Bad habits can sneak in quietly and if you think you are getting away with them, you won’t be able to stop them. A weekly weight reading keeps you aware of where things are going.

-The second reason is to help you identify patterns. When you lose weight, study what you did right. When you gain weight, study what you did wrong. Assigning a consequence to a behavior is critical to learning whether or not you should continue or avoid that behavior. Over a period of months, you will learn exactly what you must do to lose weight and exactly what causes you to gain weight. Consider your weigh in a data point to help you gauge your program and make any necessary adjustments.

How to weigh yourself accurately and consistently

1) It all starts with an accurate scale. I am a big fan of Tanita Iron man scales. These are research quality scales that also let you measure your body fat. They are a bit more expensive than your typical scale but last for years and years. You can pick these up on Amazon.com and learn more about them at Tanita.com. I have been using one of the IronMan series for years and love it.

2) Weigh yourself one time a week, first thing in the morning, in your underwear, before you eat or drink anything. If you had a cheat meal with refined carbohydrates like bread, pasta or white rice, a particularly salty meal or a few drinks containing alcohol, it is perfectly normal to retain a few pounds of water. This can impact your weigh in, so find a day to weigh yourself when you have been eating clean for at least 2 full days. Most of my clients splurge on Wednesday and Saturday nights, so a Wednesday morning or Saturday morning weigh in is perfect. Record your weight in a log to make it easy to keep track of trends.

3) Lastly, keep the right mental attitude when weighing yourself. A lot of my clients got very nervous about their weekly scale reading at first. If they did not lose weight, they would get upset and feel like they failed. It is totally normal to have weeks where you don’t drop weight and weeks where you even gain weight along the way. Don’t freak out if this happens here and there. Look at the weigh in for what it is, a weekly data point to help you gauge your progress, keep you focused and make any necessary adjustments to your program.

How Can I Optimize My Immune System?

Given the Covid-19 epidemic, many people are wondering what they can do to keep their immune system running at peak efficiency. I have fielded this question from clients for many years. Here is how I answer them:

To keep your immune system in great shape, you need to focus on 4 areas:

1) Eat healthy. Follow a low glycemic load Mediterranean diet. This includes:

-Lean and healthy protein sources like beans, nuts, chicken and fish. 

-Low glycemic carbohydrates like fruits, vegetables, legumes and whole grains.

-Healthy vegetable fats like olive oil, canola oil, nuts and avocados.

2) Exercise. Cardiovascular exercise should be in the range of 150-180 minutes per week. Also be sure to hit the weights at least twice per week. Keep exercise intensity moderate. Too much exercise can result in overtraining which will actually impair immune function.

3) Get at least 7 hours of sleep each night.

4) Engage in some type of stress reducing program each and every day. This can be meditation, progressive muscle relaxation, deep breathing or yoga. Shoot for at least 10 minutes of focused stress reduction per day.