The Bad News, But Not Hopeless

Dr. Arya Sharma has a brief post today about "Why Diet and Exercise is Not a Treatment for Obesity."  In brief, heavy people who lose weight must work much harder to keep it off than do those who are naturally the lower weight.

It's true for me that I have to eat like a person who weighs dozens and dozens of pounds less than I do to maintain my current weight at nearly 15% below my highest weight.  And I still have a long way to go.  But I'm not giving up: although I'm currently eating about 1200 calories and losing nicely, I'm much more satisfied with those calories as nutrient-dense foods than I could ever be with that number of calories in Special K, aspartame-sweetened yogurt, Lean Cuisine, and Slim Fast.

My typical day looks like this:

Breakfast -- 1/3 cup (dry) oatmeal made with one piece of fruit and 1/2 oz nuts

Lunch -- giant salad of mixed greens and other veggies with 1/2-1 cup beans, 1/2 oz nuts, and one fruit

Supper -- different cooked veggies, usually one serving of starchy vegetable or rice, either beans alone or 1-3 oz of fish/poultry/meat, a fruit

Snack or Dessert (sometimes) -- a couple of fruits in a smoothie with flax and kale, or a slice of Ezekiel bread toast with peanut butter and a little homemade jam, or just some fruit

A Refreshing Approach to Weight Loss

I have always appreciated the work of Arya Sharma and Yoni Freedhoff, two family physicians who really "get" the challenges of obesity management and educate the public through their blogs.  The Canadian Obesity Network, of which they are both members, has developed a great tool for physicians, and I wanted to note it here for my own reference as well as for others.

In particular, the "tool" of the 5As of Obesity Management recognizes the difference between ideal weight--what the charts call for--and "best weight"--what a person can sustain while still enjoying life.  The tool notes that 5%-10% weight reduction can make major differences in quality of life, shows the difference between classes and stages of obesity, and ultimately makes me feel more a success than a failure.  I've sustained a 10%-20% weight loss for the last five years, and though I still have a long way to go, with ongoing diligence on many fronts and course correction as needed, the work of these physicians gives me contentment with what I have accomplished even as I work for more.

Thanks, guys.

Wisdom From Dr. Sharma

I really appreciate Arya Sharma and Yoni Freedhoff, two Canadian doctors who work with compassion and realism in weight management.  Dr. Sharma posted this today:  Core Principles of Obesity Management.  In my own struggle over the years I get real encouragement--not just pipe dreams--from this.  I've achieved some of these aims, briefly had some of them, and look to them again as I manage this thing.

(I'm finishing up an intense academic year and hope to be posting here again this summer.)

Depressing, But I'm Not Giving Up!

Dr. Arya Sharma posts this:  "Why Diet and Exercise is Not a Treatment For Obesity."

It turns out that "keeping it off" is much harder for those of us who have had to lose it.  I'm almost 20% lighter than my highest weight, but I have a distance yet to go.  But like my dad always said, "Life is not fair."  :-)

Telling final quote:  "Whoever said that treating obesity was simply a matter of ‘eating less and moving more’ (ELMM) probably also believes that they [sic] can live forever by simply breathing less."

Kitchen Work

When you're eating nutritarian, you have a lot of food prep to do, unless you're into an ascetic minimalist approach (apple and banana for breakfast, can of beans poured over bagged salad for lunch, boiled zucchini and a baked acorn squash for supper).  I'm really loving my Vita-Mix, but I'm beginning to lament my knives.

I have a pretty knife block with red-handled knives I got on clearance at Wal-Mart, and I have a single high-carbon knife that I use for "strong" things, as it has a heavy long blade. I have another ancient cleaver-type high-carbon knife that we inherited with our first home, built in 1958. But I don't sharpen these. And then I like those little colored-handle paring knives that come in a set of three for $1 - $3 and break easily, though they are sharp while they last. My favorite cutting tool lately is my julienne peeler from Pampered Chef--it's perfect for making zucchini "spaghetti" that can be tossed in a pot (sometimes with just a few noodles) to create a satisfying nutritarian base for a veggie sauce.

My usual experience is that I suffer through dull or wrongly-shaped knives for most of my chopping and paring.

I think I need a knife makeover.  With a busy household of careless people, I dare not buy several great knives and toss all the mediocre ones. The good ones will be misplaced, misused . . . I just don't trust those folks.  But after seeing this blog and watching the embedded Jamie Oliver video, . . . I think I need a real chef's knife. At least to start with, and a good sharpener--is that sword-thing he used sufficient? My dad used to have a sword ritual with one of those before cutting roast beef or turkey, but it was only occasional and, I think, superstitious rather than effectual. But it's an indelible and pleasant memory. :-)

Nutritarianism Explained

Thanks to Darryl McCullough, a math professor at University of Oklahoma and a nutritarian, I would like to present a big one-page summary of nutritarian principles:

How to Eat

Darryl does a good job explaining the basics for those who want to understand the science of the nutrition. In my own "best practice,"* I have a few differences:

• occasional alcohol and the equivalent of one mug of caffeinated coffee per day
• use of 1% cow's milk or yogurt instead of soy or nut milks and soft tofu in small amounts in recipes
• use of "regular" vitamins (Costco Kirkland brand multi-vitamin/mineral) with a 2:1 calcium/magnesium supplement (Kirkland) for heart palpitations and a single D3 (Kirkland again) bead each day
• occasional tiny amounts of regular sugar (in amounts like a spice) and salt, though I'm getting away from any additional salt in my recipes
• with just a couple of animal product servings per week, I plan to make use of the grass-fed beef we're buying from friends soon, but for no more than one serving per week, carefully planned

I just don't see a need to be so ultimately purist. For example, this week I had some grapefruit in a smoothie and someone suggested that it's been associated with higher estrogen levels and strongly associated with breast cancer in post-menopausal women. I'm not there yet :-), but I passed on the article/study to hubby, who is a biophysicist who has studied some of these toxicology/metabolism issues. I take his counsel on things like this. Handy to have around!

*Note that "best practice" does not mean "what I do every day, without exception." It means what I do when I'm doing what I know I should be doing. :-)

Healthy Foods Myths?

Here is a good, sane article on the health effects of Raw Food Vegan Diets.  Too often I see folks in a vegan-type health lifestyle who fall prey to superstitions and pursue (usually expensive) purist paths of one sort or another.  In that light, I have a few questions. (Caveat: I am setting aside the "ethical vegetarian" concern about avoiding animal foods. That's a discussion of another sort--I'm thinking mostly about health.)

How are liquid aminos nutritionally superior to traditional soy sauce? I realize the sodium content is lower, but equivalent to lower-sodium soy sauce. Where do these aminos come from, besides the high-priced health-food store?

The article discusses raw food enzymes, but I wonder about how the process of long dehydration (even at low temperatures) really preserves any nutritional content better than other methods of cooking.

Are the fats in nuts and avocado SO superior to the fats in oils that a free hand with nut purees and such is really better for us than a bit of olive oil or other oil (or even butter!)?

The same goes for cheeses--recently I've seen on at least one blog that folks are excited about a new vegan cheez (great spelling!) that will make their meals look and taste just as cheesy as the SAD meals, but with nutritional superiority (I assume).  I wonder whether the intensive processing that goes into making such a product results in something that is inherently nutritionally superior to regular old cheese (or a lower-fat version)?

It seems to me that creating vegan versions of omni foods sometimes goes to the point of ridiculousness, especially for those vegans who aren't really watching the calories. It reminds me of the tradition I once heard of whereby strictly-vegetarian Buddhists create mostly tofu-based foods that mimic animal foods to the point of looking just like a fish on the plate, for example.

Is it REALLY that important to substitute stevia or a pureed date for a tiny half-teaspoon of sugar in my fresh-picked blackberries from the garden?

How much of the "current practice" of many vegans and vegetarians is powered by the marketing power of product manufacturers?

I won't even get into the "organic" thing, but that's a particular interest of those who really focus on whole foods. Seems like some marketing gets in there, too! My husband the scientist (with work in toxicology and DNA damage and repair) is not impressed with the superiority of organics in many cases, though he's happy to avoid treating things in our garden when possible!

I'm trying to eat nutritarian for health reasons, so my recipes often include small amounts of things many purists eschew (what a great word!) when I don't see a real advantage to the vegan alternative, though it's certainly others' prerogative to make those substitutions.  And I feel like a bit of a slacker when I post those ingredients, too! :-)

A Lecture that Might Change Your Life

I found this ninety minutes or so from Dr. Fuhrman very motivational:  2010 Health Getaway Presentation on Food Addictions.

If you have the time to spend on this video, you will learn . . .

• Why a "beans and greens" diet is optimal
• What "toxic hunger" is and how to beat it
• How diabetes really CAN be reversed, and who doesn't want you to know that
• Why those of us who naturally gain weight easily can have the MOST optimal mature years--can you believe we actually have an advantage somewhere?

(This is one of our basil plants -- wonderful addition to many nutritarian dishes!)

Why Drugs Won't Work in the Long Run

Thanks to Yoni Freedhoff of Weighty Matters (7-24-10), here is a sensible article about the drug approach to weight loss: "Weight Loss and Wonder Drugs: Something is Fishy."   Dr. David Katz says that when we gain weight on the diet and inactivity of our modern life our bodies are not betraying us but doing exactly what they were meant to do--storing up in time of abundance for a time of want.  The problem is that we never really come to that famine time so we just keep adding to our stores. It's a natural survival mechanism of the body, betrayed by our prosperity.

And when we turn to drugs--to raise our metabolism, to block our hunger, to control our insulin--of necessity we have to introduce powerful pharmaceutical changes to counteract the way our bodies are designed by God (or "Nature" or evolution) to function. And those drugs have potentially and have demonstrated repeatedly to cause very serious side effects. An excerpt:

When one considers that the problem we are asking weight control drugs to fix -- a body turning surplus calories into an energy reserve -- is normal human physiology, the conclusion that they may prove to be elusive not just now, but forever, is hard to avoid. . . .

None of this is to deny the important insights that will doubtless derive from the scrupulous pursuit of scientific details relating to weight control. Rather, it is to note we miss the forest- the fundamentals of human metabolism in native context -- for the densely clustered hormonal, neurochemical, and genetic trees- at our evident peril.

In a word, the ease with which many of us gain weight in our culture (I've noted a lot more heavy brides  lately than when I married 24 years ago, and though I was "overweight" at the time I was slimmer than most of the current chubby brides I'm thinking of.) has a lot to do with our individual responses to our culture. Advertising and abundance can suggest that we really do "deserve a break today" and need to "indulge" and luxuriate in the foods that only kings and queens could have had in years gone by--ice cream, for one! But I think our amazing prosperity can be used to benefit our health if we take advantage of the opportunity and learn to really value the rainbow of produce available at even a modest modern grocery store. I'm learning not to look at the prices of the upscale salads in fast food restaurants because I know that a couple of dollars more will get me a really healthy choice. I deserve THAT break today! And that is part of my survival strategy.

Exercise is Good, But Food Makes the Difference

Just read a post at "Weighty Matters" on an interesting study. Here's the relevant commentary:

The folks who reported a marked increase in exercise over a decade found themselves a whole 1.2lbs lighter ten years later than the folks who didn't and had waist circumferences half a centimetre (roughly a fifth of an inch) smaller.

Huzzah?

This of course leads me to conclude that this study is in fact consistent with the bulk of the evidence which suggests that in the absence of dietary interventions exercise does not dramatically impact on weight over time. It also leads me once again to beg researchers to stop focusing on weight as an exercise study's primary endpoint and instead focus on those things more likely to demonstrate the incredible benefits of exercise - things such as high blood pressure, cholesterol levels, arthritis, cardiovascular fitness and overall quality of life.

This is a good reminder to me of what I (and Dr. Freedhoff) know by experience is true!

Food as Drug

This article nicely summarizes some of the trouble . . . As I've said before, the food does matter:

"Many of us are wired in the brain to eat" from the Edmonton Journal.

(Thanks to www.drsharma.ca )

The Food Matters

This article (November 13 blog post), entitled "Gut Bugs Revisited" suggests that those who have difficulty maintaining a healthy weight may have different intestinal flora than do those who can maintain normal weight. The interesting thing to me was that mice with human "gut bugs" rapidly gained weight when switched from a low-fat high-veggie diet to a "Western diet" of high sugar and high fat, and that the metabolic pathway changed within just a day!

The good news is that though the study didn't investigate this, it seems to make sense that the changes can go the other way, as well! That's what I am discovering: a 1500-calorie day of "Western diet" leaves me feeling very deprived and doesn't lead to sustained weight loss, even when the regimen can be sustained; but a 1500-calorie day of nutritarian eating leaves me full and energetic, and I'm losing weight at over two pounds per week after over a month.

We'll see how the weeks and months to come turn out.

Scientific types who want to protest my conclusions, please recognize I'm just speculating and reading between the lines! :-)