How to Improve Restrictive Diets with A Few Tweaks – Atkins, Ornish, Vegan

I’m not a big fan of low-carbohydrate diets, or most other restrictive diets for that matter. For one thing I’ve been doing hard exercise since I was 10 years old and I’m not about to stop anytime soon. You need optimal quantities of carbohydrates and a reasonable quantity of quality fats and protein for health and performance: ask any serious sports nutritionist or athlete. (As opposed to some of the quacks one reads on the net.)

Even so, healthy eating requires that you eat a good proportion of those carbs and fats as quality carbohydrates and fats and proteins –  fibrous wholegrains, fruits and vegetables, beans and nuts, and lean meats and unsaturated oils.

But let’s say you like low-carb Atkins type diets (20% carbohydrate) or an Ornish very low-fat diet (10% fat) or a vegan diet with no animal products; yet some aspects of the diet just doesn’t suit you and you struggle to stay with it, which is not surprising because less than 10 percent of people who try such restrictive diets actually maintain them for more than about 6 months.

For example, you don’t exercise well on low-carb or you get too lean and lose some muscle on very low-fat or vegan. The answer to this problem is just to move the baseline a little to modify the existing diet to a point where you can follow, more or less, the general principles of the regimen you like, yet maintain a quality eating pattern day in, day out. You adjust the eating rules so that the pattern moves closer to what you’re comfortable with, yet without compromising dietary quality or your preference for that particular dietary style. You do this by implementing healthy eating principles within the confines of your dietary approach. Here’s how you might do this with various restrictive diets.

How to improve a low-carbohydrate diet and stay on track

Low-carbohydrate, Atkins type diets are still somewhat popular, although many followers are moving emphasis to healthy fats and a little more quality carbohydrate in order to sustain them.

1. Increase carbohydrate consumption to around 40% of total energy intake.
2. Keep saturated fat and trans fats low (under 10% saturated and trans). This means choosing lean and low-fat animal foods and including more vegetable protein.
3. Include plenty of high-fibre or low-GI carbohydrate and eat more fruit. If you don’t like wheat or gluten, eat wholegrain rice, buckwheat or polenta, and choose more berries or low-carbohydrate fruits like oranges or other citrus.
4. Some might argue that 40% is not low-carb, but this site is not called Food, Fitness, Health for nothing — I expect an exercise program — and this is the minimum quantity of carbohydrate you can get away with if you want to hit the workout hard, week in, week out. Even then, it may not be ideal for many heavy exercisers.

How to improve a very low-fat diet and stay on track

Ornish very low-fat diets have been used in heart disease rehabilitation with some degree of success. The Pritikin Diet of 20 or more years ago was very similar. At 10% dietary fat, this is a very restrictive diet for most people. A few changes might not alter the overall utility, and may even improve the success of it for most people.

1. Increase fat intake from 10% to around 20% of total energy of the diet.
2. Eat at least two pieces of oily fish per week (or supplements).
3. Stay with the very lean proteins like chicken and turkey breast, or possibly add them if you were doing a vegan version and you have no objection to an upgrade (see below).
4. Add some wholefood vegetable fats like avocado, and nuts like almonds and walnuts. You can keep the screws on added oils and just increase plant-based fats in whole foods.
5. Continue to avoid added sugars and refined carbohydrate foods.

How to improve a vegan diet and stay on track

Vegans eat no animal foods at all — meat, eggs or dairy. A little care is required to get the best out of a vegan diet.

1. We’ll make similar changes to the vegan diet as for the very low-fat, Ornish type diet – without the meat. Aim for at least a 20% fat diet.
2. In my experience, vegans often under-eat, especially those who do a reasonable amount of exercise. The quantity of fibre in vegan diets can be up around the 50 to 60 grams/day mark, about 3 times the average intake. This amount of fibre, although likely a healthy quantity, is very filling and can reduce appetite.
3. The dietary constituents on the low side – other than the commonly deficient B12 — are likely to be fat and protein. Vegans should ensure they consume plenty of nuts, avocado, bean foods, full-fat soy milk and the regular stir fry — and not get into the habit of existing on salads, fruits and bread and cereals and pasta.

Summing up

There you have it – your cake and eat it too — as long as it’s a bran and blueberry oat cake.

What You Need to Know About Burning Fat

 
The idea of “fat burning” has become something of a cliché these days. I’m not surprised. It sounds logical that if you want to lose weight you should burn up that body fat that makes you fat . . . right?

In a way that’s correct, but what has been grossly misunderstood — even by people who should know better — is that you don’t have to ‘target’ fat burning during exercise with low to medium effort because, as the mythology goes, that is the ‘fat-burning’ zone.

At this point I should declare that an article I wrote a few years back for About.com Weight Training is the number one article for “fat burn” as a Google search term — out of nearly 25,000,000 articles indexed by Google (US).  The reason it ranks so high, is, I suspect, because it was one of the first popular articles, if not the first, to describe what really happens with your metabolism as you exercise in relation to the use of fat as a fuel.

How Fat Burning Works During Exercise

I won’t repeat it all here — you can follow the link — but the nub of the matter is that, yes, low-intensity exercise burns a greater percentage of fat than high-intensity exercise, but as you increase the intensity, and the percentage of fat used falls, it’s still possible to use more fat as fuel than you did at lower intensity because the total energy expenditure is greater — for a similar duration of exercise. But that’s not the end of it . . .

How Fat Burning Works After Exercise

Now here’s the thing most people don’t consider. Even allowing for that little calculation above on how much fat you use to fuel any activity, energy use and fat burning needs to be seen as a continuum over an extended period. Twenty-four hours is a nice round number. You need to consider what happens after you stop exercising as well as when you are exercising. Here’s one thing that happens when you exercise at higher intensities, say above 75% of maximum heart rate. As you use glucose for energy at higher intensities, your blood, liver  and muscle glucose (glycogen) falls somewhat — and of course this is tricky for endurance athletes like marathoners because glucose is a more empowering fuel up to 2 hours or so of racing than fat. But then, when you stop exercising and you have low blood and muscle glucose, insulin is low, the hormone glucagon is rising and so is hormone-sensitive lipase, a hormone that promotes the break-up of fat triglycerides to free fatty acids for fuel. Fat burning is prioritised, even though eventually you will replenish glucose stores with food and you will start to burn a little more glucose and less fat. It’s a cyclical process. You could even prolong this fat burning phase by eating low-glycemic index foods after your workout.

What You Need to Do to Burn Fat

The main point here is that you don’t have to worry about fat-burning zones and exercising at a mythical fat-burning intensity for weight loss. It all gets sorted out over a 24-hour period as the priority fuels fat and glucose wax and wane according to physical activity intensity and food intake. All you need to be concerned about for weight loss is energy expenditure, and, of course, creating an energy deficit, which means not pigging out after your workout and destroying all your hard work.

Exercise Won’t Make You Fat – And Pigs Still Can’t Fly

The poor guy. His name is John Cloud and he recently wrote an article called Why Exercise Won’t Make You Thin for TIME magazine. He, and the article, have taken a real battering from fitness industry stalwarts, including me over at my About.com gig: Exercise Won’t Help You Lose Weight – Wrong!

But you would expect the fitness industry to react to something like Cloud’s article; and I’ve no doubt he knew exactly what he was doing because it did get a disproportionate amount of publicity. His main premise is that exercise makes you hungry and therefore you tend to overeat; or that you reward yourself for those 20 reps you did with a one kilo set of dumbbells by eating a Big Mac, large Coke and large fries.

Exercise Alone Works, But You Have to Commit

Even so, the large scientific reviews of the subject of physical activity and weight loss agree that exercise alone is a difficult road to travel if you want to lose substantial weight. The trouble with large reviews are that they aggregate results. Someone with a strong will and who is determined to lose some weight really doesn’t want to know that most people fail at this — they want to know if it’s possible for them to succeed if they put their mind to it. Yes it is. Absolutely. Tom Venuto wrote a more elaborate rebuttal on his site: Why Time Magazine Owes the Fitness Industry a Big Fat Apology.

Look at it this way. If you burn off 8400 kjoules/week (2000  kcalories) — not an inordinate amount of exercise — that’s roughly around 400,000 kjoules/year (95,000 kcals), allowing for a few weeks off.  A kilo of body fat has around 32,300 kjoules (7700 kcals) (which allows for some water). You can do the numbers, but this works out to a deficit of 12 kilos or 27 pounds a year. Not a lot for some, but a good start for a strategy that relies on exercise alone. Even so, along the way, you need to ensure you don’t ‘pig out’ because you consider you’ve done enough exercise. Add modest calorie restriction, and getting to the fabled weight loss target of a half to one kilo a week is within reach.

The idea that certain people are ‘compensators’ or ’set-pointers’ who sub-consciously adjust their energy intake and expenditure to maintain any given weight just doesn’t hold up for me. A few people with such a genetic or psychological profile may exist, but I suspect – and there are studies to show this – that people who say they exercise and diet and still can’t lose weight actually eat much more that they admit or show in food records.

Exercise and Moderate Calorie Restriction is Best

In any case, the ideal weight loss strategy is exercise combined with modest calorie restriction. That way, you lose weight and get to keep that muscle and bone that’s so important to overall health as well. The problem with diet-only strategies, especially very-low-calorie diets, is that it’s very easy to lose muscle and bone, and in addition, difficult to maintain nutrient density. Increasing physical activity allows a better diet and helps create that energy deficit that will give you the weight loss.

However, all’s not lost with the Cloud article because it has highlighted a few salient facts about food and physical activity that we should all be aware of. The first is that one hour of walking at fast pace uses only around 1700 kjoules (400 kcalories), while a large, sweet muffin and flat-white coffee and sugar will see you take in about the same amount of energy. Don’t do it unless you’ve done some real work, like an hour of jogging at around 3300 kjoules  (800 kcals). Even then, you need to build that food energy intake into your daily calorie allowance, and not make it an extra.

The other physical activity strategy that works is increasing non-exercise activity called NEAT. Non-exercise activity is the movement you do when you’re not doing organised exercise. The differences in energy use between NEAT maximisers and NEAT minimisers can be up to 1000 kcalories a day, and even just standing for two hours rather than sitting for two hours can use several hundred kcalories extra a day. It is an important strategy in weight loss and should be taken into account.

Summing up, there is nothing new in the TIME article, but it should warn enthusiastic weight watchers that exercise does not give you an lifetime ticket to the smorgasbord. You still have to grind, grimace, deny and denounce. There’s no secret to weight loss and there never was. You do it or you don’t.

Acid and Alkaline Foods – What Are They?

We all know that citrus fruits and pineapple are acid foods: right? Coffee and tea are acid forming: right?

Are Antioxidants Finished as Dietary Supplements?

Twenty years ago, antioxidant supplements ruled. The famous, now infamous, supplement combination of vitamins A, C and E, was supposed to be a miracle supplement combo that would fight everything from heart disease to cancer. Famous cardiologists started to take vitamin E — and say so — and the whole ACE thing boosted the reputation and sales of supplements the world over.

Vitamin A and beta-carotene

Then things started to go seriously wrong. In 1996, the Beta-Carotene and Retinol Efficacy Trial (CARET) reported on a test of the combination of 30 mg beta-carotene and 25,000 IU retinyl palmitate (vitamin A) taken daily against placebo in 18314 men and women at high risk of developing lung cancer. The CARET intervention was stopped 21 months early because of clear evidence of no benefit, and substantial evidence of possible harm: there was 28% more lung cancers and 17% more deaths in the group that received the beta carotene and vitamin A. These results were similar to those produced in a trial of beta carotene in smokers in Finland.

Strangely, the trial had been prompted by the observation that increased consumption of carotenes (orange to purple colours) in fruit and vegetables might provide protection against lung cancer. This observation seems to hold to this day for food sources of beta carotene — but not for supplements.

Vitamin E

Well, what about vitamin E then? Surely that has some benefit as a supplement? Probably not; in fact, vitamins E, A and beta-carotene supplements may increase mortality. The latest Cochrane review (Bjelakovic) of ACE supplements said this:

“We found no evidence to support antioxidant supplements for primary or secondary prevention. Vitamin A, beta-carotene, and vitamin E may increase mortality. Future randomised trials could evaluate the potential effects of vitamin C and selenium for primary and secondary prevention. Such trials should be closely monitored for potential harmful effects. Antioxidant supplements need to be considered medicinal products and should undergo sufficient evaluation before marketing.”

(Cochrane reviews provide systematic evaluation of the evidence for various biomedical interventions. See http://www.cochrane.org/)

Vitamin C

Vitamin C supplementation seems not to do serious harm but provides little benefit either for most end points, including cancer, heart disease and immunity. Even the early promise of ACE supplements for the prevention of age-related macular degeneration of the eyes has not been confirmed; and in the light of potential harm from E, A and B-C, this course is not recommended, even though a high dietary intake of whole plant foods may be beneficial.

There may still be health niches where vitamin C supplementation is useful — in smokers with poor dietary intake and in low-dose supplements and multivitamins for example — but the good old days of vitamin C as a miracle vitamin is long gone. High and megadoses >200 milligrams/day may even be limiting for athletes and regular exercisers by interfering with energy systems and oxidative metabolism – but that’s another story.

Selenium

Selenium, not so long ago, was the new kid on the block with promise of prevention of prostate cancer, cancer in general, and heart disease. But now, it seems that the infamous J curve could be at work again. In sufficient amounts, selenium might do all of these things or at least not be toxic, but at higher supplement doses, perhaps even under the upper limit of safety in the recommended dietary intakes (400 mcg/day), selenium might cause type 2 diabetes (Bleys) in long-term consumers. This data has been somewhat of a shock to researchers and will surely be followed up for confirmation.

After early promise, recent trials of selenium supplements have not shown that selenium supplements reduce prostate cancer risk either.

While it’s obviously still important to get the RDI for selenium (15 to 70 mcg/day infants to adults), supplementation with higher doses does not seem wise.

B vitamins – folate

While not strictly an antioxidant, folate supplementation advice for heart disease and cancer prevention reached a crescendo in the 1990s. Another magic bullet it seemed. Folate’s apparent long-term success in preventing neural tube defects in childbirth added to its reputation as an important vitamin in preventive health.

In a new approach, folate supplementation was supposed to reduce blood levels of the protein homocysteine, high levels of which were thought to contribute to heart disease risk. Reduced heart disease risk has not been borne out in supplement trials, and homocysteine as a risk factor in cardiovascular disease has turned out to be something of a dud (apparently more a marker rather than a cause) — and so has supplementary folate as a useful tool in lowering heart disease risk.

Further, folate works to prevent birth defects by protecting cell division and differentiation. But what if certain cells — colon, prostate, breast — are cancerous or pre-cancerous? Could high folate intakes actually promote cancer by protecting the aberrant cell division? This is the question being considered by cancer researchers. It is not proven, but some are cautious. The evidence for protection or causation with folate, especially for colon and breast cancer, seems mixed. High doses of folate can also mask vitamin B12 deficiency.

Summing up

While various trials will continue to test the value of dietary antioxidant supplements in preventive health, the writing is surely on the wall for their demise for many of the traditional uses for which they acquired reputation — cancer and heart disease. This does not mean that diets high in antioxidant status from plant food consumption may also be harmful. I’ve not seen any evidence that that is true, or even defensible, and most evidence suggests the reverse is true and diets high in natural plant foods are protective.

- Omenn GS, Goodman GE, Thornquist MD, et al.  Risk factors for lung cancer and for intervention effects in CARET, the Beta-Carotene and Retinol Efficacy Trial.  J Natl Cancer Inst. 1996 Nov 6;88(21):1550-9.
- Lin J, Cook NR, Albert C et al.  Vitamins C and E and beta carotene supplementation and cancer risk: a randomized controlled trial.  J Natl Cancer Inst. 2009 Jan 7;101(1):14-23.
- Bjelakovic G, Nikolova D, Gluud LL, et al. Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD007176.
- Evans JR, Henshaw K. Antioxidant vitamin and mineral supplements for preventing age-related macular degeneration. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD000253.
- Sesso HD, Buring JE, Christen WG, et al. Vitamins E and C in the prevention of cardiovascular disease in men: the Physicians’ Health Study II randomized controlled trial. JAMA. 2008 Nov 12;300(18):2123-33.
- Gaziano JM, Glynn RJ, Christen WG, et al. Vitamins E and C in the prevention of prostate and total cancer in men: the Physicians’ Health Study II randomized controlled trial. JAMA. 2009 Jan 7;301(1):52-62.
- Lee IM, Cook NR, Gaziano JM, Gordon D et al. Vitamin E in the primary prevention of cardiovascular disease and cancer: the Women’s Health Study: a randomized controlled trial. JAMA. 2005 Jul 6;294(1):56-65.
- Sauer J, Mason JB, Choi SW et al. Too much folate: a risk factor for cancer and cardiovascular disease? Curr Opin Clin Nutr Metab Care. 2009 Jan;12(1):30-6.
- Bleys J, Navas-Acien A, Guallar E. Selenium and diabetes: more bad news for supplements. Ann Intern Med. 2007 Aug 21;147(4):271-2.
- Marcus J, Sarnak MJ, Menon V et al. Homocysteine lowering and cardiovascular disease risk: lost in translation. Can J Cardiol. 2007 Jul;23(9):707-10.
- Lonn E, Yusuf S, Arnold MJ et al. Heart Outcomes Prevention Evaluation (HOPE) 2 Investigators. Homocysteine lowering with folic acid and B vitamins in vascular disease. N Engl J Med. 2006 Apr 13;354(15):1567-77.

The Top 6 Lifestyle Tips to Prevent Heart Disease

If you read about healthy lifestyles, fitness and health regularly, some of these tips may seem like old territory — but wait — you may not know some of the finer details that I’ll share here.

1. Eat Less Animal Fats and Cholesterol and More Unsaturated Fats and Plant Foods

There’s no doubt that diets high in animal fats, saturated fat and cholesterol and trans fats, and low in unsaturated fats and plant foods cause heart disease. But what about plant foods high in saturated fat but no cholesterol? Saturated fats are found in large amounts in palm oil and coconut oil and some of these saturated fats also block cholesterol receptors that help keep cholesterol in the blood under control. However, heart-healthy foods like nuts, olive oil and avocado also have saturated fats in percentages up to around 15%. So what’s the difference?

Apart from the absolute amount of saturated fat in each, here’s the thing: nuts, olives and avocados and their fats also have high amounts of polyunsaturated and, or, monounsaturated fats and fibre, which likely offset or reverse any damaging effects of  their saturated fats. The overall effect is to lower cholesterol. Palm kernel oil contains over 80% saturated fat and coconut oil over 90% saturated fat and are mostly eaten as oils and not as whole foods.

In addition, there is evidence that a synergy exists between consuming saturated fat and dietary cholesterol in a regular diet. The bacon and eggs fried in butter or palm oil is not a good combo.

Regarding animal fats, it should be pointed out that oily fish like sardines have plenty of polyunsaturated omega-3 fats that are strongly recommended in heart disease prevention even though in this context  they are “animal fats.” Also, meats contain some monounsaturated fats and omega-3 fats, especially if grown free-range or grass-fed organic. Naturally lean meats are preferred. The fatty meats are also more likely to contain toxic contaminants like dioxins, PCBs and chlorinated organic pesticides, which are stored in fatty tissue and which some studies show increase cardiovascular risk.

Heart disease risk is further complicated by the fact that some people are cholesterol responders and in these people, blood cholesterol increases in response to cholesterol (and saturated fat) in the diet as a result of genetic susceptibility. And you can’t tell if you’re one of them unless you monitor your diet and cholesterol numbers. In others, regular consumption of cholesterol foods does not raise cholesterol appreciably. However, diabetics seem to be particularly adversely affected by dietary cholesterol — especially egg consumption – and second, if you already have high cholesterol numbers, lowering dietary cholesterol may reduce your blood cholesterol. There’s a difference between steady state consumption and the effect of reducing consumption — even in non-responders.

Overall, that’s why the American Heart Association still recommends low-cholesterol diets of no more than 300 milligrams/day for healthy people and less than 200 milligrams/day for people with existing heart disease or risk, and a saturated fat intake of less than 7%.

2. Consume Less Added Sugar

Sugar is a concentrated form of food energy, so naturally if you’re trying to maintain or lose weight to improve your heart health it’s a good idea to limit your consumption of sugars — cane, beet or corn syrup, or honey for that matter — it’s all “sugar.”

Okay, so sugar can be fattening but at least it’s not saturated fat or cholesterol . . . but wait, are you sure? When you eat too much sugar, especially the fructose part of it, the liver turns fructose into . . . yes, you guessed it, a saturated fat called palmitic acid – one of the worst ones for raising blood cholesterol. Fruit is not going to be a problem because the fructose is in smaller quantities and it has the fibre to slow down it’s digestion and to prevent any conversion to fat. This is called lipogenesis. An apple has about 5 grams of fructose and a can of soft drink about 25 grams. Drink more than a few soft drinks a week and you could be well on the way to the fat farm plus a higher cholesterol reading.

I always like to point out that fit, athletic people who do a lot of hard training have more choice when it comes to consuming added sugars, in fact sugars can be a valuable tool in meeting energy requirements and generally the fructose does not get turned into fat but is converted to valuable glucose for energy.

3. Consume Fewer Refined Carbohydrates Unless You Exercise a Lot

 The story with starches like white bread, white rice and cakes and pastries — apart from the hidden fat and salt in the refined and processed foods — is a little different. Starches end up as glucose, which is not as easily converted to fat because it can be stored in the body in liver and muscle (and fat cells) for future use. Again, athletes and heavy exercisers of normal weight have a little more choice when it comes to refined carbs. The quickly assimilated white bread roll and sports drink at the end of a tough training session could be more help than hindrance.

If you don’t exercise, or if you’re unfit and overweight, starchy  carbohydrates are best eaten with plenty of fibre in whole food form if possible. This will slow down digestion and provide better blood sugar and perhaps appetite control. Use the glycemic index (GI) if you like, but I’m not a big fan of the GI. In my view you’re better off aiming for a high-fibre diet up around the 0.5 grams fibre per kilogram of body weight. That means a lot of plant food in the diet — nuts, beans, seeds, fruit and veges and whole grains.

4. If You Drink Alcohol, Keep It Moderate

It’s not yet clear whether the reasonably certain heart benefits of moderate alcohol consumption are more pronounced with red wine than for other alcoholic drinks. The research data are a little mixed from what I can make of it. Even so, theoretically the red and purple polyphenols in red wine and perhaps grape juice, including resveratrol, may have additional benefits. Overall though, there seems little doubt from the accumulated research that moderate alcohol consumption lowers cardiovascular risk compared with abstinence. That’s in the range to two drinks a day for men and one for women.

It gets a little tricky because alcohol (ethanol) is toxic for the heart and cardiovascular system at higher doses, resulting in increases in blood pressure and even cardiomyopathy at pathologic rates of consumption, along with a wide range of other adverse effects at excessive consumption levels. In addition,  ethanol is also a reasonably strong carcinogen. Breast cancer risk in women increases from about one drink a day and trends upward. Ethanol is a known cause of cancers of the mouth, throat, oesophagus, bowel (colon and rectum), liver and female breast. Alcohol is a potent toxin no doubt, but the dose  makes the poison.

If you don’t drink, it’s difficult for anyone to tell you that you should — including me — and your doctor probably won’t.

5. Do a Combination of Aerobic Exercise and Weights

Aerobic exercise or cardio is a must for building cardiovascular fitness and strength. It builds heart and lung capacity for oxygen processing and also increases capillary blood supply to the muscles and probably even collateral blood supply in the heart muscle to provide support for the coronary arteries plus additional beneficial changes to artery and heart function.

Yet cardio like walking, running or swimming can be a little unbalanced, even though the benefits are undisputed. By adding resistance or strength training you train the whole body and consequently develop regional fitness as well in a way that running or swimming cannot. For example,  by building muscle and maintaining muscle as you age, you provide additional storage sites for glucose disposal. Muscle loss and higher blood glucose readings need not be an inevitable consequence of ageing. High blood glucose levels are a risk factor for diabetes and heart disease. Weight training also improves bones, balance, flexibility and strength. What’s not to like!

6. Don’t Smoke and Maintain Normal Weight

No list would be complete without these two somewhat obvious risk factors. Get there any way you can.

In total, that’s a relatively uncomplicated list. From a lifestyle perspective, you don’t have to attend to much more than these six measures to keep your heart in good nick — except you must get regular checkups because genetics and family history play a large part in your heart disease risk.

A Low-Fat Mediterranean Diet – Is It Possible?

This may seem like a contradiction in terms for anyone who has been used to the propaganda that the traditional dietitians’ low-fat diet and the traditional Mediterranean diet are poles apart. Frankly, it’s bunkum. In fact, the differences between the early Mediterranean diets of Crete and similar regions, and a well-constructed low-fat diet are not much at all.

Here’s what it all boils down to. Take a look at the Oldways diet pyramid and recommendations. The people at Oldways have been studying and promoting Mediterranean diets for 20 years. They note that the Mediterranean diet was not highly specific, but a variable eating pattern within which a range of consistent food consumption and lifestyle behaviours were evident. Here’s what they list:

1. An abundance of food from plant sources, including fruits and vegetables, potatoes, breads and grains, beans, nuts, and seeds.
2. Emphasis on a variety of minimally processed and, wherever possible, seasonally fresh and locally grown foods (which often maximizes the health-promoting micronutrient and antioxidant content of these foods).
3. Olive oil as the principal fat, replacing other fats and oils (including butter and margarine).
4. Total fat ranging from less than 25 percent to over 35 percent of energy, with saturated fat no more than 7 to 8 percent of energy (calories).
5. Daily consumption of low to moderate amounts of cheese and yogurt (low-fat and non-fat versions may be preferable).
6. Weekly consumption of low to moderate amounts of fish and poultry (recent research suggests that fish be somewhat favored over poultry); from zero to four eggs per week (including those used in cooking and baking).
7. Fresh fruit as the typical daily dessert; sweets with a significant amount of sugar (often as honey) and saturated fat consumed not more than a few times per week.
8. Red meat a few times per month (recent research suggests that if red meat is eaten, its consumption should be limited to a maximum of 12 to 16 ounces [340 to 450 grams] per month; where the flavor is acceptable, lean versions may be preferable).
9. Regular physical activity at a level which promotes a healthy weight, fitness and well-being.
10. Moderate consumption of wine, normally with meals; about one to two glasses per day for men and one glass per day for women (from a contemporary public health perspective, wine should be considered optional and avoided when consumption would put the individual or others at risk.)

I don’t necessarily agree with some minor points in this list, but note item number 4. This suggests a range of total fat consumption —  from less than 25% to 35%. The low-fat diets of the American Heart Association (AHA), traditionally regarded as the devil itself by the low-carbohydrate crowd, are in the range 25% to 30% — not much difference.

At number 8, consumption of red meat is very limited — by much more than most people would assume in a Mediterranean diet. So, let’s not pussyfoot around with this: the real Mediterranean diet is quite a restrictive diet for those who are used to eating large amounts of red meat. The idea that you can  splash olive oil on everything, eat some walnuts, drink red wine with the lamb shanks and baklava every night and go to Corfu in 1965 in your dreams is exactly that. Although I would suggest that slightly more red meat in the diet would not necessarily be unhealthy. (Limiting red meat in the diet has received much impetus in recent years from studies showing increased risks of bowel cancer in individuals who eat diets high in red meat.)

Quality Fats, Protein and Carbohydrate Is the Key

The big mistake the AHA and associated nutritionists and dietitians made with early low-fat diet recommendations was that they made little attempt to recommend quality macronutrients — fat, protein and carbohydrates.  Keep saturated fat very low (poly and monounsaturated fats are best); eat a high-fibre diet with nuts and seeds;  concentrate protein on fish, chicken, low-fat dairy, beans and pulses; choose wholegrain cereals and bread; and keep added sugars and refined carbohydrates to a minimum. We’ve known this was a healthy diet for 40 years. They mucked it up. People gorged themselves fat on low-fat cookies, soft drinks and junk food. How stupid was that!

I suspect it’s not the red wine or the olive oil but the abundance of whole, fibrous, natural plant foods and a diet low in animal fats and cholesterol that works in Mediterranean diet studies to reduce heart disease — and probably cancer. Substituting canola oil or even soy or peanut oil for olive oil would probably make little difference. In any case I’d rather keep added oils to a minimum and get healthy fats from whole foods like nuts, seeds, avocados, peanuts and beans.

A low-fat diet of 25% to 30% of mostly good fats within the above eating pattern IS the low-fat Mediterranean diet.

Regular Exercise Rules

Number 9 is a recommendation for regular physical activity. It’s not that the early practitioners of this Mediterranean eating pattern put on their jogging shoes or headed off down to the gym every day to work out. No, they were too busy doing hard manual labour much of the day in the fields and gardens or out on the fishing boats. Try working out how much extra energy you would use working in a job like farming/gardening every day compared to sitting in an office. Don’t worry I’ve done it for you: six hours at walking pace is about 1200 kcalories. Many would have worked much harder and longer than that. What does your regular gym session or run use? Average about 400 to 600 kcalories for 45 minutes.

The thing is, if you work or play hard enough, you can get away with eating and drinking a few refined carbohydrates and sugars. In fact, you may need  them to fuel your work or play. A nice sourdough white bread is a real treat. Honey or even modest amounts of sugar in fruits, juices and desserts is not going to be an issue for those who workout or work hard. Physical activity really is an essential part of any diet pyramid these days. And it should not be an add-on but an integrated component that possibly affects the macronutrient composition of the diet. Try telling a marathoner that he can only eat a 35% carbohydrate diet! Or a hand cane cutter or woodchopper.

The Diet Wars Are Over

Yes, they are, as that article says. Call it Mediterranean, low-fat high-fibre, semi-vegetarian or whatever you like. The principles are pretty much laid out now. All you need  is the will to do it. And the thing is, it’s probably the easiest healthy diet to implement compared to the stringency of low-carb, very low fat and all the other extreme ideas. Go to it.

My Top 3 Internet Fat Loss and Fitness Gurus

I get to read a lot of articles from many different internet trainers, nutritionists and health and fitness experts. Sometimes it’s just curiosity and sometimes I really learn from what they have to say.

Although I mostly rely on my own research of the scientific literature for assessing the worth and veracity of any particular aspect of the preventive health sciences, expert writers and commentators can help by providing analysis, exploration and summary of what’s reasonably known about any particular subject;  from fat loss to muscle building and the prevention of the big three preventable diseases — cancer, heart disease and diabetes.

 As far as fitness, fat loss and nutrition are concerned, but not necessarily preventive health in its wider aspects, here are three guys I enjoy reading. That’s not to say there are not others of similar worth, especially academic and institutional professionals that specialise, but these guys have a good grasp of nutrition and fitness training combined with practical experience – and they also know how to convey a message with lucid communication. They all have their strengths and I might even disagree with a minor point here or there, but read up on their blogs and free articles and you will learn a lot about weight loss, fitness training and general nutrition for the masses — pretty much without any loony stuff or weird approaches — which is more than can be said for some other sites.

• Christian Finn’s Facts About Fitness
• Tom Venuto
• Lyle McDonald’s Body Recomposition

Each of them has something to sell but none are too pushy. And by the way, I don’t do commissions or affiliate stuff with these people at all. By all means buy their products, but they all have plenty of free content to keep you going for some time.

The 7 Mega Principles of Diet and Exercise for Fat Loss

Yes, I am somewhat proud of the fact that if you do a Google search (at the main google.com site), an article of mine still comes up number 1 for the term fat burning. It’s an article I wrote for About.com Weight Training over 12 months ago. I am surprised at this because Google records about 3.1 million records for the search term ’fat burning’. And when you see all the goony, loony web sites and weight loss schemes and supplements and silly diets and downright ripoffs that plague the internet, it does seem unlikely that a truthful and accurate article still has a chance of getting to the top. Three cheers for Google.

In any case,  for Christmas I’ll do the KISS thing and “keep it simple, stupid” by summarising the no-fail approach to weight loss that emphasizes fat loss and muscle maintenance. If it fails for you, then you are either eating too much, moving too little or have a genuine pathology or genetic disorder — and mostly this is rare as a cause of obesity.

7 Rules to Rule Them All

1. Don’t sweat the small stuff. The number 1 rule is not to get hung up on the trivia. This is the 90/10 rule or whatever you want to call it. The idea is that you must concentrate on putting most effort into doing the things that bring you most return and success. It’s okay to  follow up on the small stuff after you get the big picture correct. Don’t get distracted by “insider secrets” or any of that web marketing hype. There are no insider secrets to achieving and maintaining normal weight. But that doesn’t mean there are not serious challenges.
2. It’s the calories stupid! Even though I saw Tom Venuto use this phrase recently, I first used it in 2001 in a book I wrote called The Organic Factor. Even so, I’m sure quite a few people  have come up with this independently, it’s so very obvious. This is one of the pieces of “big stuff” that I refer to in the rule above. You need to get into negative energy balance territory (but not too negative) to lose weight and that means eating less and exercising more. And the best way to cut calories? Limit animal fats, added fats, added sugars, alcohol, and reduce  excessive portion sizes.
3. Adopt a lifestyle. Most diets will work for a short while – low-carb, low-fat, meal replacement shakes, you name it. If you take in less than you expend in energy, you will lose weight. However, you need to find an eating and exercise pattern that suits you, that works, and that you can adopt more or less every day of your life.
4. Do regular aerobic Exercise. Aerobic exercise is walking, running, treadmill, cycling, swimming, class aerobics and  rowing. You need to put some effort in so that you puff and sweat to some extent. Do this at least 5 times a week, for at least 30-40 minutes, even if it’s walking fast around the block.
5. Do regular weight training. Get to a gym or buy some dumbbells and a bench for home and do at least 2 sessions of weight training each week. It helps maintain muscle and bone while you lose fat and builds strength, flexibility and mobility for the future.
6. Move more at home and work. Under-rated and misunderstood, this is the science of NEAT or “non-exercise activity thermogenesis.” Moving more at home or work builds a feedback system that upregulates your metabolism. Get a pedometer and try to rack up 5,000 steps each day. It can be gardening, housework, playing with kids, lunchtime walks at work, stair walking, anything in addition to programmed exercise. Upper-body movement counts as well.
7. Get a brain plan. Tackle weight loss as a personal project. Keep a diary, set goals, review your progress each week, do lots of internal head talk, adjust your approach when necessary, be patient, stick to a lifestyle you can tolerate, and get encouragement from friends or a group.

That’s the nub of it. No secrets, no surprises. Good luck.

Dioxins in Food and Water Could Cause Diabetes

I’ve been aware of an increasing number of recent studies that seem to show that the chemical pollutants called POPs – dioxins and similar compounds – could be at least partly responsible for the current epidemic of type 2 diabetes. Now it’s not conclusive, but some aspects of these investigations are certainly interesting. Like the fact that when controlled for dioxin content of tissue, even obese people were at no higher risk of type 2 diabetes if their dioxin levels were low. This could be a chance occurrence, or other factors could cause this to occur, but overall there are some compelling aspects to this research.

Here is what one author had to say:

“The strong associations seen in quite different studies suggest the possibility that exposure to POPs could cause diabetes. One striking observation is that obese persons that do not have elevated POPs are not at elevated risk of diabetes, suggesting that the POPs rather than the obesity per se is responsible for the association. ” [Rev Environ Health. 2008 Jan-Mar;23(1):59-74. Review.]

POPs are “persistent organic pollutants.” This class of pollutants includes dioxins, PCBs, DDT, DDE and many chlorinated organic pesticides. They accumulate in your body and in the fat of the animals we eat.

History of Dioxins and Diabetes

Some years ago I worked in occupational and environmental health and safety, advising on toxic chemicals and health. As well as working to establish the first chemical list for Australia’s National Pollutant Inventory, I also helped out the local Vietnam vets with their Agent Orange herbicide case. Much of the finer detail of the toxic risk assessments involved dioxins — exotic chemical contaminants that result from chemical manufacture and combustion. Levels of dioxin were very high in Agent Orange. There are over 200 varieties of dioxins, furans and polychlorinated biphenyls (PCBs) – chemicals with somewhat similar structure and varying toxicities to humans. Sometimes the toxicity of these dioxin-like chemicals are referred to collectively with ‘toxic equivalents’ or TEQ.

Studies of manufacturing workers exposed to dioxins and similar compounds had already revealed a higher incidence of diabetes, and animal tests had confirmed this possibility to some degree.

The early emphasis of dioxin toxicity research was on birth defects and cancer. However, it took some time for the US Veterans Affairs Department to acknowledge limited evidence in support of a connection of Agent Orange exposure with type 2 diabetes, to the extent that disability pensions are now paid on this basis.

Other pieces of research seem to fit the puzzle. It seems that endocrine disrupting chemicals in general, especially ones that persist in the environment, are associated with diabetes. And a most recent research study suggests that the much-publicized plastics residue bisphenol-A is also possibly involved.

POPs and Diabetes: What You Can Do

While these contaminants are everywhere – from the Antarctic to the purest looking lake water – they also contaminate food by accumulating in animal fats – and which we consume in meat, chicken, dairy and fish products and fats.

If you want to reduce  your intake, you really need to either find wild or organic and lean products from pristine places, or reduce your intake of animal foods, especially fat, or perhaps do a combination of both. This issue is also another reason why high-meat and fat diets like Atkins low-carb can be a recipe for disaster. And as for those so-called diet gurus who say we should eat more saturated fat . . . here’s a very good reason not to.

- Rignell-Hydbom A, Rylander L, Hagmar L. Exposure to persistent organochlorine pollutants and type 2 diabetes mellitus. Hum Exp Toxicol. 2007 May;26(5):447-52.
- Rylander L, Rignell-Hydbom A, Hagmar L. A cross-sectional study of the association between persistent organochlorine pollutants and diabetes. Environ Health. 2005 Nov 29;4:28.
- Ropero AB, Alonso-Magdalena P, García-García E, Ripoll C, Fuentes E, Nadal A. Bisphenol-A disruption of the endocrine pancreas and blood glucose homeostasis. Int J Androl. 2008 Apr;31(2):194-200. Epub 2007 Oct 31. Review.
- Wang SL, Tsai PC, Yang CY, Leon Guo Y. Increased risk of diabetes and polychlorinated biphenyls and dioxins: a 24-year follow-up study of the Yucheng cohort. Diabetes Care. 2008 Aug;31(8):1574-9. 2008 May 16.
- Michalek JE, Pavuk M.  Diabetes and cancer in veterans of Operation Ranch Hand after adjustment for calendar period, days of spraying, and time spent in Southeast Asia. J Occup Environ Med. 2008 Mar;50(3):330-40.

Recommended Dietary Intakes – Do You Need Supplements?

Here’s a quick definition of RDIs — or RDAs as they are called in some countries.

Recommended Dietary Intakes (RDIs) (or allowances, RDA) are the levels of intake of essential nutrients considered, in the judgment of national health and nutrition authorities on the basis of available scientific knowledge, to be adequate to meet the known nutritional needs of practically all healthy people.

RDIs are given for vitamins, minerals, protein and some fats, and for different life stages, and pregnancy, and are usually daily quantities. They represent the needs for sustenance and avoiding deficiency disease.  See examples for Australia and the US.

Now that sounds simple enough, but unfortunately the RDIs and other measures of nutritional adequacy are widely misunderstood. That definition above does not imply that the RDIs are the “minimum” quantity required to stave off malnutrition or starvation.

In calculating RDIs, a safety margin is used so that biological differences from person to person can be accommodated. It may be that some individuals have less of a margin than others, but overall, the RDIs and RDAs are designed to exceed the minimum requirements for just about everyone, significantly. The idea that they are minimum values finds great comfort in the vitamin and mineral supplement industry of course.

Optimising Diets for Chronic Disease Risk

 Even so, there is recognition that higher intakes may help prevent some chronic diseases. To be fair, this is likely to be where misunderstandings occur. For example, the RDI for vitamin C is 45 milligrams/day, yet the suggested target for reducing chronic disease risk is 220 milligrams/day — quite a difference. Folate is another example where the suggested dietary target or SDT is much higher than the RDI.

Other Standards in Nutrient Reference Values

Although terminology can differ from country to country, here is a full list of acronyms worth noting within the broad range of nutrient reference value (NRV) or dietary reference intake (DRI) standards as applicable in the US, Canada and Australia based on the Institute of Medicine proceedings.

• EAR (Estimated Average Requirement). A daily nutrient level estimated to meet the requirements of half the healthy individuals in a particular life stage and gender group.
• RDI (Recommended Dietary Intake). The average daily dietary intake level that is sufficient to meet the nutrient requirements of nearly all (97–98 per cent) healthy individuals in a particular life stage and gender group.
• AI (Adequate Intake – used when a recommended dietary intake cannot be determined). The average daily nutrient intake level based on observed or experimentally-determined approximations or estimates of nutrient intake by a group (or groups) of apparently healthy people that are assumed to be adequate.
• EER (Estimated Energy Requirement). The average dietary energy intake that is predicted to maintain energy balance in a healthy adult of defined age, gender, weight, height and level of physical activity, consistent with good health. In children and pregnant and lactating women, the EER is taken to include the needs associated with the deposition of tissues or the secretion of milk at rates consistent with good health.
• UL (Upper Level of Intake). The highest average daily nutrient intake level likely to pose no adverse health effects to almost all individuals in the general population. As intake increases above the UL, the potential risk of adverse effects increases.
• AMDR (Acceptable Macronutrient Distribution Range). An estimate of the range of intake for each macronutrient for individuals (expressed as per cent contribution to energy), which would allow for an adequate intake of all the other nutrients whilst maximising general health outcomes.
• SDT (Suggested Dietary Target). A daily average intake from food and beverages for certain nutrients that that may help to prevent chronic disease.

Dietary Supplements

Supplementation has a role to play, but it needs to be done with caution, restraint and knowledge. The bottom line is that there will be individuals and population groups that do not meet the RDIs for individual nutrients.

• This can result from poor nutrition practices or even special diets poorly implemented. Low-carbers could be short on fibre and vitamin E; vegans on zinc, iron and B12; and very low-fat dieters on long chain omega-3.
• Populations in nutrient poor regions might lack iodine and selenium; and certain cultural habits like full body clothing can result in inadequate vitamin D intake in the absence of food or supplement sources.
• Athletes and heavy exercisers may need a modest increase in some nutrients, but this is usually accounted for by increased calorie intake — as long as the extra food is nutrient dense for the most part.
• Older people absorb vitamin B12 less well and this may require supplementation. The ill or infirm who do not get adequate sun exposure may require vitamin D supplements.
• Pre- and during pregnancy, folate supplementation is a useful reassurance against neural tube abnormalities.

However, not only is it likely wasteful to take mega-doses of supplements, it may even be unsafe. The recent scientific examination of vitamin E and beta carotene in high supplement doses has not yielded promise and has suggested adverse effects. If you feel you need to take an individual supplement or a multi, first check out the excellent information at the Office of Dietary Supplements at the NIH. then try not to exceed the RDI by more than a few times for any individual nutrient, unless there are indications that it’s safe and effective to do so.

The Diet Wars Really Are Over

John Tierney over at TierneyLab recently had a bit to say about the New England Journal of Medicine study that compared an American Heart Association low-fat diet with Atkins and Mediterranean diets.

I’ve discussed the details and the implications in a longer page post called Diet Wars, but the upshot of this and many other bits and pieces of nutrition research from recent times pretty much suggests that we stop wasting time debating low-fat or low-carb or in between and get on with recommending a healthy eating pattern that spans a wider macronutrient range for fat, protein and carbohydrate.

Let’s get the faddists, fanatics and false prophets on the run.

How to Boost Immunity With Diet and Exercise

How many times have you seen an ad for some wonder ‘erb or other that’s supposed to boost the immune system. It’s echinacea today and some Chinese herb the next, as well as a vast array of products that the supplement industry claim “support the immune system” — whatever that means.

Diet and Immunity

I’m not suggesting that diet and nutrition don’t have an important role to play in maintaining a healthy immune system. Meeting the recommended intake of macronutrients, vitamins and minerals and fats, and consuming copious quantities of antioxidant nutrients as part of healthy eating is bound to promote good immune system function — as far as it goes. However, the evidence for consuming individual dietary components or special foods or supplements beyond the RDI (recommended dietary intake) is mostly speculative or at least inconclusive.

Exercise and Immunity

If you follow a healthy lifestyle approach with healthy eating and a program of physical activity, here are a few things to note about how the immune system responds to exercise:

• A regular, low to moderate intensity exercise habit is associated with a reduced incidence of infection compared with those who do very little exercise or physical activity.
• Heavy, and or prolonged exercise training can impair the immune system, possibly leading to susceptibility to infection, particularly in a period of up to 24 hours after a heavy training session or event.
• Exercising at high intensity for prolonged periods without food — 90 minutes and beyond for example — may make you especially vulnerable to infection as a result of immune system depression.
• Consuming carbohydrate at the rate of 30-60 grams an hour during intense and prolonged exercise can help to maintain immune system function. That’s 1-2 sports drinks and hour or equivalent. (One drink is probably adequate for most situations except for extreme conditions and intensity.)
• Meeting your daily requirements for micronutrients like zinc, iron, and B and C vitamins is essential. Although a multivitamin supplement may help, consuming mega quantities of vitamins and minerals may be counterproductive. See article on Vitamin C and training adaptation.
• A recent review confirmed the value of carbohydrate supplementation and a possible role for vitamin C (note caution above), but no other supplement showed up as useful for heavy exercisers.

It’s worth noting the value of carbohydrate to immunity in a balanced diet and exercise program. Low-carbohydrate intake with low blood glucose, plus the stresses of exercise, increases cortisol production to the point where the immune system is compromised. Low-carb, high-fat diets, especially saturated fat, are not appropriate if you have a robust exercise program. In addition, saturated fat has been shown to impair immune response. Low-carb is not where you want to be if you exercise a lot.

J Sports Sci. 2004 Jan;22(1):115-25. Exercise, nutrition and immune function. Gleeson M, Nieman DC, Pedersen BK.
JEur J Clin Nutr. 2007 Apr;61(4):443-60. Nutritional modulation of exercise-induced immunodepression in athletes: a systematic review and meta-analysis. Moreira A, Kekkonen RA, Delgado L, Fonseca J, Korpela R, Haahtela T.
Scand J Immunol. 2008 Jul;68(1):30 42. Differential effects of a saturated and a monounsaturated fatty acid on MHC class I antigen presentation. Shaikh SR, Mitchell D, Carroll E, Li M, Schneck J, Edidin M.

The Truth About Organic Food

I’ve been a keen gardener most of my life, following a strong family tradition. We’ve grown everything from flowers and ornamentals to fruit trees and vegetables — with varying measures of success. Organic growing in a home garden, and wherever feasible commercially, just seems like sensible environmental management to me . . . and it’s especially applicable to home gardening. I’ve also written about organic growing and been a member of a growers group for decades.

Organics may not be the only solution

Even so, I’m not an absolutist, and I am a pragmatist . . . I accept that there may be other farming and cultivation systems that could indeed be regarded as “sustainable and healthy” even though they may not pass organic certification. But that’s not my argument here. I’m going to look critically at the notion of why you should buy organic food and whether the advantages stack up — give or take a few generalisations.

Here are the usual reasons for supporting organic food production:

• It’s healthier because few, and low-toxic pesticides are used and residues on crops are not a problem
• It’s healthier because organic food is higher in dietary nutrients
• It’s more sustainable because soil is managed better without chemical fertilizers
• It’s safer and sustainable because beneficial organisms like bees and predatory organisms and wildlife are not poisoned by pesticides
• It’s safer because humans are not poisoned by pesticides as they use them.

Pesticide residues

Even allowing for cheating, it is clear from testing that organic food has fewer residues of detectable pesticides than non-organic food. The issue is whether the presence of residues in non-organic food is a health hazard. Clearly, in some cases it is. The cases of aldicarb pesticide poisoning from melons in California is a classic case. This was only detected because of the severe symptoms. Many other cases are likely in which the victim has less acute symptoms and the cause remains unidentified. And, the effect of long-term exposure to small quantities of residues is unknown, but could be significant.

Testing for safe food. With the world food supply increasingly traded across borders, ensuring “clean” food by monitoring it for contaminants has become increasingly difficult. Recent issues in food safety in relation to food products imported from China make this all too clear.

Organic food has more nutrients

This is the one the professional agriculture, health and nutrition communities have resisted so strongly for so many years. In essence, it is a complex issue. To measure this accurately, you really need to set up controlled growing conditions for a reasonable comparison, and even though quite a few early studies showed advantages for organics in some nutrients like vitamin C, iron, omega-3s and a few other minerals, the design was often somewhat amateurish — until the European Union Newcastle University study came along. Read the results here: “Organic produce better for you”.

Variability abounds. The authors caution that variations in qualities exist across the organic and non-organic spectrum. What this might mean for you, as a purchaser, is that a badly grown organic apple could very well be inferior to a well-grown non-organic apple. One might expect that across a continuum of organic produce, the nutrient value may be higher, but don’t expect that any one purchase will give you that guarantee.

Phytonutrients finally. Over the years of this organic nutrient debate, the one thing that has mostly been absent is an evaluation of the non-vitamin and mineral nutrients. These are the antioxidants, the polyphenolics, carotenes, sulphur compounds, the omega-3s and many more that are known to be health-giving principles in foods. Finally, this also seems to have been answered. In the Newcastle University study:

They found levels of antioxidants in milk from organic cattle were between 50% and 80% higher than normal milk.

This is not surprising, overall, because Alyson Mitchell, associate professor and food chemist at the University of California, Davis, found exactly the same thing in her work analysing tomatoes. Soluble fertilisers, especially nitrogen, and strong pesticides may inhibit the plant production of phenolic compounds. See Mitchell again for a discussion.

One would have to say that early professional bias against the idea of organics having higher overall nutrient values, in a dietary sense, seems to have been ill-founded and perhaps influenced by various vested interests. However, this should not suggest that eating organic foods, even with a premium supply of antioxidants, results in superior health outcomes: that is yet to be proven.

Organic growing is more sustainable

As a general rule this is probably true, and is likely to be more so for smallholdings rather than large commercial enterprises. The definition and evaluation of “sustainability” is variable, but one issue is the recycling of inputs to the system versus importing inputs like organic fertilizers from elsewhere. Sustainability is about being able to make systems last without degrading the system.

Nevertheless, several recent studies — University of Michigan, the USDA and the FAO and others, have found that organics actually outperform conventional agriculture in measures of soil sustainability and biological sustainability — and may even approach the production efficiency of non-organic farms in some cases.

Safer for wildlife and diversity

New Scientist reports: “Organic farming boosts diversity”.

Organic farming increases biodiversity at every level of the food chain – all the way from lowly bacteria to mammals. This is the conclusion of the largest review ever done of studies from around the world comparing organic and conventional agriculture.

Enough said about that one.

Occupational health and safety

This is the sleeper issue in organic production. It receives less attention than other aspects. The human health legacy of toxic pesticides in developing nations has been monumental. And even in the developed nations, the misuse and overuse of pesticides has resulted in substantial impacts on human health. The US Agricultural Health Study has reported on some such results.

Here is what esteemed toxicologists Levine and Doull said about pesticide poisoning worldwide in 1992:

Global estimates of acute pesticide morbidity and mortality. Levine RS, Doull J. Rev Environ Contam Toxicol. 1992;129:29-50.

Mathematical models have projected increasing numbers of pesticide poisoning throughout the world, rising from 500,000 cases/yr in 1972 to 25,000,000 cases/yr in a 1990 estimate.

Summing up

Organic food is more expensive; you have to decide if it’s worth it. In addition, the science of organics is a bit fuzzy at times. Some modern pesticides actually have lower toxicity than approved organic pesticides. The more popular and affordable organic food becomes, the more we will see mainstream food manufacturers taking advantage of it. No folks, the organic pop tart is not a health food. Overall, though, organics is a neat package of environmental health and safety practice. I support it strongly.

Low-Carb Diets Make You Dumber and Slower

Low-carb diets have had their share of weight loss success; and most of it can be attributed to dietary restriction of food choice. That’s how most restrictive diets work, from low-fat to low-carb and vegan: tell people they can’t eat something that’s clearly identifiable, and they will lose weight because choice is curtailed and they find it easier to eat fewer calories.

The trouble starts when they find they can’t maintain such a restrictive regimen — and then they get discouraged, guilty, and the relapse occurs.

But what if low-carb dieting helped you lose weight for the time being, but actually inhibited your personal performance in day-to-day living? Would you continue with it as a lifestyle choice?

What I’m about to discuss does not necessarily apply to moderately low-carb diets, but mostly to ketogenic diets, in which carbohydrate intake is usually less than 20 percent. Even so, there is a possibility that the effects apply across a continuum of low-carb eating from very low to low.

And those adverse effects? Low-carb makes you think slower and move slower.

Low Carb Makes You Dumber

In a study in 2007 in the American Journal of Clinical Nutrition, researchers compared the cognitive abilities of dieters on a low-carb, high-fat (LCHF) diet with another group of dieters on a high-carb, low-fat diet (HCLF) . Here is what they found:

However, the IT test score (a measure of the speed of visual information processing) was affected by diet composition. The results showed that participants consuming the LCHF had significantly less improvement in the minimum stimulus time required to make a correct response than did those consuming the HCLF diet . . . Our findings are consistent with those of an earlier study in obese women showing that performance of a complex, cognitively demanding task assessing mental flexibility was significantly worse after the consumption of a very-low-energy, low-carbohydrate, ketogenic diet than after the consumption of an isocaloric, nonketogenic diet with higher carbohydrate and lower fat content. Similarly, the treatment of young rats with a ketogenic LCHF diet for 1 month resulted in severe cognitive impairment, and a series of rat studies showed that the chronic ingestion of a high-fat diet, in particular a high-saturated-fat diet, can adversely affect cognitive performance.

Low Carb Makes You Slower

In a study in the Journal of the American Dietetic Association in 2007, a team of investigators measured the fatigue and perceived effort of one group of dieters on a ketogenic low-carb diet and another group on a diet with much higher quantities of carbohydrate. Here’s what they concluded:

These pilot data indicate that ketogenic, low-carbohydrate diets enhance fatigability and can reduce the desire to exercise in free-living individuals.

This is not surprising because athletes know that glucose (and phosphocreatine) supply energy at a rate that supports fast, high-powered activities, whereas fat and ketones can only supply energy at a rate biochemically rapid enough for mostly slower activities.

Evidence from the Paleolithic

Now, you might think that would be a good place to leave this discussion — the evidence is reasonably clear — but just for speculative fun, let’s take a look at our evolutionary pre-history and the diets of emerging Homo sapiens — modern humans — in the Paleolithic period of evolution.

About 800,000 years ago, primates moved out of Africa to the north and into Europe to colder climates. This early pre-human form was called Homo erectus, and this species probably evolved into Homo neanderthalis, the Neanderthals, while erectus lived on as a parallel species.

The curious thing is that a second migration of early humans north from Africa started about 50,000 years ago and spread throughout Europe and beyond. It seems that this smart new species, Homo sapiens or ‘intelligent human’, was much more intelligent than earlier species such as erectus and neanderthalis. As far as evolutionary science can establish, Homo sapiens swept all before it and replaced the Neanderthals and erectus with modern humans throughout the world. The other species were out-competed and did not survive.

Paleo Diets and the Evolution of Power and Intelligence

Enthusiasts of Paleo dieting like to contend that early humans were very healthy on a diet mostly of meat, vegetables and some fruit, but virtually no grains or tubers — that is, a low-carbohydrate diet. However, it’s pretty clear that early humans started to eat grains about 20,000 years ago, perhaps earlier, and, according to Richard Wrangham, Elizabeth Pennisi and others, probably ate tubers well before then. See Did Cooked Tubers Spur the Evolution of Big Brains?

Paleontologists have speculated as to why Homo sapiens so dominated the other species in Europe and beyond as they moved into their territory from 50,000 years ago.

Here’s where I speculate that the burgeoning consumption of carbohydrate foods in the form of tubers and grains in East Africa, the cradle of early humans, fed a growing brain that thrives on glucose. Glucose from carbohydrates supplied abundant energy substrate for the evolving brain to build those complex neural networks that we know provides the complex reasoning capabilities of modern humans.

Carbohydrate foods were abundant in the East African savannah. As Wrangham points out: “Today, there are 40,000 kilograms of tubers per square kilometer in Tanzania’s savanna woodlands.” The book The Lost Crops of Africa, documents the prolific grain resources in this region. It would be unlikely if the evolving Homo sapiens did not take advantage of these abundant food resources at some time.

The Neanderthals, by comparison, most likely had a more limited food supply, relying mostly on meat and some vegetables and fruits in season, and eggs but fewer carbohydrate resources, especially in the cold north.

I think it’s a fair bet that Homo sapiens, as they moved north out of Africa from 50,000 years ago, armed with complex brains fueled by rapidly accessible glucose from carbohydrate food resources, simply out-competed the slower moving and thinking Neanderthals and the remaining Homo erectus. Not only were modern humans smarter, they probably moved faster as well.

The thing is, we can still simulate the best qualities of the diets of our ancestors, which were most likely characterised by being low in saturated fat, high in plant foods and fibre, and with sufficient carbohydrate to keep us out of ketosis and to fuel the powerful movement and activity required for good health and fitness.

High carb. Simply smarter, faster.

American Journal of Clinical Nutrition, Vol. 86, No. 3, 580-587, 2007
J Am Diet Assoc. 2007 Oct;107(10):1792-6.

How the Cholesterol Skeptics Can Harm You

Do a search for ‘cholesterol and heart disease’ in Google and you will see that many of the results in the first few pages are from sites that dispute the current medical view that cholesterol is a major factor in causing heart disease.

Some of the advocates of this position are well known ‘alternative’, or at least fringe movements that have a particular dietary barrow to push. Many belong to the low-carb brigade, indigenous diets advocacy, Paleo nutritionists, and sadly, some bodybuilders and weight trainers and men’s health advocates. And, of course, it should be said that many reputable people within these movements do not accept the ‘cholesterol myth’ line.

Cholesterol is a factor in heart disease and these people are dangerously wrong. They rely on dumbing down a complex scientific issue to impress a gullible audience. I could write a long review of this issue, fully supported by references, but I won’t waste my time, or yours. Here are a few crucial points to consider.

It’s the Cholesterol, Stupid!

1. In the condition familial hypercholesterolemia (FH), individuals have naturally very high cholesterol levels as a result of a genetic abnormality. If undiagnosed, or without treatment, such people can die of heart attacks in childhood or in early adulthood depending on the severity of the condition. Brown and Goldstein won the Nobel Prize for their work on cholesterol, HF, and how cholesterol causes cardiovascular disease. The science of HF alone, should be enough to send the cholesterol skeptics packing — but still they persist.
2. Although I am no promoter of pharmaceutical company interests per se, there is little doubt that statin medications improve heart disease conditions and fatal outcomes in people with high cholesterol by a combination of lowering LDL cholesterol and probably raising HDL cholesterol. The evidence is just too overwhelming. In fact, in recent years, the cholesterol skeptics have subtly shifted their attacks from “cholesterol does not cause heart disease” to, “saturated fat does not cause heart disease”, which is a softer target for them considering the complexities of different chain length saturated fats and the interactions of mixed diets.
3. The skeptics like to juggle the medical literature to try to show that there is no valid evidence linking high cholesterol to heart disease. However, it’s not in dispute that heart disease is dramatically low in healthy populations with total cholesterol levels under 150 mg/dL or 3.9 mmol/L. Cardiovascular disease rises with increasing total cholesterol, and especially LDL cholesterol, in most populations.
4. Even so, some populations in some countries seem to defy this trend, and these are the people the skeptics concentrate on when delivering their message. The thing to remember is that heart disease is multifactorial — that is, cholesterol may only be one factor among several, even though it is a major factor. Some populations will, through genetics or lifestyle, defy the atherogenic effects of higher cholesterol to some extent. This seems to be the case with the ‘French paradox’, in which French populations have much lower heart disease than other country groups with similar cholesterol levels. That does not mean that cholesterol is not a major factor in heart disease for most populations.

Overall, considering the established science of familial hypercholesterolemia, and the evidence from statin drug trials, including regression of plaque with cholesterol lowering, the evidence is so overwhelming for a dominant role of blood cholesterol in heart disease, and the influence of poor nutrition in raising blood cholesterol, that one can only assume the cholesterol skeptics have another agenda. I don’t know what it is, but it doesn’t take too much thought to come up with a list of industrial food interests that might benefit from this hogwash. Believe them at your peril.

Exercise Really is Necessary to Maintain Weight

Recently I got into a discussion about whether exercise is really necessary in a weight loss program. The other guy was saying . . . ‘well, if you just cut calorie intake you’re going to lose weight . . . if you starve you lose weight; witness concentration camps and so on’. And of course, Gary Taubes has been stirring up the diet and exercise community with his irreverent, but flawed views.

It’s a trite argument isn’t it? If you don’t eat, or eat very little, inevitably you will lose weight, fat and muscle. We all know that; except that’s not what we’re really talking about today. If you’re overweight you need to find a pattern of living that allows you to maintain a normal weight and eat well enough so that you enjoy life without having to do “diets”.

What I recommend is moderate calorie restriction in conjunction with a substantial increase in physical activity. And I’m not alone. Increasingly the science supports this, as do many successful weight losers.

Calorie-restricted diets

The trouble with low-calorie diets by themselves is threefold:

1. You reset your metabolism — downward. This is diet-induced thermogenesis. The body senses a low-calorie environment and decides to reduce its basal energy expenditure. It’s a survival mechanism that’s evolved over thousands of years.
2. On low-calorie diets you lose not only muscle, but bone as well. Okay, when you stabilise your weight you may get some of this back, but it’s not ideal.
3. Without exercise, you don’t get all those other proven benefits like protection from heart disease and some cancers, improved bone density, mental health, and perhaps protection from dementias as well as a list of other benefits.

Proven as a practical approach

Professional physical activity guidelines have for several years recommended that one needs to exercise an hour a day for most days of the week to lose weight and to keep it off. This has recently been confirmed by a study of women published in the Archives of Internal Medicine

Not only that, but the US National Weight Control Registry – a program that keeps track of successful weight losers — found that most of their successful listers did just that: exercised for about an hour a day in addition to their day-to-day activities. It doesn’t have to be all high-intensity stuff, because many did a lot of walking.

Low energy density, high-nutrient foods

One way to trick the body into maintaining metabolism while you reduce calorie intake is to eat plenty of low energy density foods — along with the increase in exercise. That means fruit and vegetables, salads, soups, bowl foods, beans, lean meat and not too much fat, refined carbohydrates and sugars. This is a proven approach called Volumetrics, which originated with Barbara Rolls at Pennsylvania State University.

Giving the body plenty of fibre, water and bulk to deal with even though the calorie count is comparatively low, tends to keep that metabolism from dropping too much.

Exercise – the fourth macronutrient

Food pyramids increasingly include physical activity in their recommendations because the best evidence suggests that uncoupling physical activity from food consumption creates a body environment that is not ideal for weight loss and maintenance, or health. This also reflects an evolutionary state built over tens of thousands of years when early humans moved much more than we do today.

I understand that some people can’t do much exercise. The infirm, injured and invalid have additional challenges, but the effort may be just as important for many people in this situation.

Top 10 Antioxidants of All Time

Okay, I know that title is over the top, but it’s tongue-in-cheek as well. We hear so much about the value of antioxidants that I get a little unimpressed sometimes. But wait, this is the real deal. Everyone likes a list and the Nutrient Data Lab of the United States Department of Agriculture has released an updated ORAC list of the antioxidant power of plant foods.

Antioxidants rule, okay?

ORAC stands for ‘Oxygen Radical Absorbance Capacity’. Oxygen radicals or free radicals are reactive chemical particles created when an electron gets dislodged from a molecule leaving an unpaired electron. This makes the particle highly reactive. Oxygen radicals result from natural processes like digestion and metabolism but also from exposure to radiation and pollutants.

Antioxidants such as vitamin C, E and the mineral selenium are able to quench these free radicals and stop them from reacting with important molecules in the body like DNA and causing cancer and many other diseases. As well as antioxidant vitamins and minerals, a host of antioxidants exist as phytonutrients in plants. Polyphenols in red grapes and wine and cacao beans (chocolate) are well-publicised examples.

The ORAC database lists the scores for individual fruits, nuts, cereals, beans, herbs and vegetables. Here are my favourites. The higher the score, the greater the antioxidant capacity. The measures are in micromoles per 100 grams.

1. Herbs and spices. As a group these are powerful antioxidants. Values for tumeric, 159,000 and oregano 200,000 are good examples. Not all herbs and spices are as high as this, but when you see some other food scores you will understand how powerful these plants are in antioxidant value. On the other hand, we only consume them in comparatively small quantities compared to a whole apple for example.

2. Apples, raw. Both granny smith and red delicious are at the top of the apples scores at around 4000 units. You need to leave the skin on for best effect.

3. Red wine has excellent capacity, as we often read, at 5000 units compared to white wine at 400 per 100 grams. Raw grapes and grape juice are in the range of 800 to 1000, so you can see that processing the skins of red grapes in wine production seems to improve the antioxidant capacity substantially.

4. Artichokes (globe) cooked. Up around the 9000 units per 100 grams, so quite a powerful punch in this vegetable. I eat the canned varieties, lightly fried in olive oil, on vegetarian pizzas and in curries. Who would have thought it?

5. Chocolate, unsweetened, baking. Get your chocky fix and also around 50,000 units/100 grams. That’s a powerful dose, and if you keep the sugar and saturated fat low, quite a healthy dose as well. Cocoa powder is around 80,000/100 grams. A teaspoon of that is only a few grams.

6. Berries. Blueberries and blackberries are in the range 5000 to 6000, cranberries 9000, elderberries 14,000 and strawberries under 4000. I don’t know why blueberries seem to get all the publicity around the place. Apples and plums are close.

7. Plums, raw. 6000 to 7000 for various varieties and prunes even higher. Dried fruits generally rank higher than fresh fruits, so I’ve not included them here. (Dried fruits may be high in antioxidants but are also high in sugars, mainly fructose.)

8. Red cabbage, raw and cooked. In this case, the cooked red cabbage is 3000 and the raw cabbage closer to 2000. Again, processing the red tissue seems to release more antioxidants — like grapes. White cabbage is the same — cooked higher than uncooked — yet both are under 1000 units.

9. Nuts, raw. Most nuts are excellent. Almonds over 4000, pecans 17,000 and hazelnuts 9000, pistachios 7000 and walnuts 13,000.

10. Cereals and bran. Wholegrain consumption consistently shows up as protective for type 2 diabetes and heart disease. Not surprising when some of these numbers are computed: rice bran 15,000; sorghum brans up to 240,000. Heavy wholegrain breads and cereals generally rate in the 2000 units range.

Antioxidant strategies

To summarise, there’s a powerful punch available in many herbs and spices, fruits and nuts and whole grains, and to a lesser extent, in many of our favourite vegetables. Carrots and tomatoes are surprisingly unimpressive, but that doesn’t mean this is the last word. It’s possible factors other than what is measured in this database are at work. And it seems to me that low-carbers who like to avoid most fruits are missing out on a lot of antioxidant variety and power.

Here’s what you could do to maximise your antioxidant consumption.

1. Grow your own fruit and veges organically if possible. Recent analysis by Alyson Mitchell has shown that organically grown plants generally have higher antioxidant capacities than those conventionally grown. (An article on this is on the way.)
2. Make regular use of powerful herbs and spices like ginger, tumeric, galangal, oregano, thyme and many others. Grow them when you are able.
3. Eat plenty of non-starchy fruit and vegetables. That means adding lots of green leafy vegetables and non-starchy fruits and root vegetables to your bananas and potato consumption.
   Eat daily of raw nuts and cooked whole grains.
4. If you drink alcohol, a glass or two of red wine each day, preferably with meals, is a reasonable approach.

Why You Need to Eat Your Greens

Green leafy vegetables like spinach, lettuce, Chinese vegetables, kale and many others are part of the evolutionary heritage of primates — and humans are no exception. Eating carefully selected green leafy plants for millions of years must have made human biochemistry beautifully adapted to these foods. Too bad many of us don’t eat enough.

They contain valuable vitamins and minerals and antioxidants including iron, lutein for the eyes and other carotenoids, magnesium for heart and muscle, folate for the heart and pregnancy, vitamin K for bones — and one nutrient that regularly gets overlooked: the plant form of omega 3 called alpha linolenic acid or ALA, which is not to be confused with the other polyunsaturated fat called linoleic acid. ALA is a shorter chain length omega 3 that the body can covert to the longer chain EPA and DHA or fish oil omega 3s. ALA is also found in walnuts and canola oil.

The other omega 3
ALA also seems to protect us from heart disease like it’s longer-chain relations EPA and DHA. In fact, that’s how animals get EPA and DHA — from eating green grass and leaves and converting ALA. And that’s why free-range beef or chickens feeding on natural grass and litter are healthier to eat than lot or coop feed animals.

What to eat, and how to prepare
I make a real effort to eat leafy greens regularly. I’ve settled on ones that I like and I grow them organically as well as buy from the supermarket. I eat mainly spinach, cos lettuce, Italian parsley (not the curly leaf one) and rainbow silverbeet, called chard in some regions. I live in a sub-tropical climatic zone, so the spinach tends to be seasonal, requiring colder weather. The cos and silverbeet will grow in all except the hottest times of year, with the silverbeet being pretty much perennial if you allow it to be. The parsley dies off and self-seeds brilliantly for next year.

Last seasons cos self-seeded and grew like a wheat-field. Fantastic. Pick the dark greens leaves when you need them and they just keep coming after a touch of blood and bone fertiliser. Unfortunately, the rabbits also found them. Such is life.

Spinach can be eaten in salads or cooked lightly with a little olive oil, garlic, pepper and lemon juice. Like some southern Europeans, I like a large bowl, steaming hot. The silverbeet is a little stronger and works better in omelettes and stir-fries for me. Parsley is more useful with the tough stems cut off, but then you can use in stir fries, salads, omelettes, bowl noodles and soups or just nibble.

Fresh, dark cos with lemon juice, pepper to taste and a small amount of olive or soy oil (more ALA in soy), with a little low-fat feta if you like, makes a great companion for main courses.

How greens help
Find some greens that you can eat on a regular basis and make them a regular part of your diet. If you exercise a lot you need a potent brew of natural antioxidants to ward off the oxidation products of exercise. If you’re trying to lose weight with a low-calorie diet, nutrient-rich foods are important to ensure you get your recommended daily allowance of vitamins and minerasls for good health. I prefer not to juice — you’ll probably lower the GI anyway — and supplements are pretty much a waste of time. So go greens!

• Archives

  Select Month January 2010 December 2009 October 2009 September 2009 August 2009 July 2009 June 2009 May 2009 April 2009 March 2009 February 2009 January 2009 December 2008 November 2008 October 2008 September 2008 August 2008 July 2008 June 2008

 

 

Subscribe RSS

Enter email address for weekly newsletter and get the FREE ebook preview of our lifestyle training program, including text of the 190 Power Point slides:

• Categories

  Select Category Cancer Diabetes Fat loss Fitness Food Heart Disease Lifestyle disease Nutrition Physical activity Uncategorized

• Recent Posts

  • The Truth About Saturated Fat
  • Are the Framingham Heart Risk Tests Useless?
  • So Long and Thanks for All the Fish – Is Paleo Dieting Finished?
  • Is Your Heart Bullet-Proof?
  • How to Improve Restrictive Diets with A Few Tweaks – Atkins, Ornish, Vegan
  • What You Need to Know About Burning Fat
  • Don’t Go Belly Up – Control That Waistline
  • Exercise Won’t Make You Fat – And Pigs Still Can’t Fly
  • All About Fructose and Why You Shouldn’t Panic
  • Survival of the Fittest
  • Acid and Alkaline Foods – What Are They?
  • Are Antioxidants Finished as Dietary Supplements?
  • Prevention and Management of Diabetes with Lifestyle Change
  • Red Meat and Chronic Disease
  • Best Exercises to Prevent Osteoporosis