MALE PATTERN FITNESS: Weight Loss Archives

March 07, 2007

Atkins Is Dead. Long Live Atkins.

Robert Atkins died four years ago. But his diet may have just gotten a second wind:

The largest and longest-running comparison of diet plans found the low-carbohydrate Atkins regimen produced greater weight loss than three other popular programs -- the Zone, the Ornish and the U.S. nutritional guidelines.

The average weight reduction was small, and participants started regaining pounds by the end of the one-year study, according to the report in today's Journal of the American Medical Assn.

Still, Atkins dieters -- who consume prodigious amounts of long-demonized saturated fats but shun carbs, such as pasta and breads -- experienced significant drops in blood pressure and cholesterol.

Atkins dieters lost an average of 10.4 pounds after one year, according to the report, compared with 5.7 pounds for those on a traditional balanced diet based on federal nutritional guidelines, 4.8 pounds for the high-carbohydrate Ornish diet and 3.5 pounds for the Zone diet, which calls for a set ratio of carbohydrate, protein and fat.

The study's results cast further doubt on the benefits of low-fat, high-carb diets, which have been touted for decades as the model of healthy eating.

I guess my work is finished, and I can retire now. Or I could, if the people advocating low-fat diets would just go away. But they won't:

Dr. Dean Ornish, president of the Preventive Medicine Research Institute in Sausalito, Calif., said the differences among the weight loss plans detected in the study were insignificant.

He added that Atkins dieters saw an increase in levels of LDL, or "bad," cholesterol.

"The conclusions of this study are highly misleading," he said.

Like most fanatics, Dr. Ornish has a bit of a problem with reality. The world just stubbornly refuses to conform to his black-and-white, carbs-are-good/meat-is-bad belief system.

Probably the most interesting comments come at the end of the L.A. Times story:

Marion Nestle, professor of nutrition, food studies and public health at New York University, who also was not involved in the study, said the findings should be interpreted cautiously.

Women on the Atkins diet experienced most of their weight loss during the first six months, raising the possibility that weight loss on all four diet plans would look the same in a longer study, she said.

"My guess is that if they carried this study out for another six months, they would converge," Nestle said.

But a similar study actually reached that conclusion. This one, published in 2005, compared Atkins, Zone, Ornish, and Weight Watchers for 12 months, and found the weight loss was about the same across the board. Adherence was higher with Zone and Weight Watchers, and lower with Atkins and Ornish. The conclusion is exactly what Nestle says it would be:

Each popular diet modestly reduced body weight and several cardiac risk factors at 1 year. Overall dietary adherence rates were low, although increased adherence was associated with greater weight loss and cardiac risk factor reductions for each diet group.

That's the point fanatics on both sides fail to comprehend: Success isn't determined by the diet that's thrust upon you. What makes or breaks a weight-loss program is what you can stick with.

Posted by LouSchuler at 08:41 AM | Comments (0)

March 02, 2007

The Wicked, Wicked World of Fitness Magazines

I want you to hold two thoughts in your head before I get into the main idea here:

First, a new study in Pediatrics shows that steroid use among adolescents did not increase between 1999 and 2004, despite growing media coverage of steroids in general, and in particular steroids in sports.

There's also this line from the study's conclusion:

Steroid use decreased as adolescents grew older.

The same group of researchers, two months earlier, published a study in the same journal showing that exposure to information about dieting in magazines increases a variety of behaviors, good and bad, among teenage girls:

For female adolescents, the frequency of healthy, unhealthy, and extreme weight-control behaviors increased with increasing magazine reading ... . The odds of engaging in unhealthy weight-control behaviors (such as fasting, skipping meals, and smoking more cigarettes) were twice as high for the most frequent readers compared with those who did not read magazine articles about dieting and weight loss. The odds of using extreme weight-control behaviors (such as vomiting or using laxatives) were 3 times higher in the highest frequency readers compared with those who did not read such magazines.

But there's also this:

There were no significant associations for either weight-control behaviors or psychological outcomes for male adolescents.

Like I said, I need you to hold these two thoughts when I get into my main news item this morning:

1. Information about dieting and weight loss in magazines does not affect boys in any negative ways, just as boys didn't increase anabolic-drug use despite much more exposure to news coverage of steroids.

2. However, exposure to information about dieting and weight loss in magazines does seem to have profound effects on young women, many of them negative.

Indecent exposure

An organization called the American Council on Science and Health has been reviewing magazine coverage of nutrition and dieting for two decades and counting. Its new study, "Nutrition Accuracy in Popular Magazines: January 2004 -- December 2005," came out this week. (Full PDF here.)

The results aren't encouraging for the ink-stained wretches who write about nutrition in popular magazines:

The quality of reporting on nutrition in popular magazines did not improve between 2000–2002 and 2004–2005 and may even have deteriorated over that time period.

Ouch!

My first instinct was to see if they said anything nasty about me personally, since I was still writing for magazines during that two-year period. Men's Health's score went up, from 71 to 76, probably because I left the magazine during the time of this survey. Men's Journal wasn't included in the study, so the articles I wrote for them are either above reproach or beneath contempt. (I'll sleep all right either way.)

Men's Health was ranked 18th of 21 magazines for accuracy, 20th for presentation, 17th for recommendations, and 18th overall. Men's Fitness ranked a dead-last 21st in every category. I'd feel bad, but I don't think I wrote any nutrition articles for MF in that period.

The study said this about MH:

A clever, attention-grabbing writing style seemed to triumph over accuracy and documentation of sources in this magazine.

And about MF:

Many articles had inaccurate, exaggerated, and/or undocumented statements about various aspects of nutrition.

Undocumented! Sounds almost political. Let's get into a few specifics of the problems the study had with these mags:

Some Men’s Health articles also contained factual
errors. The July/August 2004 article “The Abs Diet” stated, incorrectly, that whole-grain breads prevent the body from storing fat and that Egg Beaters are nutritionally equivalent to whole
eggs. The November 2004 article “Right On, Red” said that creatine is an enzyme. It isn’t. And the previously mentioned article “Build the
Perfect Feast” indicated that fructose and high-fructose corn syrup are the same thing. They are not. All of these errors would almost certainly have been caught before publication if the articles
had been reviewed by a registered dietitian.

As an aside, I should note here that some of the stupidest things I've ever heard about nutrition came out of the mouths of registered dietitians. How long did it take them to figure out that starches, which fall into their beloved category of "complex carbohydrates," were actually making people fat?

Here are some of the specific problems the study has with MF:

Other articles in Men’s Fitness ... led us to
wonder whether this magazine is in the business of publishing fiction. The most notable example was the March 2005 article “The Best and Worst Foods a Man Can Eat,” which managed to make inaccurate, exaggerated, or undocumented statements about most of the 54 foods it evaluated. The lack of documentation was a real disappointment; we would have loved to read the studies that allegedly show that “guys who eat bran cereal frequently are happier, more alert, and have greater energy levels than guys who don’t” or those that demonstrate that “alcohol plus a steak dinner works like lighter fluid on your metabolism.”

Conversely, the highest-rated magazines overall included Shape (#2 overall), Glamour (#4), Fitness (#7), and Self (#11). The only women's magazine down in the gutter with the men's mags is Cosmo (#19, just one notch above Muscle & Fitness).

So now comes the big question:

If the men's magazines are so deficient, how come their readers exhibit no unhealthy behaviors based on the advice they get from those magazines? No eating disorders, no increase in steroid use.

But the teenage girls getting all that accurate advice from Shape and Glamour have problems that range from fasting and skipping meals to vomiting and using laxatives for weight loss. The more they read those magazines, the more problems they have.

So perhaps it's time to address that 800-pound magazine publisher in the room: What the magazines say doesn't really matter. What matters is what the magazines show. Young readers of men's magazines are, we can assume, inspired to get lean and muscular without developing extreme behaviors to reach those goals. But young readers of women's magazines, despite getting information that passes muster with these self-appointed watchdogs in the dietetics community, develop extreme, health-threatening behaviors in apparently linear proportion to how often they read those magazines.

So is the problem with the information? Or do the images they show cancel everything else out?

Posted by LouSchuler at 07:03 AM | Comments (1)

February 12, 2007

Monday Linkage

Just because I'm too busy to organize these stories with a unifying theme ...

Why extreme stress makes you stupid

This story shows that when you lose sleep, your brain stops making new brain cells.

This test was pretty extreme, since it kept subjects awake for 72 hours. In real life, that would only happen in times of war, personal tragedy, or natural disaster. And it doesn't really say anything about what happens to brain cells when people just lose a few hours of sleep here and there.

But the news is still kind of scary: If you're involved in something so traumatic that you don't sleep for 72 hours, it takes two full weeks for your brain to catch up.

Sleep it off

It's not news that sleep is important to weight control. So this short item about kids and sleep isn't surprising, but it reinforces what we already know:

Researchers at Northwestern University in Evanston, Ill., used detailed diaries kept by families to examine children's sleep behavior and its relationship with weight. They determined that an extra hour of sleep cut the likelihood of being overweight from 36 percent to 30 percent in children ages 3 to 8, and from 34 percent to 30 percent in those ages 8 to 13.

Not a huge difference, but it's still something. Parents, turn off the TV or computer or PlayStation, and enforce a consistent bedtime. And if you have any of those things in your kids' bedrooms, where you can't monitor whether they're on or off, get them out.

And make sure they get a good breakfast when they wake up.

There. I just solved the childhood obesity problem in two easy steps.

Cut it out

I meant to blog last week about the rise in obesity surgeries for teenagers. But like so many things, I never got around to it. So this morning's L.A. Times has a handy roundup story about how weight-loss surgery is getting safer across the board:

What really improved safety, experts say, was the introduction, in 1994, of laparoscopic procedures into weight-loss surgery. Using lasers and cameras, surgeons make a few small incisions and perform procedures without cutting a person's belly.

Between 1998 and 2004, the death rate of patients undergoing obesity surgery dropped 80 percent, according to a 2006 report by William Encinosa of the federal Agency for Healthcare Research and Quality in Rockville, Md. -- probably due to simpler surgery.

Maybe someday surgery will be as common for people tired of being overweight as Lasik is for people who're tired of wearing glasses. If it's truly as safe as it now seems, it's hard to argue against it.

Use it ... and lose it anyway

I spent the weekend watching my older daughter skate. She probably skated four hours on a friend's frozen pond on Saturday, and then another three hours Sunday at an indoor rink -- she had her regular lesson, then tore around on the ice with friends for another hour and change.

At 50, I'm lucky if I get in three hours of exercise a week, but for her that's just a regular old Saturday afternoon.

Of course, I'm only doing what my body tells me to do -- I'm supposed to slow down with age. This is a process that occurs naturally in every species. It's not just activity levels that downshift. Performance declines as well after about the age of 30, even with elite-level talent and serious conditioning.

A new study sheds some light on why our bodies persist in getting older and slower:

The team from the Howard Hughes Medical School at Yale University School of Medicine compared the skeletal muscle of three-month-old rats and two-year-olds. They found that a process called AMP-activated protein kinase (AMPK) slowed down in the older animals.

AMPK's role in skeletal muscle is to stimulate the body to burn off fat and to fuel cells, via the production of mitochondria -- cells' power sources. ...

The animals were exposed to a chemicals which stimulates AMPK and were also fed more food, which also stimulates the process. They found that the older rats had lower AMPK activity than the younger animals.

What's funny about this story is that it portrays this loss of muscle function as all-or-nothing:

Dr. Anne McArdle, an ageing specialist at the University of Liverpool, said: "Loss of skeletal muscle mass and function as we age is a major problem which has a significant effect on quality of life of older people." ...

But she added: "The data suggest that the ability to increase AMPK activity is completely abolished and so there is little evidence to suggest that 'working harder' would overcome these deficiencies."

There's still a pretty big gulf between "doing nothing" and "working harder." No one walking around with a 70-year-old body thinks he just needs to work a little harder to make his body perform like a 20-year-old's. But there's plenty you can do that falls in between the extremes. Some exercise is always better than none, and exercise in combination with a good diet will do wonders to delay the inevitable -- to slow the slowdown.

So what'll you bet the next time we see the acronym "AMPK" in a news story, it'll be about a drug company that's invented a product to increase AMPK activity in older people? "It's Viagra for your muscles!"

Posted by LouSchuler at 08:56 AM | Comments (0)

January 30, 2007

The Muscle-Loss Diet

A small study is getting a lot of attention the past couple of days, as do most recent studies of calorie restriction.

This Reuters report has a pretty good summary of the findings:

Eating less and exercising more are equally good at helping take off the pounds, U.S. researchers said in a study that challenges many of the popular tenets of the multibillion dollar diet and fitness industry.

Tests on overweight people show that a calorie is just a calorie, whether lost by dieting or by running, they said.

They found there is no way to selectively lose belly fat, for instance, or trim thighs. And their carefully controlled study added to evidence that adding muscle mass does not somehow boost metabolism and help dieters take off even more weight.

I haven't seen the entire study, so I can only guess at some of the reasons for the statements I just quoted.

The abstract notes that there were 24 active participants in the study, and 11 controls. They were equally divided among men and women, which means there were just six men in each of the two groups. I emphasize gender because if an exercise or weight-loss study is going to show dramatic results, it tends to be the men who'll get them. So when the researchers talk about increased muscle mass not affecting the results, it's important to realize the group they're talking about included just six men.

It's also worth noting that the "exercise" they're talking about is endurance exercise. So I'm not sure why they'd throw in a gratuitous line about how "adding" muscle mass doesn't increase metabolism, since the participants in the study clearly lost muscle mass. (I'll break down the numbers in a moment.)

And even if they'd really gained a bit of muscle, nobody thinks that the minuscule hypertrophy of slow-twitch muscle fibers seen in endurance exercise will increase metabolism outside the context of the exercise itself. You need strength training to do that, and even then you probably wouldn't see much of an effect in a mixed group of men and women. Whatever gains the men made would be canceled out by the women, who would be unlikely to gain enough muscle mass to affect their resting metabolic rates.

That said, this part is a surprise:

The volunteers in both groups lost about 10 percent of their body weight, 24 percent of their fat mass and 27 percent of their abdominal visceral fat. Visceral fat is packed in between the internal organs and is considered the most dangerous type of fat, linked with heart disease and diabetes.

The distribution of the fat on the body was not altered by either approach -- helping prove that there is no such thing as "spot reducing," Ravussin said in a telephone interview.

I don't have time to look them up this morning, but I've certainly seen studies where exercisers lost more midsection fat than non-exercisers. Maybe those studies looked at all mid-body fat, rather than visceral fat exclusively, which would explain the discrepancy.

Alwyn Cosgrove looked at the study and came to this conclusion:

The take home message is, once again, [that] steady-state aerobic exercise appears to contribute nothing to fat loss over caloric restriction alone. A good fat-loss program should include some form of caloric restriction, resistance training and some higher-intensity cardiovascular work to create a caloric deficit and ramp up metabolic demand.

To that I'd add this:

Wouldn't it be interesting to look at the participants, and see if there's any visual difference in the two groups? Does either group look healthier than they did before they lost the weight? Does the group that combined diet and exercise look fit and athletic?

I wouldn't recommend either approach -- radically cutting calories, or just dramatically cutting calories while also doing death-march endurance exercise five days a week. But I can't argue with the results -- they lost about 18 pounds on average, including about two pounds of visceral fat.

The diet-plus-exercise group lost slightly more fat -- 14 pounds, vs. just under 13 for the diet-only folks. But that's still a surprisingly good result for the people who were starved. To lose 18 pounds in six months, 10 percent of total body weight, and only lose five pounds of muscle is a damned good trick.

But in a way, that was the easy part. The hard part comes over the next six months, when they try to continue restricting diet and/or exercising at those levels.

Posted by LouSchuler at 07:03 AM | Comments (4)

December 04, 2006

Clash of the Straw Men

Lots of things drive me nuts in my field. I'm predisposed to excitability anyway, so I confess I'm easily worked up. But this is the type of media report that's worth the cortisol I generate when I criticize it:

Women who are clinically obese don't need to diet to improve their health, say UK researchers. A programme which encouraged women not to diet but to take part in exercise classes found significant improvements in health and mental well-being.

The women in the study were also taught about good eating habits, such as how to cook, and received social support.

After a year, the women had only lost a little weight but were significantly fitter and happier with themselves.

First off, the question of "diet" vs. "exercise" is a false choice. I understand that the researchers here wanted to see what would happen to their subjects without dietary restriction; that's a perfectly legitimate scientific experiment. (Although it's hardly the first to show that an exercise program improves health and well-being even in the absence of weight loss. We've known that for almost as long as I've been writing about health and fitness.)

But for the average overweight person, there's no reason on earth to choose one over the other. And I think it's utterly ridiculous to suggest that anyone make such a choice.

The women in the study did low low-intensity exercise programs (water aerobics, circuit strength training, tai chi) and were "counseled" to cook more and eat whatever they wanted in moderation.

But, if these were real-world individuals being coached by fitness and nutrition professionals, they'd be given much more detailed dietary information. Simply telling them to avoid certain types of foods while filling up on others could help them lose weight, and leave them feeling even better about themselves, since the effects of the program would be visible. As it stands, the women lost an average of eight pounds, while obese women in a control group gained an average of seven pounds. That's not bad, but just switching out some carbs with protein might've doubled that.

Here's the token expert quoted in the story:

Dr. Erika Borkoles, exercise psychologist at Leeds Metropolitan University, said health professionals needed to shift their focus from weight loss to helping people become healthier.

"What is important is we don't set people up for failure. Psychological and physical health and metabolic risk factors greatly improved so that should lead us to think differently about intervention programmes.

"Don't go on a diet," she advised. "Change the way you eat, you can eat what you want in moderation."

Yeah, except that getting people to change what they eat will produce even better results, without people having to cut calories drastically or feel as if they're starving.

After all these years, I have no idea why it's somehow repugnant to tell people that some foods work better than others for weight control.

In what other profession is it considered bad form to offer people the best possible advice? Do financial advisors avoid telling clients about the best possible investments, out of fear of offending people who prefer to stuff money under their mattresses? Would a mechanic suggest that you change your oil but not mention the benefit of rotating your tires, out of fear of overwhelming you with choices?

I just don't get it.

Posted by LouSchuler at 08:59 AM | Comments (0)

November 27, 2006

Monday Math

A handful of fun and interesting stories to check out this morning:

TV + exercise = weight loss.

A schizophrenia drug + a blood-pressure drug = an ejaculation-preventing contraceptive pill for men.

Slow reaction times + poorly functioning memory = heart attacks.

Making more money may or may not = more happiness. (And check out this New York Times story on how the really rich are separating themselves from the merely successful and affluent. Is anyone happier because he's making millions instead of hundreds of thousands?)

Posted by LouSchuler at 07:51 AM | Comments (1)

November 10, 2006

Does This Diet Make Me Look Fat?

Rannoch Donald, our linkmaster in Scotland, sent along this article from an Australian newspaper, which profiles a pair of weight-loss researchers in Canada. I'm not great at geography, but I think that's three continents in two different hemispheres to reveal one simple truth:

Long-term weight loss is more about lifestyle changes, a conference on the Sunshine Coast will be told this weekend. Keynote speakers at The Clinicians Challenge in Treating Obesity will be husband and wife team professors Peter Herman and Janet Polivy.

The couple are psychologists at the University of Toronto, Canada, and world authorities in restraint theory, which holds that if you deny yourself food, you ultimately overeat.

Prof Polivy said most people trying to lose weight had unrealistic expectations and self-defeating behaviour from the start of their diet. When it failed, they were actually likely to gain weight before the next attempt, and so the cycle continued.

"I'll be talking about how restraint eating leads to the false-hope syndrome and how this results in failed attempts at dieting but renewed attempts that are no more likely to succeed," Prof Polivy said.

"Losing weight involves actually changing permanently how people live their lives."

Most of us reading this already know that. If you're hungry, you've already doomed your weight-loss effort. But even more important than that, dietary restraint slows down your metabolism. That's why, since my colleagues and I wrote this book way back when, I've been advocating a different way to look at food for weight control: Focus on what you should eat, rather than on what you shouldn't.

I don't know how many guys told us that the T diet seemed like too much food to them, that they felt unusually stuffed the first couple of weeks. A diet with more protein and healthy fat will have that effect, if you aren't used to it. A lot of these guys were actually eating less, in terms of calories, but felt as if they were eating more.

The biggest question we heard then, and sometimes hear even now, is whether the diet we advocated is healthy. Most of us grew up with the idea that fat is bad, and figured that if bodybuilders eat extra protein then there must be something wrong with it as well. By default, that means carbohydrates must be good. If they weren't, what the hell would we eat?

For all our assurances that a higher-fat, higher-protein, lower-carb diet is ideal for any number of reasons, including overall health as well as weight control, we still found some skepticism.

This new data, from Harvard's Nurses' Health Study, should help alleviate those lingering doubts:

Our findings suggest that diets lower in carbohydrate and higher in protein and fat are not associated with increased risk of coronary heart disease in women.

The researchers crunched the data two ways. When they compared those eating the most animal fat and protein, and the fewest carbs, with those eating the least animal fat and protein and the most carbs, the meat-eaters had 6 percent lower rates of heart disease.

But when they looked at the data in terms of who ate the most and least vegetable fat and protein, the results were much more dramatic. Not surprisingly, the Washington Post's Sally Squires focused on those numbers:

Women who eat a diet moderately low in carbohydrates, but rich in vegetable fat and vegetable protein, can cut their risk of heart disease by as much as 30 percent compared with just following a low-fat approach, according to a new Harvard study.

The findings, drawn from a study of more than 80,000 nurses, reinforce a growing shift in nutritional advice toward moderate amounts of healthful fat found in such foods as nuts, avocados, liquid vegetable oils and seafood along with less-processed carbohydrates, including whole-grain bread and cereal and fruits and vegetables.

I think most people in the nutrition biz would agree that vegetable fats, such as olive oil, are healthier than animal fats, although Squires isn't being particularly helpful to her readers when she says the diet is "moderately" low in carbohydrates. The women eating the fewest carbs got fewer than 30 percent of their total calories from that category of nutrients. To most people, that's less than "moderately" low.

But that's just one of the odd turns Squires' story takes:

"We didn't really design the study to look at weight loss," said lead author Frank Hu, associate professor of nutrition and epidemiology at the Harvard School of Public Health. But after analyzing 20 years of food information collected from participants who reported eating a moderately reduced carbohydrate diet, Hu and his colleagues concluded that there is "no significant long-term effect on body weight."

The findings suggest that "there's no magic formula for weight loss," said Lichtenstein of Tufts. "You still have to focus on calories."

Really?

If you're just cutting calories without focusing on which calories you cut, then all you're doing is feeding yourself at a level below your comfort zone. That would fall into the category of dietary restraint -- making yourself hungry -- and we already know that doesn't work. So if someone sets out to change the hunger equation by eating more protein and fat, which leaves him feeling fuller longer, and fewer carbohydrates, then isn't that the best way to eat fewer calories without triggering the body's natural resistance to dietary restraint?

Loaded question, I know.

Last point -- look who gets the almost-final word in Squires' story:

The new study may also help to put to rest some concerns about heart disease that once dogged the reduced carbohydrate diets. But some experts including physician Dean Ornish, a proponent of a very low-fat, vegetarian approach that has been proved to reverse blocked arteries, cautioned that the report should not be used to resurrect the Atkins diet.

"I worry this will confuse people and potentially mislead them to think that low-fat diets don't decrease your risk of heart disease, because they do," Ornish said.

This is almost a political question: Why do reporters quote experts saying things that are clearly contradicted by the evidence presented in the story ... and then not point out that the evidence contradicts the expert?

I asked a friend to send along the full study from the New England Journal of Medicine (thanks Cass!), and the data couldn't be more clear:

Those eating the most carbohydrates -- and thus the least fat and protein -- had more heart disease than those eating the fewest carbohydrates.

The researchers divided the nurses into 10 groups. The first group ate at least 56 percent of their total calories in the form of carbohydrates. The 10th group got less than 30 percent of their calories from carbs. And the 10th group had slightly less heart disease than the first group.

The way the study's abstract is written, and the way it's described by Squires in the WaPo, you get the impression that the women who had the least heart disease were getting their fat and protein primarily from vegetable sources -- protein from tofu and beans, fat from olive oil, that sort of thing.

But the women in that category weren't eating exclusively from those sources. To get into the highest decile, they had to get at least 26 percent of their total fat and protein from vegetable sources. But they still were eating fewer than 30 percent of their total calories from carbs. So there's still a lot of animal fat and protein in their diets.

In other words, Dean Ornish is totally wrong. Shouldn't somebody point that out?

Posted by LouSchuler at 06:54 AM | Comments (0)

October 30, 2006

Fast or Slow?

I confess I've never seen an entire episode of a reality show. I've surfed past them a few times, and occasionally lingered for a minute to try to fathom what was going on. Each time, I was reminded of Quiz Show, the movie directed by Robert Redford about the game-show scandals of the 1950s. In an interview, Redford said he remembered watching the shows, and realizing in some part of his brain that they were rigged. Just the way the contestants answered questions made it clear they weren't really confused about the answers, which they'd been given in advance by the producers. It screamed "fake!", but it took years before the scandal occurred.

In its way, it was like the steroid scandal in major-league baseball. Watching Mark McGwire and Sammy Sosa in 1998, it was clear to me that both guys had juiced. The tipoff was when McGwire talked about how he was "in awe" of his own prowess. He was telling the world he was in awe of what steroids had allowed him to do with a bat in his hands, but couldn't come out and say it.

I'm not saying the contests on these shows are rigged; I have no idea if they are or aren't, and I have no reason to suspect they are. I'd have to care to work up a case for or against, and I can't bring myself to do it. The signature fakeness that sets off the "change the channel" alarms in my brain lies in the preposterousness of the situations -- throwing people together who'd never cross paths in real life isn't my idea of "reality." It's like watching a guy who knows the answer pretend he doesn't, or watching a juicer pretend he hasn't juiced. Fake is fake.

But that's just me.

Anyway, as someone who's in the body-transforming biz, I know I should be interested in The Biggest Loser, if for no other reason than to assess the techniques they use to help people lose weight. But I can't work up the enthusiasm even for that.

Fortunately, somebody has, which is why a story in today's L.A. Times asks a serious question about a silly show: Is it a good idea to lose weight as fast as the contestants on The Biggest Loser?

The experts quoted seem to agree that it doesn't really matter if you lose weight quickly or more gradually, although fast reduction has a psychological advantage:

"Studies have shown that long-term, it doesn't matter if you lose it fast or slow," says the University of Colorado's Wyatt. "One or two years down the road, the people who lost weight slowly were equal," in keeping weight off to the people who lost it fast.

In fact, sudden weight loss can even be a boon over more traditional, steady plans, but not for medical reasons, says John Jakicic, director of the Physical Activity and Weight Management Research Center at the University of Pittsburgh and author of more than 50 papers on exercise and weight loss.

"My guess is that the closer you can get the person to a healthier weight, the more you might motivate that person to keep it off because they've had a life-changing event," he says.

One thing I didn't know about the show is that the medical expert in charge of the weight-loss programs emphasizes the importance of retaining muscle mass, which of course is a key point in everything I've written about the subject:

Assume there are two 300-pound men, each with a body composition of 180 pounds of lean mass and 120 pounds of fat, and each loses 100 pounds total. If one loses 10 percent of the weight in lean mass and the other loses 20 percent (the norm is 20 percent to 30 percent), both will reduce the number of calories they burn at rest.

But the one who loses only 10 percent of lean mass (thereby retaining more of it) will burn an extra 200 to 300 calories per day.

Lean mass, which includes muscle, bones and organs, burns about 12 calories per day while at rest, says Hill, whereas fat burns about two to three calories. Over time, this differential adds up, he says.

That's a pretty good summary, although I would add that merely having the muscle isn't nearly as important as using it. That's when the metabolic value of having a pound of muscle goes from burning an extra 12 calories a day to burning three or four times that many.

The article does discuss exercise as a key to maintaining lost weight, but, maddeningly, focuses on endurance work -- "60 to 90 minutes of daily moderate-intensity exercise" -- when anaerobic exercise like strength training and intervals could accomplish the same goal in a fraction of the time.

Posted by LouSchuler at 08:55 AM | Comments (1)

September 14, 2006

Running to Oblivion?

In doing research for my next project, a fitness and nutrition book for women, my coauthor Cassandra Forsythe showed me some eye-popping studies on the cascade of negative consequences that occur when women who do serious exercise try to restrict calories at the same time.

In some sports, female athletes are just screwed. If you're a skater, dancer, or gymnast, you have to be skinny and you have to perform at your peak without enough calories to allow you to recover from one workout to the next. In other sports, such as swimming, the champions are going to be big girls, and if you want to swim with the big fish, you have to eat enough to support the muscle mass you need to compete.

An athlete who's restricting calories for the sake of restricting them -- either because of an eating disorder or aesthetic concerns -- is in big trouble, as this New York Times story shows:

For a runner, Alex DeVinny wasn’t all that skinny on the day that she won a state track title in 2003. At 17, she was 5-foot-8 and weighed 125 pounds.

Few people watching her run the 3,200 meters in 10 minutes 53 seconds would have guessed that she had had symptoms of an eating disorder since age 9 and that she had yet to start menstruating. Her coach didn’t know. The college recruiters certainly did not know.

She was never going to run for those colleges. The summer after she won the title, Ms. DeVinny, from Racine, Wis., began to run even harder and eat even less. When she came out for cross-country in the fall, she looked frail and underweight. Her coach was concerned enough to prevent her from competing in several meets, but he allowed her to do two-thirds of her training. He never asked about her menstrual periods and did not know about her anorexia.

Ms. DeVinny sneaked in extra workouts, but her dazzling window of athleticism had already begun to close. “Her body kind of broke down during her senior year,” said her sister Gabby Fekete, 27. “She had lived on adrenaline.”

Last March, Ms. DeVinny died from cardiac arrest related to her starvation. She was 20 and weighed roughly 70 pounds.

I'd be the last person to say you can compare someone with an eating disorder -- a mental illness -- with people who aren't suffering from that affliction. But still, there are plenty of women in sports who're in the gray area in between. They aren't eating enough to recover from their workouts, and their bodies are breaking down as a result. The technical term for this is the "female athlete triad," which includes disordered eating, loss of periods (amenorrhea), and subsequent loss of bone mass (osteoporosis).

Consider this, from the same article:

Dr. Anne Hoch, the director of a women’s sports medicine clinic at the Medical College of Wisconsin in Milwaukee, found in one study that the overall prevalence of the triad is high. Of 80 varsity athletes she recently surveyed at an all-girls high school, 75 percent had one or more components of the triad.

Some studies have found that athletes are two to three times more prone to suffer from menstrual dysfunction. “We know it is higher than what we see in sedentary women,” said Anne Loucks, a biology professor at Ohio University, “and highest in women who are doing the most training, and who are younger.”

Because half of an athlete’s bone mass is developed during adolescence, losing a period can have lifelong consequences for bone health, Dr. Loucks said. “We don’t have evidence that if their cycles return, their bone is going to return to normal density.”

If you have a daughter competing in sports, or just working out to look better, keep your eye on her diet. The thought that exercise can make someone's long-term health worse is just mind-boggling.

Weight weight, don't tell me

Yesterday's Times had another article about exercise and weight control, this one in the weekly health column by Jane Brody.

She set out to show that creating a caloric deficit with exercise isn't as easy or straightforward as it looks. It's stuff that most of us in the biz know pretty well, but it's worth noting the basic message:

[Y]ou may have wondered why, after you took up activities that were supposed to burn 500 calories a day, you failed to lose that pound a week.

What is the truth about exercise and weight, and how can you accurately calculate the caloric value of various activities?

In the August/September issue of ACE Certified News (published by the American Council on Exercise), Ralph La Forge, managing director of the Duke Lipid and Disease Management Preceptorship Program at Duke University Medical Center, compiled a detailed analysis of the various factors that influence the effect of exercise on weight loss.

Mr. La Forge started by refuting the prevailing belief that since a pound of fat (when burned) gives off 3,500 calories and since running or walking a mile burns 100 calories, a person should lose a pound for every 35 miles. In other words, if a previously inactive person starts running or walking five miles a day, that person should lose a pound a week, all other things being equal.

Not so, says Mr. La Forge, because this estimate fails to subtract the number of calories that person’s body would have used had it just sat still for those hours. Rather, for a 154-pound person, the net caloric cost would be 54 calories per mile when walking up to 3.5 miles per hour, 97 calories speed-walking at 3.5 to 5 m.p.h., and 107 calories jogging or running.

Still, it is possible to lose substantial weight with exercise, and without calorie restriction. Craig Ballantyne sent me this study, which makes that case.

The researchers at Washington University in St. Louis put four dozen middle-aged adults (median age: 57) into one of three groups. The first group set out to restrict their calories by 20 percent. The second group exercised with the goal of burning more calories than they took in. The third group was counseled on healthy living.

They were regular-sized folks at the beginning of the study, with an average body-mass index of 27.3. (A man who's 5-10, 190, would have a BMI of 27.3.) The researchers followed them for a year.

The most interesting result of the study may be that neither the calorie-restriction group nor the exercisers achieved their goals. The dieters managed, on average, to cut 11.9 percent of their calories, or 57 percent of their target. The exercisers did 59 percent of their workouts.

Both groups lost weight -- 10.7 percent of their starting weight for the dieters, 8.4 percent for the exercisers. (The group who got counseling lost 1.7 percent.)

The study abstract doesn't say how much fat each group lost, except to say the first two groups lost significant and similar amounts, while the counseling group didn't.

There's an encouraging take-away here: You can lose fat by restricting calories without exercising, or by exercising without restricting calories. (I recommend exercise, but that's just me.)

What's not said, but what many of us have learned the hard way, is that it's foolish to try to lose weight by increasing your exercise and cutting your calories at the same time. Assuming your diet is already clean -- that is, you've already cut out all the obvious crap that you know you shouldn't eat if you want to be lean and healthy -- you have to choose one or the other.

Otherwise, there's a real risk of doing more harm than good.

UPDATE:

Reader John B. sent this along, showing that undernourished female athletes have yet another health risk to worry about:

Female college athletes on low-calorie diets could be putting themselves at risk for stress fractures, according to new Saint Louis University research published in this month’s The American Journal of Sports Medicine.

Researchers studied risk factors for exercise-related leg pain, including stress fractures in women participating in four popular fall sports -- cross-country running, field hockey, soccer and volleyball.

Women with "disordered eating," which includes eating disorders such as bulimia and anorexia but more generally refers to insufficient caloric intake, were more likely to develop stress fractures as a result of decreased estrogen production, says researcher Mark Reinking, PT, Ph.D., chairman of the department of physical therapy at Saint Louis University's Doisy College of Health Sciences.

"When people expend more calories than they consume, they release fewer hormones, which slows down menstrual cycles. This decreases estrogen in the body, which is responsible for bone development," says Reinking, also chairman of the American Board of Physical Therapy Specialties.

Leg pain is one of the most common problems afflicting athletes, Reinking says.

"It causes people to miss practices and competitions, and I wanted to understand if two people were undergoing the same exercise regime, why only one of them would have leg pain," he says. "It’s not as simple as 'Run less' or 'Change your shoes every 300 miles.' It's a complex problem, and you can't prevent something if you don't know what causes it."

Posted by LouSchuler at 08:52 AM | Comments (0)

August 15, 2006

Born to Sit

Normally, studies about fidgeting drive me up a wall. (Then again, since I'm a natural-born fidgeter, everything drives me up a wall; I couldn't sit still if my life depended on it.) Each new study seems to show about the same thing: People who fidget are thinner than those who don't. The first one was interesting, but after that it's just been more of the same. Since no study has shown that non-fidgeters can become fidgeters, I don't see the point in giving overweight people yet another unrealistic standard to achieve.

This study is more of the same, performing the semi-useful work of establishing the genetic basis for non-movement:

Lean rats -- but not fat rats -- are sensitive to a brain signal that makes them restless, find Catherine M. Kotz, PhD, and colleagues at the University of Minnesota and the Minnesota Obesity Center.

"The results point to a biological basis for being a couch potato," Kotz said, in a news release.

Kotz's research team bred two colonies of rats. They bred lean rats with lean rats until they got a strain of obesity-resistant rats. And they bred fat rats with fat rats until they got a strain of obesity-prone rats. Given the same amount of food, the obesity-resistant rats stay lean while the obesity-prone rats get fat.

Motion detectors attached to the animals showed that obesity-resistant rats moved around much more than the obesity-prone rats. This held true from an early age -- even before the obesity-prone rats got fat.

This report is from WebMD, a site I don't visit often because of its annoying propensity to state the obvious.

But this particular story does something really, really interesting: Immediately after the paragraphs I just quoted, it says this:

This suggests that getting people to be just a little more active may be the key to weight loss.

Does it really suggest that? I read it to mean something very different: It's brutally hard to get chronically inactive people to move more when their bodies are telling them to move less. It doesn't offer any hope that activity is the key for people who are genetically inactive.

Time for a weird analogy:

Let's say you've asked a woman out on a date, and she's just told you that she really hates going to movies, and that it must be genetic, because her mother and grandmother and all her siblings likewise have this strange aversion to movies. Would your first response be, "Great! Let's go see Talladega Nights!"?

If it is, I think that relationship would end before it started.

So why would a journalist's first response to news that some people are genetically averse to exercise be to suggest that they just need to get more exercise?

But there's an even bigger head-scratcher in the second half of the article:

The scientists discovered that the brains of the lean rats were very sensitive to a brain chemical called orexin. When injected with orexin into their brain, the lean rats got even more fidgety than they were before.

But orexin injections didn't have much of an effect on the fat rats. Their brains weren't very sensitive to orexin.

Human brains, too, respond to orexin. It may be that an orexin-like drug could make people more active and thus help them lose weight.

Didn't the article just say that the inactive rats didn't respond to the chemical? Why would that suggest a solution involving the very chemical that didn't work?

Posted by LouSchuler at 09:11 AM | Comments (1)

July 11, 2006

Dense

Jane Brody, in today's New York Times, sets out to explain why Americans are gaining weight despite all our efforts to do the opposite.

She trucks out one of the usual suspects -- portion size -- and it's hard to fault the logic there. Everything's bigger now, and it's well-established that the more food you put on a plate, the more food the recipient of that plate of food will eat.

Fine.

But then she gets into the ways people can control their weight, and I got this bizarre sense that she's repulsed by the word "protein." To be fair to Brody, I get that sense just about every time I read a story about weight-control strategies in the mainstream media. And to be even more fair, I don't think she's wrong when she cites the work of Barbara Rolls, who's certainly earned the legitimacy she's given by the media:

Dr. Barbara J. Rolls and colleagues at Pennsylvania State University have recently shown that portion size acts independently with another characteristic of meals -- energy density -- in satisfying hunger and reducing the number of calories ingested.

What is likely to be more satisfying, a quarter-cup of raisins or two cups of grapes? Both supply about the same number of calories. How many calories are packed into a given amount of food can make a big difference in how many extra calories people consume.

The more energy-dense a food is -- that is, the more calories per ounce or gram -- the more calories people tend to consume.

In previous studies, Dr. Rolls found that, all other factors being equal, people eat about the same weight of food each day.

If those foods are in the moderate range of energy density like meat, cheese, pizza and French fries or at the high end of energy density like crackers, nuts and cookies, people consume more calories than they do if their meals contain lots of low-energy-density foods, like soup, green salad, nonstarchy vegetables and fruit.

Okay, but who in the Altered Metabolic States of America does not know that it's better to eat fruits and vegetables than cookies and French fries? Rolls' studies of soup are interesting, but how practical is it to tell people to eat it over and over and over again for the rest of their lives? Most people, I suspect, would rather be fat.

Now, if you bring protein into the conversation, you have something that is easily and consistently available, is satiating (that is, when you eat high-protein foods your appetite is sated longer than it would be following a high-carb meal), and that has a growing catalogue of published research backing it up.

In the latest issue of Strength and Conditioning Journal, my friend Joey Antonio cites four studies (all published since 2003) showing that the swapping protein for carbohydrate in a diet not only leads to weight loss, but limits weight regain following a successful diet.

You can lose weight any number of ways, as I've written more times than I care to remember. The key isn't changing what you eat so much as how you eat. That said, what you eat can make a difference, and protein remains highly underrated as a change agent.

Just don't hold your breath waiting for the New York Times to acknowledge it.

Posted by LouSchuler at 10:01 AM | Comments (0)

May 23, 2006

How the Other .01 Percent Lives

If you're not in the publishing biz, you probably didn't know that the annual Book Expo America (BEA) was held last weekend in Washington, D.C. More than 500 authors, 2,000 exhibitors, and tens of thousands of publishing professionals showed up with a singular purpose: to not talk about me or my books.

Oh, I'm sure they had other items on their agenda, like selling their own books and getting drunk at cocktail receptions. But, from my perspective, the most important order of business was not talking about me.

This is why I'm never invited to these things; it's a lot harder to not talk about me when I'm actually standing there.

Some actual news came out of BEA this year: Oprah and her trainer, Bob Greene, signed a $12 million deal for a weight-loss book.

You may wonder, as I did, how any book can contain $12 million worth of information about weight loss, considering that we all know how to do it. That doesn't mean it's easy or simple or foolproof. But we all know the drill:

1. If you're eating crap, cut it out. Fast food is perfectly designed for overconsumption. The flavors have been manipulated with sugar and salt to make them stimulate your taste buds, while the two things that might slow your appetite down -- fiber and protein -- are either absent or minimized. You can't eat it without overeating.

2. Have lean protein at every meal -- more is better.

3. You can lose weight with low-fat or low-carb diets. The key to either strategy is that the food must be slow to digest. Successful low-fat diets have lots and lots of fiber. Successful low-carb diets have lots and lots of protein and healthy fats, both of which are slower to digest than the highly processed carbs that you have to eliminate on either diet.

4. If you regularly consume liquid calories -- soda, alcohol, sports drinks -- you probably have to cut them out.

5. Weight loss is never a straight line from thick to thin. It's like a fourth-grade geography class, full of peaks, valleys, and plateaus, with the occasional isthmus or archipelago thrown in to make it more entertaining.

Ultimately, it's a balancing act, with your metabolism in constant flux and all your senses conspiring to make you eat more than you want or need. It never seems to work the same way for any two people. In fact, each individual will probably find that weight control is a different battle from month to month and year to year.

If Oprah and Greene can come up with $12 million worth of advice on how to deal with all that, I'll be happy to go on her show and congratulate her for the accomplishment ... and maybe talk just a bit about my own books.

Posted by LouSchuler at 07:59 AM | Comments (0)

April 05, 2006

The Purgatory Diet

According to this, starvation diets may be the next big thing:

A low-calorie diet, even in people who are not obese, can lead to changes in metabolism and body chemistry that have been linked to better health and longer life, researchers are reporting.

The findings lend support to the theory that eating less, long known to prolong life in rats and mice, may do the same for people, by preventing heart disease, cancer, diabetes and other diseases, and by slowing aging.

I've been writing for years that slowing down your metabolism is a bad idea, but this research portrays it as a kind of Holy Grail:

Among the main findings of Dr. Ravussin's study was that calorie restriction led to decreases in insulin levels and body temperature. Both are considered signs of longevity, partly because an earlier study by other researchers found both traits in long-lived people. The diet also led to a drop in thyroid hormones and declines in DNA damage. ...

Scientists have known for years that when people cut calories and lose weight, the body tries to compensate by slowing its metabolic rate. The slowing is a defensive mechanism to fight weight loss. It was probably preserved by evolution because it saved people from starving to death when food was scarce, but it is the bane of dieters because it means that the more weight they lose, the harder it is to keep reducing.

Several explanations exist for why a strict diet, low in calories but high in nutrients, may slow aging. Many scientists think that an important factor in aging is DNA damage caused by free radicals, highly reactive oxygen-containing molecules formed during normal metabolism. Eating less leads to a slower metabolism and fewer free radicals.

Another possibility is that being deficient in calories turns certain genes on and off, with a net effect of slowing the clock.

I don't doubt that they're right about all that. But there are also consequences that aren't mentioned here. For one thing, it's just about impossible to exercise on a low-calorie diet. You have no energy for it. Exercise also increases metabolism, so it works at cross-purposes with the low-cal diet. If we all agree that exercise is good for humans, then why would something that thwarts the ability to exercise also be good?

Second, especially if we're talking about younger people, low-cal diets have a disruptive effect on hormones. Testosterone drops in men, leading to a loss of muscle mass and often depression. Estrogen drops in women, leading to amenorrhea. It seems impossible that an intervention that compromises reproductive health so dramatically could actually be good for us.

Third, low-cal diets increase cortisol, a stress hormone, which has a long list of documented detriments to the human body. Again, how can something destructive be part of an ultimately beneficial protocol?

Here's the experience of one participant:

Another participant, Oscar Couvillion, 45, an insurance database administrator, said he was lured by a radio advertisement offering participants $7,000. There was heart disease in Mr. Couvillion's family, and at 5-foot-9, he weighed 192 pounds, about 30 pounds too much.

He wound up in the group assigned to cut calories by 25 percent. At first, he said, "I was starving to death, I had headaches, I was grouchy." But cheered on by therapists in the study, he stuck with it and lost 30 pounds. He said joining the study was one of the best decisions he had ever made.

"You're not going to ask me what I weigh now, are you?" he said, adding that he weighed 176. "I have to repent. Now I know what to do."

Really?

Posted by LouSchuler at 07:23 AM | Comments (0)

February 10, 2006

Why Fast Food Makes You Fat

The concept seems obvious enough, as someone who writes about these things. But in the realm of science, it's an open question -- one addressed in a study and editorial in the new issue of the American Journal of Clinical Nutrition.

The study looked at the effects of the American diet on Spanish adults, and found something that shouldn't surprise anyone reading this: People who ate a lot of hamburgers, pizza, and sausage gained weight in the 28 months in which they were tracked. There was a smaller effect for red meat in general and sweetened fruit juice. The effects were particularly pronounced in those who'd already gained weight in the five years prior to the study period.

Here's what the editorial says -- and I'll apologize in advance for my use of ellipses and brackets; I wanted to unpack the journal-speak to make it easier to grasp:

[Danish obesity researcher Arne Astrup] asked what makes fast food fattening. Considering the convenience, low price, and high-energy format of fast food, he said, "Human beings have only a weak innate ability to recognize foods with high energy density and to down-regulate the bulk eaten to meet energy requirements appropriately." Animals gain weight if energy intake is greater than energy expenditure, and they lose weight if energy intake is less than energy expenditure.

Cupples stated that body weight is closely regulated under most conditions; a failure in energy balance can have severe consequences for the organism. In the long run, energy consumption must be matched to energy expenditure. The situation is remarkably subtle, however; the mean excess of [10 pounds] gained over 15 [years] by fast-food eaters constituted only 10 [calories per day], assuming that [one pound of] fat corresponds to [3,500 calories].

Clearly, it would not take much disturbance in satiety and sensing of energy intake to throw energy balance off by only a few [calories per day]. Besides portion size, energy density, and consequent changes in insulin action, small differences in taste or rates of stomach emptying could make this a large difference.

Individual susceptibility to weight gain varies; I suspect that a sedentary lifestyle is important in this respect. Energy intake may be determined, in part, by energy expenditure.

The late Henry L. Taylor favored a model that linked energy intake to energy expenditure in a J-shaped curve (personal communication, late 1970s). The first part of his concept was that energy intake is in exact homeostasis with energy expenditure under conditions of high energy expenditure. The second part was that there is a failure of homeostasis in a sedentary lifestyle because of its accompanying low energy expenditure. He postulated that body signals go awry in sedentary lifestyles; when a person does no physical work, the body will not recognize that it is being overfed. Sedentary persons may lose the innate ability to compensate for inactivity by reducing their eating.

I find that to be an absolutely astounding revelation. Don't you? It certainly explains why diets don't work for most people: Without exercise, your body simply can't regulate food intake. All your body's innate mechanisms for shutting down your appetite when you have enough food are rendered inoperable if you don't exercise.

In other words, your body is like a self-winding watch: If you never move your wrist, your watch always stops.

Taylor believed that energy intake falls out of homeostasis with energy expenditure when physical activity falls into the sedentary range. Even if homeostasis could be maintained in sedentary people, however, the low energy intake that may prevent obesity may at the same time deplete micronutrient intake to such an extent that some metabolic systems would not operate properly.

In other words, if sedentary people cut their calories to the point that they didn't gain weight, they'd risk organ failure from malnutrition!

One thing worries me about writing this: It's exactly what spokesfiends for the fast-food industry have been saying for years. "It's not our food that's the problem! It's the fact that the people who eat our food don't go out and run marathons! Blame them!"

So let's be clear: We know fast food is unhealthy. To pick just one example, McDonald's recently announced that its french fries actually have more calories and trans-fats than previously believed. It's bad for you. Don't eat it unless you have to, and even then, don't eat it often.

But whether you eat fast food or avoid it, the key message is, "Don't skip that workout."

(Thanks to Craig Ballantyne for the heads-up.)

Posted by LouSchuler at 10:15 AM | Comments (1) | TrackBack

February 07, 2006

Protein: It's Back!

Sally Squires, in today's Washington Post, writes about a new study:

In the study, researchers report for the first time that consuming nearly a third of daily calories as lean protein, such as lean meat or poultry without the skin, revs a person's metabolism during sleep. And the benefits aren't just nocturnal: The researchers also found that higher protein intake boosted the burning of calories and fat during the day.

Plus, when the study's participants, who were all women of healthy weight, ate more protein, they said they felt fuller, more satisfied and less hungry than when they consumed a diet with the typical amount of protein, about 10 percent of calories.

The findings suggest that increasing lean protein daily "enables you to reach the same level of satiety that you are used to with about 80 percent of your normal energy intake," notes the study's lead author, Margriet Westerterp-Plantenga, an associate professor of human biology at the University of Maastricht in the Netherlands. "That means you can eat about 20 percent less and still have the same satiety. ... It's a very easy way to ingest" fewer calories and without feeling hungry all the time.

Hmmm ... a third of calories from protein. Where have I heard that before? Oh, yeah, now I remember.

The satiating power of protein isn't exactly new. Squires notes that the same Dutch research team has been cranking out studies on that topic since the late '90s, and Danish researcher Arne Astrup has also been on the case, along with others.

But if we step back from appetite and weight control and look at how protein intake impacts health, the argument for a higher-protein diet becomes stronger.

According to this, the typical U.S. diet today is about 15 percent protein, 33 percent fat, and 52 percent carbohydrates. But higher-protein diets have been shown to improve cholesterol levels, prevent muscle loss during a weight-loss diet (high-carb diets caused muscle loss), and reduce blood pressure.

In epidemiological research, we've seen that women eating the most protein have the least heart disease, and that populations who eat the least protein have the most strokes.

And yet, "protein" is still a dirty word in some circles. I guess to those doctors and nutritionists it's better to be fat and die young than to eat a few extra chicken breasts and a little less bread.

Posted by LouSchuler at 07:03 AM | Comments (1) | TrackBack

April 14, 2005

Ephedra: Comeback Trail?

When I was blogging this morning about the new study showing the dangers of drinking too much water, I almost made a smart-ass remark along the lines of, "Good thing we banned ephedra."

Meaning: Lots of things in life are more dangerous than the once-popular over-the-counter weight-loss drug.

Including, in some cases, plain old water.

I thought it was a cheap shot, and given that I was already blaming Gatorade for the prevailing myth that American athletes and exercisers are chronically dehydrated, a myth that has proved fatal to several runners, I figured I'd leave well enough alone.

Well now:

A judge in Utah today struck down the FDA's ban on ephedra:

The judge ruled on Thursday in favor of a Utah company that challenged the U.S. Food and Drug Administration's ban. Utah-based Nutraceutical claimed in its lawsuit that ephedra "has been safely consumed" for hundreds of years.

Supplements that included ephedra have been widely used for weight loss and bodybuilding, but have been linked to 155 deaths. The FDA ordered the substance off the market in April 2004.

Judge Tena Campbell's ruling sends the matter back to the FDA "for further rulemaking consistent with the court's opinion" and keeps the agency from enforcement action against the companies.

FDA officials did not immediately return a call seeking comment.

Company president Bruce Hough said the decision is about "protecting the public's access to safe and effective dietary supplements."

You can't tell from the press reports so far, but at issue was the recommended dosage. This is from an email I got earlier this afternoon from Doug Kalman, R.D., of Miami Research Associates:

The courts essentially found that the FDA did not have a preponderance of evidence to state that the risk of 10 mg dosage or less outweighs potential benefit.

This has been the argument I've always found most compelling: Yes, there's some risk that goes along with using ephedra, but does it really outweigh the potential benefit for someone who loses a few pounds of fat?

I'm not sure what happens next. Doug says that unless the FDA refiles or asks for a new hearing, ephedra will once again be legal to sell in the U.S. in doses of 10 milligrams or less.

Will supplement companies take advantage? Should be interesting.

Posted by LouSchuler at 03:28 PM | Comments (0) | TrackBack

April 07, 2005

Fat Profits

Most of us could guess that obesity would hold someone back in the business world. Companies today are addicted to young, slim, good-looking spokesmodels, and the effect snowballs.

Good-looking executives want to hob-nob with other good-looking executives, and it all becomes one big daisy chain.

(Major League Baseball has bravely fought this trend; its motto could be, "With a commissioner this ugly, we have to be good!")

It sucks to be fat in many ways (this story, for example, shows that overweight shoppers are treated rudely, even when the shoppers are really thin people wearing fat suits).

But, as this package of stories and photos from Forbes shows, some fat and formerly fat people are cashing in, and in a major way.

One is plus-size model Emme Aronson, a 190-pounder who banks big bucks both as a model and as a symbol of a large woman who does all right in the land of the lightweights. (Gratuitous personal anecdote: I met a plus-size model many years ago at a party in L.A. She was the only woman at the food table who was eating anything she wanted. We chatted for a bit, and she told me she had about the best possible life you could have in the modeling biz; she had plenty of work, it paid well, and she didn't have to diet.)

And then, of course, there's Jared, a one-man punchline for whatever you find annoying and banal about the weight-loss industry. (Whoever wrote this about Jared's college days takes the punchline to a whole new level.)

But what I think is most interesting about the Forbes reporting is the financial side of the weight-loss business.

A few numbers:

* Americans spend $46 billion on diet and weight-loss products, including books.

* It's expensive to diet: an average of $85.79 to follow a popular diet, vs. the $54.44 the average American spends on food each week.

* "[T]wo-thirds of American dieters regained all the weight they had lost within a year, and 97 percent had gained it all back within five years."

My favorite part:

And despite the extra cost, most diets currently on the market are not effective. "Let's face it," says Dr. Stephen Gullo, a New York City doctor and author of The Thin Commandments Diet, "this is the only growth industry in the United States where most of the customers fail."

Any honest advice about weight loss has to include this harsh truth: To lose weight and keep it off, you have to change your life. You have to behave differently from the moment you wake up until the time you go to bed. I could name some simple adjustments that might help you lose a few pounds, but big weight loss requires an every-waking-hour overhaul of your approach to food and exercise.

Anybody who says otherwise is just picking your pocket.

(Thanks to Dave Lewis for the Forbes link.)

Posted by LouSchuler at 06:33 AM | Comments (1) | TrackBack

March 28, 2005

The No-Brainer Diet

Reader Rob Siders sent me this email this morning:

One of the things that I find most troubling about [the Terri Schiavo circus] is that she’s now in this state because she is/was bulimic. Heart failure is the number-one cause of death among people with eating disorders, due to electrolyte deficiencies.

Rob goes on to note that eating disorders are the most lethal mental illness of all.

At least one newspaper, the Burlington County Times (based in suburban Philly), picked up on that angle:

Fifteen years ago, her heart, which doctors believe was strained by bulimia, shut down briefly. It was long enough to starve her brain of oxygen.

For Schiavo, a young, attractive woman who was the picture of health, normal life was over.

Experts on eating disorders say the original cause of Schiavo's medical problems has been obscured by debate on end-of-life issues. And they say the case might raise awareness of the dangers of bulimia, anorexia and other food-related syndromes.

Caryn Hartman of the Renfrew Center in Philadelphia, a treatment facility for eating disorders, says even people in her line of work are only now discovering that earlier chapter in Schiavo's medical history.

"I don't think that this [cardiac arrest] happened overnight," said Hartman, the center's assistant vice president and director of nursing and clinical support services.

"As I've done more reading about it, she had struggled with this for a while," Hartman said. "Her symptoms probably worsened over time. She struggled with the over-exercising as well as purging, or vomiting."

And that brings me to perhaps the biggest irony of this death-bed political circus:

The people who want so desperately to keep Terry Schiavo alive are people who, in any other circumstance, would say that Schiavo brought her problems on herself.

Editorial dissonance

Recently, a blogger I like said that watching CNN is a bewildering experience: They purport to cover news 24/7, but they never get around to talking about the issues he actually cares about.

I find almost all media bewildering these days. My wife pointed out to me that our local paper, on a day in which real news was being generated, had a front-page headline about Jennifer Aniston filing for divorce from Brad Pitt.

But what's most disturbing is the selective way so many people choose to consume that media.

Take my father in law, a terrific guy whom I genuinely like.

Somehow the Easter-dinner conversation turned to Terry Schiavo, and he immediately began bombarding us with "facts" that he'd picked up who-knows-where.

Some nurse said "in a sworn affidavit" that Schiavo pointed to her abdomen every month when she started menstruating. Another witness swore under oath that Michael Schiavo -- by no accounts a nice guy -- walked into her hospital room and asked, "Is the bitch dead yet?"

This was news to everyone else at the table. My father-in-law went on about how Michael Schiavo just wanted money, and needed his wife dead so he could marry his longtime girlfriend, to whom he had begun referring as his "fiancee."

Is any of that true? I have no freakin' idea. After he left, I looked up the most comprehensive story I could find, which happened to be this New York Times story about the history of the problems between Michael Schiavo and his in-laws, the Schindlers:

As the brain-damaged Ms. Schiavo lay dying in a hospice and her husband and parents continued to the end their battle over her fate, the rancor built and a transfixed nation wondered how a 12-year-old fight -- even one that everyone agrees began over money -- ever became so bad, culminating in daily court fights and decisions.

The hurled accusations persist: adulterer, opportunists, murderer, liars. Everyone on the street has taken sides, guessing at the motivations of Michael Schiavo and the Schindlers but never knowing for sure.

I couldn't find anything in there about menstrual cycles or Snidely Whiplash questions about whether "the bitch" had shrugged off her increasingly inconvenient mortal coil.

But I did find this, in another Times story:

Patients who have suffered brain damage from oxygen deprivation -- like Ms. Schiavo, whose heart briefly stopped in February 1990 -- almost never recover if they have remained in a vegetative state for more than three months. Most neurologists who have examined Ms. Schiavo say she has been in a vegetative state for about 15 years.

Dr. Ronald Cranford, a Minnesota neurologist who examined her in 2002 as part of a previous court case, said a CT scan of her brain showed very little but scar tissue and spinal fluid. An electroencephalogram measuring electrical activity in the thinking parts of her brain showed no evidence of continued function, he said.

"It's totally flat -- nothing," Dr. Cranford said, "and this is very unusual. The vast majority of people in a persistent vegetative state show about 5 percent of normal brain activity."

So that's what I read when I go looking for concrete information about Schiavo. There is no hope for her, and that's been the acknowledged truth for at least 12 of the 15 years since her initial heart failure.

All the rest of it is just noise. Maybe the husband really is a prick. Maybe they really did have marital problems. Maybe the parents really are saints and he really does want his wife dead so he can collect the rest of the insurance money and live a comfortable life with his girlfriend and their two children.

It doesn't matter.

She had an eating disorder, which seems to have caused her heart failure, which cut off oxygen from her brain and left her in this persistent vegetative state.

If she were the daughter of liberal atheists, and Barbara Boxer and Hillary Clinton were fighting for tax money to keep her on life support, the right-wing echo chamber wouldn't be telling us about poor Terri's menstrual cycles.

They'd be saying she brought her problems on herself, and that brain damage is exactly what she deserved.

Charity isn't their strong suit.

Posted by LouSchuler at 01:34 PM | Comments (2) | TrackBack

March 02, 2005

Rise of the Machine

Two of the three weekly newsmagazines feature weight-loss stories on their covers.

(Time's cover is about the "can-women-do-math" dustup, which for some reason I can't work up a scrap of interest in.)

U.S. News & World Report has a real weight-loss story, which I'll get to in a bit, while Newsweek has this type on its cover:

"Martha's Last Laugh

After Prison, She's Thinner, Wealthier & Ready for Prime Time"

Of course, I couldn't resist wondering what it is about a prison in West Virginia that would help someone like Martha Stewart lose weight (about 20 pounds, according to the article). Alas, the article doesn't say.

But it does report Stewart is popular with her fellow inmates, along with other assertions that smell a lot like relentless PR.

Whatever she's paying her publicist, it's a bargain, since it produced a line like this one: "Prison, it turns out, has been Martha's best career move since she broke out of Westport, Connecticut, 23 years ago."

That's not a press release -- that's a line a journalist wrote in fucking Newsweek.

As publicity goes, it doesn't get any better than that.

Side note: The article talks a lot about her new reality show with Mark Burnett.

I can't read Burnett's name without remembering the days, about a million years ago, when he was promoting an ultra-endurance race called the Eco-Challenge.

He used to call up people like me -- I was at Men's Fitness at the time -- and practically beg us for coverage.

Most of the magazines gave in; I suspect it was more because everyone liked Burnett -- whom I consider a genuinely nice guy, based on my limited contact with him -- than because any of us thought the Eco-Challenge was a particularly newsworthy event.

Let's twist (the truth) again

U.S. News' story carries this headline:

"Eat More, Weigh Less

The Answer May Lie in the New Science of 'Volumetrics'"

Of course, the idea that Volumetrics is "new" disregards the fact that the original Volumetrics book was published more than four years ago.

And, from what I can tell in the U.S. News story, it's the same thing as it's always been: a low-fat diet packed with fiber that helps you feel more full on less food.

I have no problem with that. I'm sure, like any weight-control plan, it works for those who're willing to change their relationship with food and their approach to eating.

Volumetrics is a system of eating that emphasizes foods with less "energy density." That is, you choose foods that weigh the most but contain the fewest calories. The weight is provided by water and fiber, and fruits and vegetables are the poster foods for the concept.

Now, if you're looking at that and thinking it sounds suspiciously "official" -- as in, a low-fat diet with lots of the foods your mother and your government have always told you to eat -- well, you're right.

If you're wondering whether or not it works, consider this, from the article:

In her lab, [Penn State professor and Volumetrics creator Barbara Rolls, Ph.D.] tested these theories recently in the first yearlong clinical trial of Volumetrics, involving 97 obese women. One group was given Volumetrics ideas and encouraged to eat more fruits, vegetables, soups, whole grains, and legumes.

The other group received more traditional and negative messages about restricting fat and portion sizes.

Neither group counted calories or fat grams, yet both groups showed a similar reduction in fat intake, and both groups lost weight. "The low-energy-density diet group ate a greater weight of food over a year but lost more body weight -- about 20 pounds," says Rolls.

The group given negative messages, to eat less fat and smaller portions, lost about 15 pounds. While the 33 percent greater amount of weight lost by the Volumetrics group may not have made anybody skinny, the group also ate more fruits and vegetables -- five servings a day compared with 3.5 -- and a diet lower in energy density and richer in important nutrients.

So, if you stop the spin machine, you see that, over the course of a year, a group of obese women lost either 20 pounds on Volumetrics or 15 pounds on a traditional, "just say low," fat-averse diet.

That's a difference of 5 pounds.

In a year.

Don't get me wrong: Rolls is a serious researcher, and Volumetrics is based on serious research. But if there's any evidence that this approach works dramatically better than any other, I have yet to see it.

Everyone knows they're supposed to eat more fruit and vegetables. Everyone knows that cookies and cakes are crap, whether they're low-fat or filled with lard. Most people know they're supposed to read nutrition labels, looking at serving sizes and calorie totals.

I just don't think, at this stage of the obesity epidemic, lack of information or knowledge is the problem. Lack of motivation, lack of social support, lack of behavioral management -- those are the 800-pound gorillas in the room, and the greatest diet in the world can't take them down.

Posted by LouSchuler at 07:14 AM | Comments (0) | TrackBack

February 04, 2005

They Stole Our Secret Formula!

World's shortest diet book.

(Thanks to Jerry Godbout.)

Posted by LouSchuler at 09:45 AM | Comments (0) | TrackBack

February 02, 2005

Do As I Say

Yesterday my 9-year-old son came home from school with a worksheet touting the Food Guide Pyramid.

Forget, for a moment, the irony of my child being taught in school what my coauthors and I helped demolish in The Testosterone Advantage Plan three years ago.

I'm writing about it because, a couple hours after I saw my son's worksheet, Adam Campbell sent me a new study published in the International Journal of Obesity.

The title:

"Physicians recommendations for and personal use of low-fat and low-carbohydrate diets"

The gist:

When doctors recommend diets to their overweight patients, 56 percent of them suggest low-fat diets, particularly commercial diets, such as Weight Watchers, Ornish, and Jenny Craig.

Just 16 percent recommend low-carb diets.

But when the doctors themselves want to lose weight, 38 percent go for low-carb diets (such as Atkins or South Beach), while just 31 percent choose the low-fat plans they recommend for their patients.

These are small sample sizes (just 97 of 402 doctors surveyed had attempted weight loss in the previous 5 years), but still offer an interesting glimpse at the disparity between what doctors tell their patients to do, and what they themselves do when the need arises.

Posted by LouSchuler at 06:06 AM | Comments (0) | TrackBack

January 28, 2005

Fidgetary Restraint*

Another year, another study on fidgeting from the Mayo Clinic.

This time, they've found that:

* Heavier people, those who gain weight easily, tend to sit still whenever possible.

* Lean people, who control their weight easily, spend up to two more hours a day on their feet.

* The instinct to fidget constantly, or to get up and pace around nervously, is genetically encoded, as is the instinct to sit still when given the chance.

In other words, tough shit, fatties!

Unless you can teach yourself to fidget, you'll have to spend the rest of whatever on a low-carb diet. Buy a treadmill, and set up base camp there.

Meanwhile the fidgety types, the ones who got yelled at in school for throwing spitballs and biting on their pencils, are now the Light Brigade, the people who can eat Twinkies and still fit into the same clothes they wore in college.

The take-away: Don't cooperate with your teachers, unless you want to be fat later in life.

The knights who say "NEAT"

Okay, I'm making fun of good research.

But I think you can understand my frustration.

The Mayo Clinic folks have been doing these fidgeting studies for something like a decade -- they even coined the term "NEAT," for "non-exercise activity thermogenesis" -- to describe the way lean people burn up to 350 extra calories a day just because they can't sit still.

I even interviewed one of the researchers (I think it was Dr. Michael Jensen) when the first of their studies came out.

These are sincere folks trying to come at the obesity problem in a different way. I'm just not convinced it's a particularly useful way.

Their research suggests that you can't change non-fidgeting fat people into nervous thin people, any more than the nuns at my grade schools could change mischievous little pricks like me into quiet, cooperative cherubs.

Born bad, born thin.

Actually, the research does have some entertainment value. Here's how New York Times writer Denise Grady describes the experimental methodology:

[R]esearchers at the Mayo Clinic outfitted 10 lean men and women and 10 slightly obese ones -- all of whom described themselves as "couch potatoes" -- with underwear carrying sensors that measured their body postures and movements every half second for 10 days on several occasions.

Each phase included a 10-day period during which they had to wear the underwear with the sensors around the clock, taking it off for only about 15 minutes a day to shower and get a fresh set from the researchers.

The top was either an undershirt or a sports bra made of Lycra, and the bottom was a risqué-looking pair of shorts with openings at the crotch and backside so the garment would not have to be lowered during the day, which would have disturbed the sensors.

Who says research is boring?

(* I desperately wanted to use the headline "Fidget Goes Hawaiian," but couldn't think of any justification for it. This is the way my brain works early in the morning, before the caffeine kicks in.)

Posted by LouSchuler at 05:24 AM | Comments (7) | TrackBack

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