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2010 Dietary Guidlines

I’ve spent about 3-4 hours going through the 2010 dietary guidelines, and didn’t learn anything new. Of course, I probably already know more than the average reader, given my research for “The Relativity Diet;” still, I was hoping for more. There has been much debate, and research these past five years (since the last round of recommendations in 2005). All of the pertinent links can be accessed here.

The guidelines are based on nearly two hundred questions from eight broad topics: Alcohol, Carbohydrates, Energy Balance and Weight Management, Fatty Acids and Cholesterol, Food Safety and Technology, Nutrient Adequacy, Protein, and Sodium, Potassium and Water.

I was most interested in the questions pertinent to low-carbohydrate diets.

Here are some of the conclusions, the validity of which I hold suspect:

“There is strong and consistent evidence that when calorie intake is controlled, macronutrient proportion of the diet is not related to losing weight.”

“A moderate body of evidence provides no data to suggest that any one macronutrient is more effective than any other for avoiding weight re-gain in weight reduced persons.”

“A moderate amount of evidence demonstrates that intake of dietary patterns with less than 45% calories from carbohydrate or more than 35% calories from protein are not more effective than other diets for weight loss or weight maintenance, are difficult to maintain over the long term, and may be less safe.”

In digging through the studies, and believe me, it was painful. I finally linked to the quoted studies, than accidently closed out the parent page and had no idea how I got there in the first place. One of the primary studies listed in support of the first conclusion listed above was of a cumbersome design that I described in my chapter on low-carbohydrate diets, with my impression being that it was almost designed to demonstrate the conclusions it drew.

The recommendations are not too dissimilar from 2005, and can be reviewed in the above link.

Eat less; low fat, whole grain, with half your plate holding fruits and vegetables, limit sodium intake to less than 2300mg/day, and so on. “Enjoy your food, but eat less,” and “avoid oversized portions.” Wow, that was almost worth the million dollars.

As I’ve said, there is plenty of debate regarding the macronutrient fractions of our diet, the exact role of high cholesterol (if any) in heart disease, and the sole emphasis on a caloric controlled, high-carbohydrate (65%) as the only way. I found the 2010 guidelines insipidly tedious, and as palatable as a bowl of cold Pablum. Instead of boldly going where no government agency has gone before, the Dietary Guidelines Advisory Committee has once again limped across their five-year finish line with a tired refrain based on political correctness and ideology.

A Higher Power

Simply posting my monthly contribution to the NWTC Newsletter, “What’s Cooking?”

There have been a couple of nutrition-related news stories that caught my attention this year past. Perhaps you’ve heard of them? The first one relates to the professor of nutrition at Kansas State University who lost 27 lbs. eating Hostess Twinkies, but to add variety, he also consumed Doritos, sugary cereals and Oreos. Ouch! Let me have some of that pain. Now, the last Hostess Twinkie “fan” of my acquaintance was a morbidly obese, Army-reservist drill sergeant with a malignant personality who tortured me one long summer, long ago in Ft. Leonard Wood, MO–but I digress. The difference between Sgt. Jefferson and the good professor is that the professor limited his caloric intake of all these things sweet to 1800 calories a day. The professor’s daily caloric need for maintenance was 2600 calories. Well? What do you think happened? Naturally, he lost weight. And in losing weight by eating a restricted diet of treats, he made international news. Big deal. This is nothing more than a validation of the first law of thermodynamics (energy cannot be created or destroyed); and should come as no surprise to anyone. I wrote about the exact same concept in The Relativity Diet three years ago, only proposed it as a snicker-bar diet. Unfortunately, I didn’t actually go on the diet—it seems that I probably should have.

The second story is a bit more subtle, slightly more nuanced, tinged with enough science and techno-wizardry to tease one with the promise of possibility. This story too was on all the major networks. It is a story of a gene test—send in a swab of spit, and for around $150 dollars you will find out which type of diet program will work the best for you: the choices being a low-carb, low-fat, or balanced diet, in addition to a targeted exercise program. The claim is based on a study from Stanford in 2007, which I actually summarize on page 282 of my book. Briefly: the study divided 311 women into four groups/diets; Atkins, Zone, low-fat/high-carb (LEARN), and Ornish (vegetarian, high-carb, less than 10%fat). The company selling the test sent swabs to all of the participants of the study, about 30% returned their saliva, and the retrospective (not ideal) results suggested that the women whose genes were matched to their diet lost five times more weight than if they were mismatched. The premise being that a woman whose genes are better for a carb-reducer diet will have difficulty on a low-fat/higher-carb diet. The findings suggest that 45% do best with carb-reducing diets, 39% with lower fat diets, and 16% with balanced diets.

So, do the results warrant one Ben Franklin and half of another? I don’t think so; not yet anyway. Genetics certainly does play a role in obesity, which would require a book or at least a chapter to expound upon; but, the answer is not the test. It is more simple than that.

We know from the above, that, no matter what, ultimately, it’s the calories that matter. You have to account for energy consumed, whether it be Twinkies or beef steak. The next most important things are having an awareness of the role of carbohydrates, taking control of your insulin/glucose axis with a reasonable limitation of the quantity of (good) carbohydrates; and focusing on controlling your intake of (good) fat. The last thing is dialing in a balance of aerobic and resistance exercise. I’m generally not one to say “I told you so.” But, in fact, I did (on page 343) Count calories, eat lower-fat foods and low-glycemic carbohydrates, and look for foods that have almost as much protein as carbohydrates.

I find it irritating, these claims of the discovery of something novel, new, magical, that will somehow make weight-loss easier, less painful, as though you might operate outside of the laws of logic. It is not a matter, at this point in time, of a pill, a test, or a bar. It is a matter of knowledge, empowerment, and the exercise of a free will; perhaps, even, in the belief of a power higher than yourself.

Still no magic pill

The weight-loss drug, sibutramine (Meridia) was withdrawn from Europe earlier this year because of increased cardiovascular risk associated with it’s use; it is still available in the US. The drug rimonabant (Accomplia) was initially available in Europe, but later withdrawn, and it never did pass muster with the FDA because of an associated risk of  psychiatric problems, including suicide.

New drugs in the pipeline include Anexa and Contrave, which contain active ingredients already available separately (bupropion, naltrexone, phentermine and topiramate; in various combinations of one or more). Early results suggest an 8-14% weight-loss as compared to 2.5% in the control group.

A new drug, tesofensine, which inhibits the re-uptake of neurotransmitters (serotonin, dopamine, noradrenaline) thereby allowing for their prolonged action, has shown very positive results in the initial clinical trials (twice as effective as current drugs), but has not yet been approved for use.

It is clear from the above that weight-loss medications are an inexact science, with potential, systemic, unintended side effects. Since I wrote “The Relativity Diet” there still is no pharmacological aid of sufficient benefit to warrant its use. I do not think the risk or expense justifies the marginal loss of 6-10% at one year.

It may be, perhaps likely so, that one day a magic pill there will be; but, not yet. It is necessary to default to science and logic, a rather timeless beauty.

Weight Maintenance II

Consider someone fifty pounds overweight. Using the quick and dirty formula for caloric need (11 calories/pound), that amounts to 550 calories per day to maintain that excess fifty pounds. Now, considering nothing else than the first laws of thermodynamics (calories in=calories out), that someone will have to go on a “diet” that is 550 calories less than what they are currently consuming.

At the end of the “diet,” what would be the most logical maintenance mechanism? Continuing on the diet, of course, forever. If you go back to doing what you were before, there is only one outcome–regaining the weight commensurate with your caloric consumption and daily activity.

A problem arises when the “diet” is not valid long-term, which I allude to in the previous post. If you don’t have ownership of your diet, if it is foreign and not your own, then the risk of recidivism is much higher. This is why I think that you need to have a direct knowledge of the caloric content, carbohydrate and protein content of the foods you eat as opposed to a “system” that gets between you and your energy consumption.

Don’t forget that there are many variables; Diet Induced Thermogenesis, daily exercise (aerobic and resistance training) to elevate your BMI, the timing of meals, and other strategies addressed in the book, all of which will facilitate both weight-loss and maintenance; because, for all my grousing about calories in and calories out, it is obviously more complex than that.

A strategy, implied in the above, that would be helpful for maintenance would be the addition of lean muscle tissue (weight-lifting) to a significant extent, which will increase your basal metabolic rate. I exercise five to six hours a week, about half resistance based, and I’ve found that I maintain my goal weight within a fairly tight range, without having to specifically count calories.

After your “diet,” and by that I also mean your daily energy expenditure habits, becomes ingrained (your new normal), you will be able to do the same.

Your diet is temporary only in the sense that it lasts as long as it takes for you to follow it naturally, without having to count and keep track on a daily basis; and if you vary by more than 5% (like the Holidays), then you start keeping track again.

Hmmm…bacon or a bagel?

When presented with the question: What’s worse for you, bacon, or a bagel? It would seem the answer to be obvious, because, of course, that’s what we’ve been taught; force-fed even, by various governmental agencies these past thirty-plus years. Another thing obvious, and not merely seemingly so, is the painfully ponderous pace with which the government responds to legitimate data, of which I could list a litany of examples; but will mention only one, that being the role carbohydrates play in our metabolic processes, specifically in regard to insulin, obesity and the metabolic syndrome.

Even today, on the National Heart, Lung and Blood Institute (NHLBI) website, you can access the “current” publication of clinical guidelines (from the National Institutes of Health [NIH]) for the treatment of obesity in adults. It is from 1998, and recommends as an optimal diet; low-calorie , less than 30% (approaching 20%) of saturated fat, and 15% protein. Well, do the math and you see that, if you approach the ideal, and limit fat intake to 20%, and protein to 15%, that leaves a remaining 65% for carbohydrates.  There is no mention of the quality studies demonstrating the positive outcomes of caloric-controlled/low-carbohydrate diets, when compared to low-calorie/high-carbohydrate diets. It is as though these behemoth agencies are so invested in their ideology of; Fat:Bad, Carbs:Good, Protein:Equivicol (unless it’s from a plant-based source, in which case it’s good), that they refuse to acknowledge what everyone else already knows—that the more effective diets are those that control carbohydrates in some fashion, and that more protein is not bad.

It’s not that the data’s not there—it is, if you look for it; for instance, a search of the NHLBI yields an article from 2005 with the title, “Replacing Some Carbohydrates with Protein and Unsaturated Fat May Enhance Heart Health Benefits.” And two more recent articles from earlier this year, both funded by the NIH, suggest that saturated fat is not the bogeyman it was long thought to be. The bogeyman, it seems, is actually carbohydrate, especially high-glycemic.

When an individual cuts saturated fat from their diet, assuming that their caloric intake is appropriate, then those calories have to come from another macronutrient, either carbohydrate, protein, or un-saturated fat (olive oil is mono-unsaturated). In one of these recent studies, in which the calories of saturated fat are replaced by those of poly-unsaturated, or mono-unsaturated fat, what is conclusively shown is a reduction in Cardio Vascular Disease (CVD) events. Additionally, if those saturated fat calories are replaced by carbohydrates (especially refined carbs), there is an exacerbation of plaque build-up, increased triglycerides and “bad” cholesterol, and a reduction in “good” cholesterol. The evidence shows that increasing the unsaturated  fraction of fat is a good thing, whereas replacing saturated fat fraction with carbohydrate is a bad thing.

The second study, also funded by the NIH, is what’s called a “meta-analysis,” which is a summary of similar studies; and this analysis was comprised of studies from 5-23 years of follow-up, and a total of 347,747 subjects. What did this study show? It showed that “there is no significant evidence for concluding that dietary saturated fat is associated with in increased risk of Coronary Heart Disease (CHD), or CVD.” I wouldn’t say that this is incredibly shocking information, based on the breadth of research available for review when I was working on my book; in fact, it is entirely consistent with the argument that I make in The Relativity Diet. It is, perhaps not entirely ironic, that these thirty-plus years of “bad information,” propagated by the NHLBI, parallels the rising incidence of overweight and obesity in our unique and exceptional nation.

The fact that fat is not the bogeyman once thought to be is not an excuse to over indulge, because it is energy-dense, at 9 calories per gram, and one still must honor the first law (energy in=energy out); but the next time you find yourself in an early morning breakfast buffet line, you’d probably be better served picking the bacon over the bagel, as long as you are within your caloric requirements, of course.

Am J Clin Nutr 2010;9(3)1:535-46, 502-9

“On Call” with Wendy Weise

I’d like to thank Relevant Radio, Dave Zelzer, and Wendy Weise for allowing me to discuss the aspects of weight-loss and emotional health as presented in The Relativity Diet. I hope that what I shared was meaningful and of use to the listening audience. As is usually the case with me, there are things I’d wished I’d said that I didn’t; but’s that life as they say; or, that’s the way the pickle squirts, as my Grandma Melarvie used to say.

Also, I am thankful for the fact that Julianne Donlon-Stanz managed to “speed read” my book in less than a day, and thought it significant enough to introduce me to Relevant Radio. And I am thankful that our son, Eric, came back home to us after being gone seventeen years (in the desert so to speak), went back to school, met Wayne in class, and invited him over to look at some trees, which is where his wife, Julianne, happened upon my book. Strange how life works. I wonder what Grandma would think about that?

I’ve posted the link to the interview on the “Listen to Radio Interviews” page, which is on the navigation bar at the top of this page.