U.S. Diet Change Over the Last Century

U.S. obesity rate over last 40 years

Beth Mazur over at Weight Maven has posted a lecture by Dr. Stephan Guyenet in which he outlines the changes in American diet over the last 100 years. It’s only 16 minutes long. You may find an explanation for our excess weight problem.

Steve Parker, M.D.

Book Review: Low-Carbing Among Friends, Vol. 1

A few months ago I read “Low-Carbing Among Friends, Volume 1” by Jennifer Eloff, Maria Emmerich, Carolyn Ketchum, Lisa Marshall, and Kent Altena.

♦ ♦ ♦

If you’re serious about low-carb eating, you’ll want this book. Five well-known low-carb cooks and chefs present many of their best recipes in a straightforward format. All 300+ recipes are gluten-free, wheat-free, and sugar-free. I read through over half of the recipes and understood all the instructions; I’m confident I could make anything in this book.

Some of of the recipe ingredients will be a little hard to find. You may have to order a few of them online, and the authors tell you where to order. Unless you’re just dabbling in low-carb eating, you’ll want to stock up on some of these anyway.

I have an incurable sweet tooth. I like to share my cooking with my wife, but she has, um, (ahem)… “gastrointestinal problems” with my usual non-caloric sweetener, Splenda. That’s not very common, but is a well-known phenomenon. I was glad to learn herein that erythritol is a trouble-free alternative, GI-wise.

One thing I miss about standard high-carb eating is baked sugary items like cakes and muffins. Sure, I’ve read that if you stay away from those for four to six months, you’ll lose your desire. Not me. And I tried. In my next stretch of days off, I’m making a batch of Jennifer Eloff’s Splendid Gluten-Free Bake Mix and spending some time in the kitchen!

Not being previously familiar with him, I was particularly impressed with Kent Altena’s background. Starting at over 400 pounds (182+ kg), he lost over 200 pounds (91+ kg) and reenlisted in the U.S. National Guard and started running marathons (26.2 miles)! Thank you for your service to our country, Mr. Altena.

The book is laced with commentary from low-carb proponents, including Dana Carpender, Jimmy Moore, Dr. John Briffa, Dr. Andreas Eenfeldt, Dr. Robert Su, and me. I am honored to have been invited.

By the way, recipe measurements are given in both U.S. customary and metric units, which non-U.S. residents will appreciate. Serving size nutrient analysis includes digestible carb grams (aka net carbs). All recipe carb counts are under 10 g; most are under 5 g. All of these would jibe with my KMD: Ketogenic Mediterranean Diet.

If you’re tired of eating the same old things, I’m sure you’ll find many new dishes here that will become time-honored classics in your household.

Steve Parker, M.D.

Disclosure: As a supporter of low-carb eating, I contributed two pages to the book. I did not and will not recieve any remuneration, and I purchased my own copy of the book.

PS: Recipes I want to try: Cinnamon Swirl Cookies, Green Bean and Bacon Salasd, Gingerbread Biscotti, Tuan Burgers, Blueberry Muffins, Pecan Sun-Dried Tomato and Bacon Cauli-Rice, Spicy Shrimp with Avocado Dressing, 24-Hour Chili, Harvest Pancakes, Breakfast Casserole, Bacon Wrapped Jalapeno Poppers, Stuffed Mushrooms, Broccoli Bacon Salad, Seven Layer Salad, Sausage Quiche, Low-Carb Pancakes, Stuffed Hamburgers, Eggplant Parmeson, Flax Bread, Splendid Gluten-Free Bake Mix, and Mock Danish.

Competing Theories of Overweight and Obesity

God, help us figure this out

A few months ago, several of the bloggers/writers I follow were involved in an online debate about two competing theories that attempt to explain the current epidemic of overweight and obesity. The theories:

  1. Carboydrate/Insulin (as argued by Gary Taubes)
  2. Food Reward (as argued by Stephan Guyenet)

The whole dustup was about as interesting to me as debating how may angels can dance on the head of pin.

Regular readers here know I’m an advocate of the Carboydrate/Insulin theory. I cite it in Conquer Diabetes and Prediabetes: The Low-Carb Mediterranean Diet and The Advanced Mediterranean Diet: Lose Weight, Feel Better, Live Longer (2nd edition). But the Food Reward theory also has validity. They’re both right, to an extent. They’re not mutually exclusive. The Food Reward theory isn’t as well publiziced as Carbohydrate/Insulin.

Dr. Guyenet lays out a masterful defense of the Food Reward theory at his blog. Mr. Taubes presents his side here, here, here, here, and here. If you have a couple hours to wade through this, I guess I’d start with Taubes’ posts in the order I list them. Finish with Guyenet.

You’d think I’d be more interested in this. I’m still not.

Moving from theory to real world practicality, I do see that limiting consumption of concentrated refined sugars and starches helps with loss of excess body fat and prevention of weight regain. Not for everbody, but many. Whether that’s mediated through lower insulin action or through lower food reward, I don’t care so much.

Steve Parker, M.D.

h/t Dr. Emily Deans

What About Raw Milk?

Caveat emptor

Interest in consuming nonpasteurized milk and cheese seems to be increasing in the U.S. over the last couple years.  I don’t know why.  Is it safe?

In case you’ve forgotten, the process of pasteurization is designed to kill pathogenic organisms that raw milk may harbor.  Campylobacter and Salmonella are two of the common pathogens.

The U.S. Centers for Disease Control and Prevention this month published an article on disease outbreaks associated with nonpasteurized dairy products.  Bottom line: Nonpasteurized products are 150 times more likely to be associated with foodborne illness compared to pasteurized product.  The CDC wants states to consider more stringent regulation.

It’s hard to be sure, but my sense is that foodborne illness related to nonpasteurized dairy products in the U.S. is pretty uncommon, if not rare.

Mark Crislip at Science-Based Medicine says pasteurization is a good thing.

As for me, I see no reason to go out of my way looking for nonpasteurized milk and cheese.

Steve Parker, M.D.

What’s Our Preferred Fuel?

Dr. Jay Wortman has been thinking about whether our bodies prefer to run on carbohydrates (as a sourse of glucose) or, instead, on fats. The standard American diet provides derives about half of its energy from carbs, 35% from fats, and 15% from proteins. So you might guess our bodies prefer carbohydrates as a fuel source. Dr. Wortman writes:

Now, consider the possibility that we weren’t meant to burn glucose at all as a primary fuel. Consider the possibility that fat was meant to be our primary fuel. In my current state of dietary practice, I am burning fat as my main source of energy. My liver is converting some of it to ketones which are needed to fuel the majority of my brain cells. A small fraction of the brain cells, around 15%, need glucose along with a few other tissues like the renal cortex, the lens of the eye, red blood cells and sperm.Their needs are met by glucose that my liver produces from proteins. The rest of my energy needs are met with fatty acids and these come from the fats I eat.

Dr. Wortman, who has type 2 diabetes, in the same long post also writes about oolichan grease (from fish), an ancestral food of Canandian west coast First Nations people.

Folks eating a very-low-carb diet such as the Ketogenic Mediterranean Diet get most of their energy from fats.

Steve Parker, M.D.

Link to Evidence in Favor of HIIT

Tabata's team used stationary bicycles

I ran across this recent scientific review article on HIIT (high-intensity interval training) and thought you might be interested. Looks like it’s slated for publication in The Journal of Physiology.

I’m interested in HIIT as a means to achieve fitness in much less time than the 150 minutes a week of exercise recommended by various public health authorities.

Why didn’t the authors at least mention the oft-cited and apparently pioneering work of Izumi Tabata et al from 1996?

Steve Parker, M.D.

References:

Gibala et al. Adaptations to low-volume, high-intensity interval training (preliminary draft). Journal of Physiology, doi: 10.1113/jphysiol.2011.224725

Tabata, I., et al. Effects of moderate-intensity endurance and high-intensity intermittent training on anaerobic capacity and VO2max. Medicine and Science in Sports and Medicine, 1996 Oct;28(10):1327-30.

Does Eating Meat, Poultry, and Fish Ruin YOUR Mood?

Cow's in a good mood. What a great place to live!

Your mood might improve if you restrict meat, poultry, and fish, according to a pilot study in Nutrition Journal. I don’t have time to read it anytime soon. Why don’t you, and comment below?

-Steve

Reference: Beezhold, Bonnie and Johnston, Carol. Restriction of meat, fish, and poultry in omnivores improves mood: a pilot randomized controlled trial. Nutrition Journal 2012, 11:9 doi:10.1186/1475-2891-11-9. Published: 14 February 2012

Does White Rice Cause Type 2 Diabetes?

Rice was first domesticated in the Yangtze River Valley in China

The following article at Yahoo News suggests it does.

http://ca.news.yahoo.com/white-rice-seen-type-2-diabetes-says-study-233837784.html

Background

Rice was first domesticated 8 or 9000 thousand years ago in China.

Among populations that eat rice as a staple food, white rice is the primary contributor to glycemic load.

Diabetes is characterized by elevated blood sugars.  Glycemic index (GI) is an indicator of how high a carbohydrate source tends to increase blood sugar.  The higher the GI, the higher the blood sugar.  The average glycemic index for white rice is 64; for brown rice it’s 55, and for whole wheat it’s 41. 

Study Method

Boston-based researchers looked for well-designed research that focused on development of diabetes over time, while measuring white rice consumption in the study population.  They found and combined four studies involving populations in China, Japan, the U.S., and Australia.  Out of a total of 352,328 participants, 13,284 developed type 2 diabetes over the course of four to 22 years.

Findings

Comparing the highest white rice consumers (over 450 g/day) with the lowest consumers (under 300 g/day, roughly), the risk of diabetes was 55% higher in the heavy consumers.  This applied only to the Asian populations.  The more rice servings per day, the higher the risk.

The Asian populations ate an average of 3 or 4 servings of white rice daily.  The Western populations ate quite a bit less: 1 or 2 servings weekly.

So What?

Western populations don’t eat nearly as much rice as Asians.  If they did, would they show a similar dose-response to white rice consumption and development of diabetes?  Nobody knows for sure, but I suspect so. 

Glycemic load has already been linked to development of type 2 diabetes in Western populations, at least in women.  To the extent that heavy white rice consumption is a glycemic load, reducing intake may lower risk of diabetes.

Chinese and Japanese at risk for type 2 diabetes should consider cutting back on white rice if they’re at the very high end of consumption.  That’s probably good advice for Westerner’s, too. 

Steve Parker, M.D.

Reference: Hu, Emily, et al.  White rice consumption and risk of type 2 diabetes: Meta-analysis and systemic reviewBritish Medical Journal, 2012:e1454.   doi: 10.1136/bmj.e1454

Whatever Happened to Lard?

Lard? Wut choo talkin' 'bout, Willis?

Lard may be making a come-back. An NPR article reviews its fall from grace, with mention of Upton Sinclair, Procter and Gamble, and Crisco.

Steve Parker, M.D.

h/t Laura Dolson

My Fitness

A maximal exercise treadmill stress test is the standard way researchers measure fitness

This is boring.  You should quit reading now.

A few days ago I suggested some baseline measurements to help you keep track of your fitness level, especially if you’re starting or altering an exercise routine. 

I’m starting a new program soon.  Here are my numbers:

  • Weight: 168 lb (76.2 kg)
  • Height: 5 feet, 11.5 inches (181 cm)
  • Body mass index: 23.3
  • Resting heart rate: pending
  • Blood pressure: pending
  • Maximum consecutive push-ups: 30
  • Maximum consecutive pull-ups: 7
  • Maximum consecutive sit-ups (knees bent, forearms folded over chest): 30
  • 1-mile walk/run: 8 minutes, 45 seconds (jogging anywhere from 6 to 8 mph, average about 6.5 mph)
  • Vertical jump (highest point above ground I can jump to touch): 108 and 3/4 inches (276 cm)
  • Waist circumference: 92 cm (standing) or 87 cm (supine)  [big difference, huh?]
  • Biceps circumference: 33 cm (left) and 33.5 (right)
  • Calf circumference: 39.5 cm (left) and 39 cm (right)
  • Toe touch (stand and lock knees, bend over at waist to touch toes): 7.5 inches (19 cm) above ground

    Me around 2007-2008

I was in much better shape a year ago after I finished 15 weeks of Verstegen’s Core Performance.  The most surprising thing about that plan was that I recovered the ability to bend over and touch my toes; I hadn’t done that since my twenties.  I’m 57 now.  Clearly, I’ve regressed since slacking off from Verstegen’s program. 

I was in much worse shape two years ago, thanks to laziness and the resultant sedentary lifestyle. 

Just before the Verstegen program, I’d also developed some bothersome aching in my left shoulder, probably supraspinatous tendinitis.  I cured that with a couple months of rotator cuff strengthening exercises.

So at this point I’m at an average or moderate level of fitness for me.  If my numbers above seem wimpy, remember that I’m 57-years-old.  Hard to be sure, but I’m fairly confident I’m above the 50th percentile for my age group.

I’ll tell you about my new physical activity plan soon.

Steve Parker, M.D. 

Update April 4, 2012:  I added sit-ups today after finding out that the U.S. Army tests soldiers for sit-ups (among other things) twice yearly.