Wednesday, August 31, 2005

Sensational Headlines: Metabolic Syndrome and the ADA

In recent days a number of headlines have suggested that the American Diabetes Association (ADA), in a joint statement with the European Association for the Study of Diabetes (EASD), have stated that Metabolic Syndrome doesn't exist.

Based on the headlines, I, too, was outraged at the suggestion that one of the leading organizations for diabetes would take such an erroneous position. But, as is often the case, the published review does not synch with the headlines. This is one reason why it is so important that we look at the actual primary sources rather than headlines reporting on the primary! In this instance, the media has sensationalized the published paper, leading to a gross misrepresentation of what the review actually says and why it was published.

Let's take a look at the actual publication in Diabetes Care: The Metabolic Syndrome: Time for a Critical Appraisal

The review opens with the critical paragraph:

The term "metabolic syndrome" refers to a clustering of specific cardiovascular disease (CVD) risk factors whose underlying pathophysiology is thought to be related to insulin resistance. Since the term is widely used in research and clinical practice, we undertook an extensive review of the literature in relation to the syndrome’s definition, underlying pathogenesis, and association with CVD and to the goals and impact of treatment. While there is no question that certain CVD risk factors are prone to cluster, we found that the metabolic syndrome has been imprecisely defined, there is a lack of certainty regarding its pathogenesis, and there is considerable doubt regarding its value as a CVD risk marker. Our analysis indicates that too much critically important information is missing to warrant its designation as a "syndrome." Until much needed research is completed, clinicians should evaluate and treat all CVD risk factors without regard to whether a patient meets the criteria for diagnosis of the "metabolic syndrome."

Basically, the statement makes sense - we know from the evidence (which dates back to the 1980's and continues through the present) of the existence of metabolic-type syndrome: a cluster of oft-related components - obesity, hypertention, dislypidemia and insulin resistence.

What is presently lacking, and what the paper highlights, is:

  • A solid, working definition that has consensus/agreement
  • A thoroughly-understood pathogenesis (that is what happens to someone with the syndrome)
  • An agreed upon treatment course for those diagnoised
  • A standard of care for those diagnosed
  • Effective strategies that can help prevent metabolic syndrome

And these are the core of the paper published - the lack of adequate evidence about what to do with a patient presenting with the components in the cluster of symptoms known as "metabolic syndrome." Nowhere in this paper is there a denial that there is real medical problem in people with this cluster of symptoms.

In reviewing the paper published it comes to light that the ADA and EASD are concerned that without the critical scientific data, we're missing critical information to guide the best treatment.

They call for additional research with specific attention directed toward:

  • A critical analysis of how the syndrome is defined. Are all risk factors equally important? Do some combinations (of two, three, or four factors) portend greater CVD risk than others?
  • A definition of the syndrome, in which variables have defined lower and upper cut points or that uses continuous variables in a multivariate score system (e.g., Framingham/UKPDS risk engine).
  • An evidence-based analysis assessing the rationale and value of adding (or replacing) other CVD risk factors (e.g., age, CRP, family history, a direct measure of insulin resistance) to the definition.
  • An assessment of CVD risk in subjects with combinations of intermediate phenotypes only (e.g., IFG/IGT, mildly elevated triglycerides, blood pressure 120–140 mmHg) and who have, or don’t have, insulin resistance or hyperinsulinemia.
  • An aggressive research agenda to identify the underlying cause(s) of the CVD risk factor clustering.

So, while the headlines blared at us that the ADA has suddenly taken to the idea that Metabolic Syndrome doesn't exist - the actual publication shows that the ADA is concerned with a lack of definition, pathogenesis and treatment; and strongly states we must use an evidence-based approach to tackle these issues. I have to say I agree!

If you're one of millions already diagnoised with Metabolic Syndrome, this paper does not sweep away your diagnosis or diminish the risks you're facing. We know, based on the evidence to date, that the most effective way to reduce risks right now, in those with Metabolic Syndrome (that is with components of the cluster of symptoms) is - weight reduction, adequate nutrition, exercise and reduction of stress.

With regard to nutrition, we now also know through Level 1 evidence that carbohydrate restriction is the fastest drug-free method for addressing the "cholesterol" (e.g. HDL and triglyceride) and "insulin" issues seen in the vast majority of those with the condition.

Saturday, August 27, 2005

Low-Carb: Two Studies - Different Findings

The media last week picked up the news that two studies investigating low-carb diets were completed and the results are in.

The first study from researchers at the University of Illinois found that diet composition rich in protein combined with exercise was more effective for weight loss than the USDA Food Guide Pyramid with both diets providing participants the same calories each day.

Both groups consumed the same number of calories, but the first group substituted high-quality protein foods, such as meats, dairy, eggs, and nuts, for foods high in carbohydrates, such as breads, rice, cereal, pasta, and potatoes.

The really important difference was the fact that when combined wiht exercise, the "high protein" group lost fat while sparing lean body mass and the USDA Food Guide Pyramid group lost muscle - as much as 25% to 30% of their weight loss - with their fat.

But, in the protein-rich, high-exercise group, Layman noted a statistically significant effect. That group lost even more weight, and almost 100 percent of the weight loss was fat, Layman said. In the high-carbohydrate, high-exercise group, as much as 25 to 30 percent of the weight lost was muscle.

In addition to the muscle-sparing effects, those following the higher protein diet also experienced greater improvements in their triglyerides and had a more dramatic (statistically significant) effect on trunk fat (in the mid-section). The researchers credit an increase in leucine in the higher protein, low carb approach as contributing to these effects.

As lead researcher, Donald Layman noted, "The diet works because the extra protein reduces muscle loss while the low-carbohydrate component gives you low insulin, allowing you to burn fat. We believe a diet based on the food guide pyramid actually does not provide enough leucine for adults to maintain healthy muscles. The average American diet contains 4 or 5 grams of leucine, but to get the metabolic effects we're seeing, you need 9 or 10 grams."

To achieve that leucine level, the researcher recommended adding dairy, meat, and eggs, all high-quality proteins, to the diet. According to Layman, losing weight doesn't have to mean relying on supplements to fill in nutritional gaps in your diet. "If you use a high-quality protein approach to your diet, you can actually improve the overall quality of your diet while losing weight," he said.

Now the above study was a four month investigation. That's considered "short-term" and researchers really prefer long-term data, which brings me to the second study in the media this week from down under.

Researchers from Otago University just completed a one-year study comparing conventional diets to Zone-type 40:30:30 diets to high protein, low-carb Atkins-tyle diets.

The new findings are a follow-up to the data released at six months where the researchers concluded that "In routine practice a reduced-carbohydrate, higher protein diet may be the most appropriate overall approach to reducing the risk of cardiovascular disease and type 2 diabetes."

As reported in New Zealand's Stuff, the researchers are now strongly advising against sticking to the restrictive diet for more than a year, because of its potentially harmful effects on the cardiovascular system and anti-oxidant levels.

Hmmm....I wonder, what changed their mind?

How about we go look at the data?

Oh, it's not yet published. But it will - soon - really - in the International Journal of Obesity!

So, we have no data to look at.

We have only a news article at this time to try to assess a research study and data.

Ya know what I call this? Convenient.

But, I digress....what the article does tell us is that the Atkins-type diets lost the most weight but gained more quickly when they abandon the strict rules. As one of the researchers, Dr Kirsten McAuley said, the change after the first six months is "[m]ainly because it was too restrictive, we would certainly have concerns about high-fat diets."

Throughout the article there is anecdotal experiences provided by some who followed the diets. Yet, there is no hard data offered. No data providing insight into cholesterol levels, bone density, weight loss, fat loss, muscle loss, glucose control - basically nothing considered hard data which is what we need here!

Based on what we do have available, it's already clear that part of the "problem" was dieters abandoning the low carb diet for another approach.

If weight gain happened after a switch to a different approach, an approach many consider "healthy and better" - one must ask - WHY! Why did the dieters success reverse on a different approach?

No one seems to be asking that question - instead we find the researchers stating that the problem was the low-carb diet, when the facts available (published data) show the approach worked.

Until the data is published it is difficult to write more about this study. What I will do is await the publication in the International Journal of Obesity and then report back to you my readers what the data reveals! Until then, I see no reason to abandon controlled-carb diets - the weight of the evidence, even with this potential study showing a negative result, still weighs in favor of controlled-carb nutritional approaches!

Thursday, August 25, 2005

The 20-Year Decline Leading to Diabetes

Researchers from Howard Hughes Medical Institute (HHMI) have found there exists a detectable decline in energy production by mitochondria in cells which seems to be a key problem leading to insulin resistance, and later to Type II diabetes. The researchers said that insulin resistance is detectable as early as 20 years before the symptoms of diabetes become evident.

The research, led by Gerald Shulman, may lead to better testing and prevention of Type II Diabetes in the future. Shulman and his colleagues found that the rate of insulin-stimulated energy production by mitochondria is significantly reduced in the muscles of lean, healthy young adults who have already developed insulin resistance and who are at increased risk of developing diabetes later in life.

Their research shows that a decreased ability to burn sugars and fats efficiently is an early and central part of the diabetes problem. This new data also suggest the basic defect lies within the mitochondria, which exist in almost every cell in the human body.

In the new studies, Shulman and colleagues discovered that the mitochondria in muscle cells respond poorly to insulin stimulation. Normal mitochondria react to insulin by boosting production of an energy-carrying molecule, ATP, by 90 percent. But the mitochondria from the insulin-resistant people they tested only boosted ATP production by 5 percent.

Among their findings was also evidence for a severe reduction in the amount of insulin stimulated phosphorus transport into the muscle cells of the insulin-resistant participants. This also points to a dramatic defect in insulin signaling and may explain the observed abnormalities in insulin-stimulated power production in the insulin-resistant study subjects, since phosphorus is a key element in the mitochondrion's complex energy-production process, the oxidative-phosphorylation pathway.

This is some very important research. Not only does it demonstrate that warning signs are evident in the body very early before one actually becomes diabetic, it also indicates that insulin is a strong influence on the overall ability of cells to function properly well before outward signs of insulin resistence and diabetes are measurable.

Today the average American is eating excessive amounts of carbohydrate from very early in life. The human body simply does not need the very high level of carbohydrate we eat on average each day. The constant high level that is eaten is taking its toll slowly inside our cells, damaging our cells ability to effectively utilize the insulin and glucose.

Controlling carbohydrate intake to a level that effectively provides the energy and essential nutrients we do need without being excessive is really an important step to long-term overall health. Not only will controlling carbohydrate help maintain your weight, it also helps to keep your insulin levels stable - something that is key to limiting or avoiding insulin resistance.

We know from various studies that insulin resistance is present in virtually every Type II diabetic. We now know that insulin resistence slowly emerges, over time, as cells lose their ability to function properly. What you eat today truly will have an impact on your health 5, 10, 20-years down the road. The good thing is that it is never too late to modify your eating habits to be health promoting - that is eat a diet rich in essential nutrients, control your carbohydrates, eliminate the junk and include adequate protein and natural fats and oils.

Wednesday, August 24, 2005

Calories Count - In More Ways than you Think

For a number of years now I've suggested that the conventional wisdom of calorie-restriction to lose weight is flawed - that it is very possible to eat too few calories and unwittingly sabatoge weight loss efforts; that many who struggle to lose weight are eating too few calories and undermining their metabolism in the process; and that the standard, one-size-fits-all recommendations to restrict calories to 1200-1600 calories per day for weight loss is too low for too many people.

Without hard data, I've relied on the idea that the Basal Metabolic Rate (BMR) in metabolism may be the trigger for a "conservation of energy" in the human body. That taking daily calories below the BMR triggers what many call "starvation mode" in the metabolism - that is, the body starts to use less energy as it prepares to survive what it perceives as a famine condition.

My recommendation has remained consistent over the years - one must try to determine their BMR and eat enough calories to meet that calorie requirement for basic function so the body will allow for loss of its stored energy - fat on the body. Interestingly, the BMR of most people is much higher than they realize and certainly higher than the often recommended calorie-restriction of 1200-1600 calories per day for weight loss.

For example, a 250-pound woman who is 5'5" tall and 35 years old has a BMR of approximately 1880-calories per day. If she restricts her daily calories each day to 1400 or 1600-calories, she will set her metabolism up to perceive a famine since she is not eating enough calories to meet her body's basic requirements to just function. Over the first few weeks she will lose weight, but she will also unwittingly be slowing her metabolism to perserve her stored energy - her fat stores - to survive the famine the body perceives with a calorie intake that fails to support basic function, which in turn causes the body to conserve energy, which slows or stops weight loss.

Recently hard data was published to support that such a metabolic slowdown exists and happens as one restricts calories.

In the Journal of Clinical Endocrinology and Metabolism, researchers published their findings in a study to investigate the effect of weight loss induced by caloric restriction on diurnal TSH concentrations and secretion in obese humans.

This was a "gold standard" study protocol - a rigorous clinical, prospective, crossover study that measured 24-hour plasma TSH concentrations at 10-min intervals along with the 24-hour TSH secretion rate. The results were fascinating!
  • The 24-h TSH secretion rate was significantly higher in obese women than in normal weight controls
  • Weight loss was accompanied by diminished TSH release (before weight loss, 43.4 ± 6.4 mU/liter·24 h; after weight loss, 34.4 ± 5.9 mU/liter·24 h; P = 0.02)
  • Circulating free T3 levels decreased after weight loss from 4.3 ± 0.19 to 3.8 ± 0.14 pmol/liter (P = 0.04)
  • Differences in 24-h TSH release correlated positively with the decline of circulating leptin (r2 = 0.62; P <>

Now I know some of you are scratching your head wondering - OK, what does that mean?

Well, the researchers stated it best in their conclusions: Elevated TSH secretion in obese women is significantly reduced by diet-induced weight loss. Among various physiological cues, leptin may be involved in this phenomenon. The decreases in TSH and free T3 may blunt energy expenditure in response to long-term calorie restriction, thereby frustrating weight loss attempts of obese individuals.

This data shows that there does exist a measurable slow down in the metabolism with calorie restriction. That slow down can significantly affect weight loss. That it is possible to restrict calories too much and affect the endocrine system in the body, making it adjust and slow the metabolic rate to conserve energy.

Now, researchers did not look at BMR in this study. What this study does confirm is the delicate balance the body has to survive - if you're not providing enough "fuel" the body will slow itself down and conserve energy so it can survive with less calories.

While many staunchly defend the "calories in calories out" perspective, those who have experienced weight loss stalls and stops during calorie restriction can now feel a sense of vindication and begin to understand how to lose weight effectively without damaging your metabolism!

Your first step is to eat enough calories to support your basal metabolic rate.

As you lose weight, your metabolism slowly does require less calories because it does not have the same "bulk" to support, so you must adjust your calories downward SLOWLY as you lose weight, not from the start. Give your body what it requires for calories to meet basic function so it does not try to conserve energy from the start.

In the above example, the calorie requirement each day should be no less than 1900-calories each day until 10-pounds are shed. Then re-calculate the BMR and adjust calories - at 240, the BMR is now approximately 1839-calories, so the requirement is adjusted down to 1850-calories a day for the next 10-pounds of weight loss. This is approximate...the key here is to make sure you're eating at or up to 10% above your BMR.

With each 10-pound loss, an adjustment of calories downward, of about 50-calories per day, helps the body maintain its basic function (blood flow, body temperature, heartbeat, etc.) and allow the loss of stored energy - fat - rather than starvation mode to conserve energy and slow or stop loss of stored energy. As one nears their goal weight, calorie intake is slightly adjusted up to the Active Metabolic Rate (AMR) to allow the body to have the calories it needs to support not only basic function, but also movement each day.

At goal, finding that balance where you no longer lose weight yet do not gain weight is not easy, but not impossible. It means taking the time to get it right and watching your weight to ensure you're not gaining again. If you start to gain, tweak your calorie intake slightly and watch. You will find the right calorie load to maintain your weight and keep your metabolism happy too!

This approach is highly individual - as it should be - and breaks the conventional wisdom that if you just restrict your calorie intake long enough you'll lose weight. Yes, you'll lose weight, but at what cost to your long-term health? To you long-term ability to keep the weight off? To you emotional well being as you struggle to maintain a calorie intake that is too low?

Tuesday, August 23, 2005

Raising the Bar on Breakfast

When you read the newspaper, do you expect the articles and bylined columns to be news or cleverly disguised advertisements?

If you're like me, you expect news or newsworthy information. Too often, in newspapers across the country, you're likely to find items that read like advertisements for a number of products on the market with the newspaper seeming to promote your purchase of such items.

Case in point - in today's Washington Post, Sally Squires' Lean Plate Club column offers readers Passing the Bar On Nutrition - a review of the various breakfast bars available in the marketplace.

Breakfast bars made by Kellogg's, Post, General Mills, Quaker, Kraft and other companies offer a fast-food option to those eating on the run in the morning. Found just down the grocery aisle from their cereal cousins, many are fortified with enough vitamins to rival a multivitamin. To make up for the missing milk, some bars also contain plenty of calcium.

This wasn't merely a 'just the facts' approach to provide information to readers about the existence of such products and the pros and cons of such products - this article named which ones tasted good and made recommendations to readers of the column.

Unfortunately, the article didn't simply state that the breakfast bars are nutritionally poor and just another junk food option you should pass on. Sally Squires actually recommended you eat more than one if the breakfast bar is your option since one may not last until lunch!

Plan on More Than One. The bars will help take the edge off your hunger, but they probably don't have enough calories to hold you until lunch. So either eat more than one bar or have a bar as part of breakfast that includes milk or a cup of low-fat yogurt and some fruit.

While taste testers basically agreed the breakfast bars were too sweet, Ms. Squires enlisted the opinion of an "expert" to encourage readers to eat them. Even so, eating a cereal bar in the morning "is better than eating nothing at all," said registered dietitian Amy Jamieson-Petonic, a spokeswoman for the American Dietetic Association. "Study after study shows the benefit of breakfast."

Yes, there is a benefit to eating breakfast...but quite frankly something that is nothing more than a candy bar in disguise is not breakfast. Ms. Jamieson-Petonic should have stated such and made a recommendation about the benefit of a wholesome breakfast. Instead, she offered nothing more than an endorsement to these various products that are unhealthy, made by companies that support the American Dietetic Association.

Even Ms. Squires idea of a breakfast is nutritionally bankrupt - just have the real thing: a bowl of cereal with low-fat milk and fruit, which can match or exceed the nutritional value of a cereal bar.

While such a breakfast may indeed be better than the breakfast bar, it remains inadequate and will most likely not keep your sated until lunch.

A better option:

Florentine omelete (2 eggs, 1/4 cup spinach, 1-ounce swiss cooked in olive oil)
1-ounce uncured Canadian Bacon
1/2 cup cut canteloupe with 1/3 cup blueberries

Now that's a breakfast to get you started for the day!

Monday, August 22, 2005

"You're Obese"....What Next?

Imagine you're in your doctor's office having an annual physical and the doctor tells you that you're obese and obesity may lead to heart disease, stroke, diabetes, gastroesophageal reflux and even might make it hard for you to find another partner should you outlive your spouse.

What do you do?

Well, for a woman in New Hampshire, her response was to file a complaint with the state Medical Board. She was offended that her doctor told her the truth! When her doctor learned she was upset, he wrote her a letter to apologize to her, but that wasn't enough.

Now you'd think the Medical Board would tell this woman 'hey, you are obese and the things the doctor said may happen because you're obese are all evidence-based' - but that's not what happened. Instead, the medical board is pursuing this case with an investigation.

[T]he board asked the Attorney General's Administrative Prosecution Unit to investigate and seek a resolution to the complaint. A settlement agreement was proposed that would have had Bennett (the doctor) attend a medical education course and acknowledge he made a mistake. He rejected the proposal.

"I've made many errors in my lifetime. Telling someone the truth is not one of them," Bennett said.

A public hearing is likely to be scheduled by the board.

I don't know about you, but to me this is a waste of resources and a waste of time. Doesn't the Medical Board of New Hampshire have some real issues to investigate, like physician incompetence or dishonesty? Do they really have nothing else to do that this is something they actually have time to pursue?

Have we as a society become afraid of the truth so much that we're willing to file complaints against doctors who tell us the truth, because the truth hurts our or someone else's feelings?

Thursday, August 18, 2005

Low-Carb Lifestyle Piques Interest of Researchers

Researchers at SUNY Downstate want to know what real people following a low-carb diet do to maintain their lifestyle.

In an effort to reach those following a low or controlled-carb diet, the researchers have teamed up with an online support forum dedicated to the low-carb lifestyle - Active LowCarber Forums, to host an online survey of 27-questions that takes about 5-minutes to complete.

The questions are designed to give researchers insight into what real people eat on a low-carb diet in the real world. An approach, that until now, researchers investigating low-carb diets have not utilized as they've followed dieters in controlled settings. Reaching those in the "real world" is often cost prohibitive for researchers, but with the access provided by the internet, researchers can now interact with those following a low-carb lifestyle more easily.

With the unique setting of an online low-carb support forum, the researchers hope to reach the very population they'd like to understand better - the low-carb dieter losing weight and those who have lost weight and are maintaining their weight with a controlled-carb lifestyle. The survey is designed to allow users to answer questions and do so only once, so if you take the survey, you cannot take it again.

Dr. Richard Feinman will be leading the study and has designed questions related to eating habits, state of health, activity level and more. For those following a low-carb diet and lifestyle, this is an opportunity to help researchers understand the way of life you're passionate about.

As the start page for the survey notes, [c]arbohydrate restriction continues to be of importance as a method for weight reduction and treatment for diseases such as diabetes and cardiovascular disease. Scientific studies, however, are largely restricted to an abstract, experimental setting and there is a lack of information as to what people really do on low carbohydrate diets and how they feel about them. This survey is designed to help provide this information. The purpose is neither to support nor to criticise any diet but only to provide information.

The survey is found online here: Nutritional Information from an Internet-based Support Group: What can we learn from the Active Low-Carber Forums?

Wednesday, August 17, 2005

Cookie Monster: A Bad Apple?

Captializing on Cookie Monster's new healthy approach to eating, the folks at Musselman's have introduced a line of applesauces designed to appeal to children. The new Sesame Street line of applesauce is promoted on the Musselman's website, which says, Kids will love the taste of Big Bird Green Apple, Cookie Monster Grape and Elmo Cherry.

Gosh, is it really so difficult to get kids to eat applesauce that we must corrupt the natural sweetness and add neon colors to motivate children to eat it?

Which would you rather feed your child:
  • Product 1
    Ingredients: Apples
  • Product 2
    Ingredients: Apples, High Fructose Corn Syrup, Water, Calcium Lactate, Citric Acid, Absorbic Acid (Vitamin C) and Natural Flavor. Yellow 5 and Blue 1 color added.

Product 1 is none other than Musselman's Apple Time Natural Applesauce. Nothing but apples in the jar!

Not only that, it's just 50-calories per 4-ounce serving with 13g of carbohydrate and 2g of fiber. Not bad. Definitely something I would not hesitate to allow my own child to eat.

Now Product 2 is the Big Bird Green Apple applesauce. A new product the website is promoting as healthful! Eating healthy is always better with friends so Musselman's has included some of your child's favorite buddies from Sesame Street on our new, delicious, flavored apple sauce snacks.

Not only does the product have 60% more calories [80 calories for a 4-ounce serving], it has more carbohydrate with 21g of carbohydrate and LESS fiber, with just 1g. It's sweetened with High Fructose Corn Syrup and has added colors!

Shame on Sesame Street for licensing its name to this new line of applesauce! Not only are these products flavored to not taste like real applesauce, they're sweetened with High Fructose Corn Syrup, which has been shown in scientific studies to increase the risk of obesity, not only in adults, but in children!

It's one thing to take away Cookie Monster's cookies - it's another to use the recongized and trusted Sesame Street characters to promote food products that simply will not help children develop sound, healthy eating habits.

These products will only continue to encourage children to develop a sweet tooth that encourages the consumption of more and more sweet foods. Cookie Monster, Big Bird and Elmo do NOT need to be used to promote products that are sweetened with ingredients that are highly suspect in the obesity epidemic we face in the United States!

You can contact the folks at Sesame Street here: Contact Sesame Street and tell them that licensing the Sesame Street characters to promote high fructose corn syrup sweetened foods is sending the wrong message to children about healthy eating habits!

Candy Disguised as Milk

So we call this progress? Milk flavored to taste like a Milky Way candy bar?

Now don't get me wrong, if as an adult you want to drink this liquid candy, that is certainly your choice. I wouldn't recommend it, but it is your choice.

However, when the media suggests that these new products "do a body good" - well, I have a problem with that. Case in point: The Orlando Sentinel today ran the article, It's a milk shake-up as new flavors hit dairy aisle, with the lead sentence, [t]he sugary alternatives still do a body good and are better for children than sodas, some nutritionists say. [emphasis mine]

It's insulting that the media thinks readers will see this as "news." This is most definitely not "news" but a carefully crafted advertisement designed to convince readers that the new flavored sugary milks are good for them and their children!

For kids who hate milk, the discovery of the newfangled flavors can be a real mouth-opener.


The push to sell flavored milk comes during growing concerns about obesity and unhealthy eating, particularly in children. For the past two years, health officials have urged schools to replace soft drinks sold in vending machines with more healthful options, such as water, fruit juice and milk.

Do you really think nutritionists and doctors who have emphasized drinking beverages other than soft drinks - like water and milk - meant sugar-added milk? I don't think so. But, you can always find one somewhere to say that such is a good idea, even when all common-sense tells you it just isn't true!

Rachel Brandeis, a registered dietitian who lives in Atlanta and serves as a spokeswoman for the American Dietetic Association, says she often recommends flavored milk, "especially to moms who can't get their kids to drink milk. . . . Soda doesn't give you any type of added value, only excess calories. Milk, even if flavored, is a good source of calcium, vitamin D and protein."

I wonder if Ms. Brandeis has even looked at the ingredients in these new flavored milks?

The Milky Way flavored milk I have pictured above is a product of Bravo! Foods, recently acquired by Coca-Cola. Their website provides complete nutrition information for visitors, including a list of ingredients in their various products. They are in PDF format, but that's OK - here is the PDF for Slammers Milky Way Milk.

This product isn't simply sweetened with sugar and high-fructose corn syrup. It also has three different artificial sweeteners in it too! I can't even imagine how sweet this is with five total added sweeteners, both natural and artificial!

Here are the ingredients, with the added sugars bolded in black and the artificial sweeteners bolded in red:
Reduced Fat Milk, Sugar, Non-Fat Milk, High-Fructose Corn Syrup, Chocolate Syrup (Cocoa Processed with Alkali, Water, Salt, Vanillin), Potassium Citrate, Sodium Phosphate, Carrageenan, Cllulose Gel, Sucralose, Acesulfame Potassium, Neotame, Vitamin A Palmitate, Vitamin D3.

This is a great example of why you need to read labels! There is no mention of the artifical sweeteners used in the article, and they certainly are not being highlighted on Bravo! Foods website either.

Not only are these products bottled with TWO SERVINGS in a bottle, they are comparable to soda and other soft drinks for sugar content.

Even worse, they have artificial sweeteners, which may or may not be problematic for children to consume...we simply do not have studies and data to support children ingesting large quantities of artificial sweeteners. And if these types of drink do become part of a child's daily diet, it is a large amount of artificial sweetener being ingested, along with added sweeteners like sugar and high-fructose corn syrup.

Folks, the only way children will learn to appreciate beverages like water, 100% fruit and/or vegetable juice and milk is if they are drinking these beverages in their natural state without added sugars or artificial sweeteners!

Tuesday, August 16, 2005

Life Without Trans-Fats

The Washington Post asked, WHAT WOULD LIFE be without pies, frosting, french fries, chips, cupcakes, doughnuts, muffins, popcorn, cookies, crackers, and all manner of processed and packaged foods? in the article Trans Fat Nation.

The above article focuses on the New York City Department of Health's proposal to resturants to voluntarily stop serving food that contains trans-fats and eliminate the use of ingredients high in trans-fats like shortening and stick margarine.

While I applaud this effort and feel consumers have a right to know if the food they're served in a restuarant was prepared with ingredients that contain trans-fats, this blog entry isn't about whether NYC is on the right track or not. It's focused on the question that opened the article in the Washington Post...what would life really be like without trans-fats in our food?

Let me start by saying, not one of the above foods listed requires the cheap, trans-fat laden ingredients to prepare and taste great! Nope, not one.

Instead we allow this ingredient to continue to proliferate in our food system because we buy foods that contain partially hydrogenated oils. We have no one to blame but ourselves if food manufacturers continue to make foods with these fats if we're buying them! It's obvious that public policy makers are not keen on banning their use or mandating their elimination from our food supply.

Why do we seem to like these foods so much? Well, for one thing they last for what seems like forever when we buy them. Shelf-life is the driving force behind food manufacturers using partially hydrogenated oils.

Just how 'shelf-stable' are foods made with partially hydrogenated oils? Try this - go to Boston Market, buy yourself a corn bread. No, I really don't want you to eat it, but this little experiment is telling.

Bring it home and just leave it in the paper bag they put it in on the counter overnight. Check on it in the morning. Is it still moist? Does it appear to still be edible? See how many days it remains in such a moist and seemingly edible state. If you just leave it in that bag it will last (I have done this experiment myself) five days before it starts to get a bit dry. That's the "magic" of partially hydrogenated oils...shelf life is incredibly long, even for foods not packaged in a plastic wrapper.

But, here's the downside. While these man-made fats may extend the shelf-life of food, what they're doing to your body far outweighs this perceived benefit.

Man-made trans-fats increase your risk of heart disease, and the more you eat, the higher your risk. The National Academy of Sciences-Institute of Medicine declared in 2002 that there was "no safe level" of these fats for humans.

If that doesn't speak volumes about how bad these fats are for your health, I don't know what will.

And to answer the question posed by the Washington Post - Life would be a lot healthier if we eliminated these man-made trans-fats from our food supply!

Doing just that isn't as impossible as it seems. All the foods that are currently produced using partially hydrogenated oils can be prepared with healthier natural fats and oils. True, that means we won't have cookies that can last a year in the pantry - but do we really want cookies that can stay "soft and chewy" for a year, or more?

Denmark was the first country to effectively ban partially hydrogenated oils. Oils and fats are forbidden on the Danish market if they contain more than 2 per cent trans fat. The penalty for violation of the law is a fine and up to two years in prison. [Danish Exec. Order No. 160 of 11 March 2003.]

Denmark's food minister said: "We put the public health above the industry's interests."

The Danish Nutrition Council stated: "The results [of four population studies] suggest that the intake of trans fatty acids compared to saturated fatty acids per gram is associated with a 10-fold higher risk increment for the development of coronary heart disease. A negative effect of trans fatty acids on the human fetus and newborns has been further substantiated. The possible effect of trans fatty acids on cancer has not yet been settled. Data from epidemiological studies and from studies on the effect of insulin suggest that trans fatty acids increase the risk of type 2 diabetes. Recent findings justify further studies concerning the effect of trans fatty acids on the development of allergic diseases in children, and of specific trans fatty acids' effect on body fat distribution and on insulin sensitivity."

So why do we, in the United States, continue to allow this ingredient in our food? It's not like the government and public policy makers are unaware of the detriments to health. In fact, they've been well aware for years!

As the Harvard School of Public Health review, Trans-Fatty Acids and Coronary Heart Disease stated:

"By our most conservative estimate, replacement of partially hydrogenated fat in the U.S. diet with natural unhydrogenated vegetable oils would prevent approximately 30,000 premature coronary deaths per year, and epidemiologic evidence suggests this number is closer to 100,000 premature deaths annually."

Let me reiterate that - 30,000 premature coronary deaths per year with evidence suggesting that number could be as high as 100,000 deaths per year! In my opinion, eating partially hydrogenated oils is like slow suicide! If the low estimate, 30,000 deaths per year is accurate, this means that 82-people per day are dying from ingesting trans-fats...scarier is the prospect that the higher estimate, 100,000 deaths per year - that's 274 people dying each day from the trans-fats in their food!

Yet our government's answer is to have manufacturers include the trans-fat content on the Nutrition Facts Panel, a mandatory requirement come Januray 1, 2006. However, that's without any warning to anyone buying a product with a high level of trans-fats in the product! And, products that contain 0.5g or less of trans-fat per serving, not accounting for the 20% margin of error allowed in labeling, can claim the product is TRANS-FAT FREE even though the product does contain some trans-fat!

I don't know about you, but I'm offended that the policy makers think I'll buy the fuzzy math that zero=0.5 or less, and may be higher when the allowed 20% margin of error is factored in.

In my world zero=zero.

The Danish government has shown that not only is it possible to mandate that food manufacturers eliminate a harmful ingredient, but that it is possible to make the same foods with ingredients that are better for us in terms of health in the long-term. Think of it this way - how in the world did anyone enjoy cookies, pie, frosted cake or other foods before partially hydrogenated oils became so popular with food manufacturers?

That's right - they made them with natural fats and oils. We can do the same today!

In the Food Industry we Trust

Food & Drink Europe today ran the commentary, In food makers we trust?

Don't be surprised if you've never heard of Food & Drink Europe - it's an industry-focused website designed to communicate breaking news to industry food marketers and retailers. That doesn't mean that there isn't good information for consumers within it however. In fact, such sites are often rich with information about and insight into the food industry.

The commentary provides some valuable talking points that consumers should be aware of. As the article points out at the start, among the hollers about obesity and the concerns over nutrition, food companies now need to work hard to ensure they clinch public trust, as a matter of insurance... This means being seen as a force for good.

Three main areas are focused on:
  1. Be honest about health
  2. Take safety seriously
  3. Go for the "good" in ingredients

While the article is geared toward an industry reader, the points made in each section can help consumers make good decisions when buying food.

All the Facts

When you're evaluating a food product for purchase, ask yourself, is this manufacturer being honest? As pointed out in the article, [t]he test is simple: would consumers rate this product as healthy if they were given all the facts?

A quick look at ingredients and the nutrition facts label can help a consumer determine if a product touted as "healthy" really is. For example, a cereal touted as a good source of "whole grain" may not be a good choice once you look at added sweeteners or sodium or the nutrition facts panel reveals very little fiber per serving.

As the clothing store Syms advertisements used to say "an educated consumer is our best customer" - food manufacturers need to promote their products with full disclosure - the good and the bad - and not rely on highlighting the good while hoping no one notices the bad.

A pretty straight forward example of this is the breakfast cereal bars Kelloggs All-Bran Brown Sugar Cinnamon Bars. They are marketed as "heart healthy" and even carry a "heart check" logo from the AHA. They're promoted as having 20% of your daily fiber, zero grams of trans-fat, and low-fat.

The ingredients tell another story:

Wheat bran and psyllium high fiber cereals (wheat bran, sugar, psyllium seed husk, oat fiber, high fructose corn syrup, malt flavoring, calcium phosphate, salt, baking soda, caramel color, sodium ascorbate and ascorbic acid [vitamin C], niacinamide, reduced iron, zinc oxide, pyridoxine hydrochloride [vitamin B6], riboflavin [vitamin B2], folic acid, thiamin hydrochloride [vitamin B1], vitamin A palmitate, vitamin B12, vitamin D, BHT [preservative], annatto color), crisp rice (rice, sugar, salt, high fructose corn syrup, malt flavor, thiamin hydrochloride [vitamin B1], niacinamide, calcium pantothenate, pyridoxine hydrochloride [vitamin B6], folic acid), granola (rolled oats, high fructose corn syrup, brown sugar, partially hydrogenated palm kernel oil), corn syrup, high fructose corn syrup, fructose, brown sugar, sunflower oil, inulin from chicory root, partially hydrogenated soybean oil, corn syrup solids, glycerin, dextrose, cinnamon, salt, natural flavor, soy lecithin, acetylated monoglycerides, polysorbate 60, defatted soy flour, almond flour, nonfat dry milk, niacinamide, reduced iron, riboflavin (vitamin B2), BHT (preservative).

While the product may indeed be within the labeling guidelines for trans-fats and not have more than 0.5g per serving, this product does contain partially hydrogenated oils - a source of trans-fatty acids! Research has shown that trans-fats are bad for heart health!

Safety First

In light of the above ingredients, the next caution to industry is valuable - that is, keeping in mind safety of the food produced. Not just in terms of potential recall due to an ingredient problem that may cause spoilage or cross contamination of food, but also to be very aware of the science and health concerns of consumers when it comes to ingredients used.

But a far more damaging prospect would be the first “asbestos” of the food industry – a food widely used today, which in future is confirmed as a killer. Whether its aspartame, soya, GM foods or high fructose corn syrup, in today’s information-driven world, pressure groups quickly move to raise public awareness of missing, or conflicting, scientific evidence. Manufacturers need to be at the forefront in monitoring such risks. They must take a proactive role in credibly removing doubts, or in replacing foods where the doubts cannot be laid to rest.

Use Quality Ingredients

I totally understand that a company needs to maintain a healthy bottomline. What I don't understand is when they use poor quality ingredients or ingredients that are suspect based on science and pretend that consumers don't care. As the article points out, [a] study by British analysts IGD recently found that high quality ingredients are the single most important factor in making a product premium. Shoppers, while still price conscious, are willing to pay the extra for something special.

I know for myself, I read labels and often put an item back on the shelf after reading the ingredients. There are some ingredients, no matter how minor in the product, I will not buy - ingredients like partially hydrogenated oils or high fructose corn syrup. Other, better ingredients are readily available to manufacturers and I simply will not purchase products using what I see as inferior ingredients.

As consumers our greatest power is in our pocketbook. If we stop purchasing products made with poor quality ingredients, manufacturers will have to pay attention if their profitability is being affected.

While I may be just one person and my single effort will have little effect on a company, when large numbers of consumers start paying attention and putting poor quality products back on the shelf - well that's hard to ignore!

Not only does refusing to purchase a product start to make companies pay attention, it also rewards those who are doing the right thing for consumers! Not only have I always found something I'm looking for, with ingredients I feel are acceptable - my purchase of those quality products enables the company making that product to continue their business and build their profitability!

Monday, August 15, 2005

Grandma Was Right

Previous generations were often fed a daily diet of fish oil (often as cod liver oil) by their parents in the belief that these oils confered some protection against illness. My mother occassionally will still interject into a conversation her experience with being made to swallow that "awful" cod liver oil each day. She hated the daily spoonful but had no choice in the matter - it was part of growing up in her day...and not only for her, but for everyone she knew.

Well, now it seems Grandma was right - fish oils are good for you!

Today the Guardian reports on a new study that shows significant benefit for toddlers given fish oils each day in the areas of behavior and intelligence.

After just six weeks of daily doses of Omega-3, parents reported a transformation in the behaviour and learning abilities of children as young as 20 months old.

Professor Robert Winston from the Institute of Reproductive & Developmental Biology at Imperial College London went on to say that children who are not getting enough omega-3 are significantly disadvantaged:

"The evidence is getting ever stronger that children who have diets poor in Omega-3 are not achieving their natural potential."

What were the significant effects of the fish oil supplementation?

The biggest improvements, however, were observed in the children's concentration and behaviour. 'The performance of almost 60 per cent of the children involved has improved dramatically,' said Dr Madeleine Portwood, educational psychologist for Durham local education authority and lead investigator at the Durham Sure Start trial. 'We saw children whose learning skills went from being six months below their chronological age to absolutely normal in just three months.'

An even bigger benefit - "Some two-year-olds went from having a vocabulary of 25 single words to being able to use whole sentences, while others were able to sit down and concentrate for the first time in their lives."

While decades ago Grandma may not have known why fish oils were good for you, we do now - it's the omega-3 content that is beneficial in our diet.

Friday, August 12, 2005

Take a Supplement? Hey, Why Not Eat Food?

The Harvard Health Newsletter this week reported that Vitamin B12 deficiency is the most common nutritional deficiency in the developing world and possibly in the United States as well.

Say what? In the land of plenty, you may be wondering just how it is even possible that such a deficiency occurs!

For starters, we're told to limit our intake of red meat and avoid too many animal products in our diet - and those that we do eat, well, we're told they should be low-fat products. But, the Harvard Health Newsletter doesn't even address this obvious possible connection to B12 deficiency. Instead they attribute the deficiency on normal aging and eating a vegetarian/vegan diet.

Why they chose not to even state the obvious is beyond me. The only reliable unfortified sources of vitamin B12 are meat, fish, dairy products and eggs.

Vitamin B12 deficiency doesn't happen overnight. In fact it takes years and years to creep up on you. Vitamin B12 is stored in small amounts by the body. Total body store is 2-5mg in adults. Around 80% of this is stored in the liver. Vitamin B12 is excreted in the bile and is effectively reabsorbed. This is known as enterohepatic circulation. The amount of B12 excreted in the bile can vary from 1 to 10ug (micrograms) a day. People on diets low in B12, including vegans and some vegetarians, may be obtaining more B12 from reabsorption than from dietary sources.

Reabsorption is the reason it can take more than 10-years for deficiency disease to develop in people changing to diets low or absent of Vitamin B12. In comparison, if B12 deficiency is due to a failure in absorption it can take just 3 years or less for deficiency disease to occur.

Why do we need Vitamin B12?
  • support for the production of red blood cells
  • prevention of anemia
  • allow nerve cells to develop properly
  • help your cells metabolize protein, carbohydrate, and fat

What can indicate a need for more high-vitamin B12 foods?

  • red or sore tongue
  • tingling or numbness in feet
  • nervousness
  • heart palpitations
  • depression
  • memory problems
  • dandruff
  • decreased blood clotting
  • decreased reflexes
  • paleness
  • depression
  • difficulty swallowing
  • fatigue
  • tingling in feet
  • weakness
  • weak pulse
  • menstrual problems

How do other nutrients interact with vitamin B12?

Vitamin B6 is required for proper absorption of vitamin B12, and deficiency of vitamin B6 has been shown to impair B12 absorption in animal studies.

Conversion of vitamin B12 from its non-active into its biologically active form requires the presence of vitamin E. Individuals at risk for vitamin E deficiency may show signs of vitamin B12 deficiency as well.

Contrary to research from the mid 1970s, supplemental doses of vitamin C above the 500 milligram level do not appear to compromise B12 function.

Excessive intake of folic acid can mask B12 deficiencies, and individuals at risk for vitamin B12 deficiency who are also taking folic acid in supplement form should consult with their healthcare practitioner.

The most recent Recommended Dietary Allowances (RDAs) for vitamin B12 were set in 1998 by the National Academy of Sciences. The RDAs were established for all persons 1 year of age and older. For infants under the age of 1 year, Adequate Intake (AI) levels were set. These AI and RDA guidelines are as follows:

  • 0-6 months: 400 nanograms
  • 6-12 months: 500 nanograms
  • 1-3 years: 900 nanograms
  • 4-8 years: 1.2 micrograms
  • males 9-13 years: 1.8 micrograms
  • males 14 years and older: 2.4 micrograms
  • females 9-13 years: 1.8 micrograms
  • females 14 years and older: 2.4 micrograms
  • Pregnant females of any age: 2.6 micrograms
  • Lactating females of any age: 2.8 micrograms

Vitamin B12 deficiency is serious stuff. While taking a supplement may help boost levels back to normal in the body, you're still better off eating real food and choosing foods that contain high levels of B12 - like liver, beef, snapper, shrimp, snapper, scallops, chinook salmon, lamb, cod, halibut, venison, milk, yogurt and eggs.

If you're avoiding red meat and eggs, consider the fish selections above!

Keep in mind, while the Dietary Guidelines for Americans [DGA] encourage you to limit your animal proteins to 5 to 6 ounces each day, this is simply not enough to meet and/or exceed your requirement for Vitamin B12. I've been saying for some time now that the DGA is too low in a number of nutrients for health and well-being. This here is a clear example of how the recommendations to limit animal proteins is potentially affecting health in the United States - if you follow the DGA and limit your animal proteins, you're limiting your intake of Vitamin B12 - a vitamin critical for long-term health!

Little White Lies

The Lexington Herald Leader this week asked, Looks like white bread. Tastes like it, too. But is it? in the article, White or wheat? Experts disagree

The bread in question - Wonder White Bread Fans, a new entry into the market from Interstate Bakeries (makers of Wonder Bread) who state on their website that the bread is the first real 100% whole grain bread created specifically for people who love the mild taste and soft feel of white bread and want the benefits of whole grain nutrition.

The Lexington Herald provided more details.

It took scientists eight long years and millions of dollars to sneak whole grains into that spongy, yeasty icon of U.S. health-unconscious consumerism. Now that they've done it, food manufacturers have begun releasing a bevy of products they hope will get people to eat whole grains.

The thinking was to get more health into the bread and other products people like. In the process, they've created some confusion, even as the U.S. Food and Drug Administration is still trying to define whole-grain products.

While it sounds like an interesting idea, I wonder, why not just make real bread? Do we really want or need food manufacturers "sneaking" ingredients into our food they think are good for us? And, honestly, can we really call this new product "100% whole grain bread"?

The process to make it requires a number of dough conditioners and processes to keep it "soft" to retain a similar "mouth-feel" of regular Wonder Bread. Good, old-fashioned, 100% whole grain bread has a very short list of ingredients and the process is simple - mix, rise, bake.

There is also a lot of marketing hype around this product and products like it right now, including articles touting the benefits of this new bread to parents.

As the Boston Globe reported, It's the business of balancing kids' finicky tastes with the government's nutritional guidelines that's attracting people like Tammy Yarmon, director of nutrition services for Omaha Public Schools. Products that pack extra fiber or other nutrients make the balancing act easier as she tries to average out nutritional requirements -- guidelines recommend at least three daily servings of whole grain -- over a week.

''The hardest thing is to get a kid to eat something that's brown or anything that looks like it has seeds in it," Yarmon said.

Again, what's wrong with simply making a child's lunch with real 100% whole grain bread? Why do adults feel the need to "sneak in" whole grains? How are children going to learn the importance of making good, sound, nutritional choices when they're fooled into thinking they're eating white bread and that it's good for them?

Apparently, not everyone is buying into the marketing hype of the new bread or products like it that are using the new albino wheat.

Touting these products as whole grain is a marketing gimmick that could confuse well-meaning parents, said Dr. Fred Pescatore, a Manhattan internist who specializes in nutrition, and is the author of the best seller, The Hampton's Diet.

Dr. Pescatore is quoted in the Herald Ledger article, "What they're doing is playing to the marketplace perception that whole grain is good for us -- which it certainly is -- but they're putting a little bit in there so they can say that it's there, they're not really doing a great service."

I agree!

Thursday, August 11, 2005

Wired to Crave

People crave the very physical and emotional reward they feel when something they eat makes them feel good. This craving is set in motion by instinct, built upon an ancient strategy for survival that in our modern world occasionally goes horribly wrong. It turns out that our craving-addictive instinct may be what helped make us become the successful species we are today.

Addictions and cravings can come in all shapes and forms, but they all stem from a fancy piece of brain gear called the mesolimbic system. Scientists call this system the reward center of the brain. It works like an internal “High 5” in our brain - when we do something perceived as positive, it tells us “Great Job!” with the release of dopamine, a brain chemical that makes us feel good.

Dopamine is a group of just 22 atoms - eight carbon, eleven hydrogen, one nitrogen and two oxygen atoms - and it plays a significant role in our lives. All the pleasures we associate with certain behaviors seem to involve dopamine. Even something as straightforward as eating gives us a dopamine reward.

When we eat, or have sex, the brain processes a positive stimuli and releases dopamine very deep in our brain, in the nucleus accumbens. The more dopamine released, the better we feel. Interestingly we can get the same feeling by inserting an electrode into the nucleus accumbens and buzzing in a bit of electricity. Understandably, most of us prefer to just settle for a good meal instead.

When the brain rewards us in this way for certain behavior, our instinct is to repeat it, reinforcing in the brain to remember that it’s good for us. While ultimately the brain is not quite that simple, most scientists agree that on a high-level, things work in the brain in this way. The question is, where did this system come from?

Back when humans were far from being the dominant species, effective breeding was the only way to ensure survival and ultimately this meant passing on those genes that favored those who had a strong desire to have sex and find food. Those strong desires were driven by our ancestors’ reinforcement system – the ‘high-5 chemical’ dopamine - that encouraged them to undertake certain behaviors, like eating and reproducing.

Because the individuals with the drive to eat and reproduce were the most likely to pass on their genes, the end result was that their food and sex seeking genes were passed on to us. Even after a few thousand generations, we’re still carrying around pretty much the same genetic paraphernalia upstairs.

While we’ve evolved somewhat from our primitive ancestors into our modern selves, when it comes down to the nitty-gritty, we still need to eat, drink and reproduce in order for our species to remain successful. So the reward system has stuck around, making sure that when we aren’t enjoying our high-tech lives, we’re out looking for food and having sex. The problem is, because the dopamine system is so good at rewarding stimuli, and humans are so good at solving problems, we’ve worked out ways to short-circuit the system and get lots of dopamine in a hurry.

Scientists distinguish between natural rewards, those experiences we evolved to find positive because they contribute to our wellbeing; and artificial rewards like drugs and alcohol, which don’t necessarily add to our wellbeing as a species. Think of it this way, natural rewards are there to make sure healthy living feels good, whereas artificial rewards are there to just make us feel good no matter what.

The most obvious of the artificial rewards humans have stumbled upon are drugs and alcohol. These invade that ‘high-5’ area of the brain to such a degree that they provide a bigger reward than our brain is wired to manage. Over time the repeated over-stimulation of the dopamine system dulls the intensity of natural rewards from things like food and can over-ride our ability to manage the cravings for more and more reward. For some people, this continued pleasure seeking is very addictive because these substances fit exquisitely into our existing dopamine reward system.

Scientists are beginning to fully understand that drugs and alcohol are not the only addictive substances we seek in our never-ending quest for ‘high-5’s’ from the brain. While eating and drinking typically give us a tiny dopamine reward, some ingredients can give us a measurably larger shot of the stuff, especially sugar. In our modern world it is not uncommon to hear someone say they crave sugary foods.

Let’s not forget though, craving and addiction are two separate things. One can lead to the other, and you can have one without the other, but they’re not the same. Craving turns into addiction when the motivation for something changes from receiving a reward to trying to prevent feeling the nasty effects of withdrawal. It’s a switch from a perceived positive reinforcement – the pleasure from the substance – to a distinctly negative reinforcement - avoiding withdrawal when the substance is unavailable.

Today I’m not focused on the addiction side of things, but on the cravings. What sets up our cravings?

You may be surprised to learn that researchers have found that something as benign as talking about a substance can be enough to trigger cravings! Just mention “Krispy Kreme” and, for some people, that’s all it takes to make them crave a donut. Add to this our sense of smell…walk into a house where fresh cookies are baking and it’s a no-brainer you’ll want some. Then there are the visual cues we receive each day – everything from advertisements showing delicious looking treats to watching someone delight in finishing off their ice cream at the table next to yours in a restaurant. Oh, let’s not forget the mouth-feel of silky smooth chocolate mousse or the happiness you felt when you were a kid and your grandfather introduced you to your first taste of banana cream pie.

It comes down to memories and pure instinct.

Simple, positive memories of a pleasurable experience make us want to repeat it.

It felt good before, it will feel good again.

But, here’s the weird part – negative experiences can have the same type of effect.

Memory is complex and we can get confused about which experiences are positive and which are negative, especially if we’re unhappy, in a bad mood or tired. In our desire to alleviate the negative feeling, we crave something we remember gives us the ‘high-5’ from our brain. We do this rather than figure out what is causing the discomfort and relieving that – if we’re tired, rather than go sleep, we’ll eat a candy bar or grab a cup of coffee. People can believe they’re craving one substance when they’re really in need something else. So when you think you need a coffee, you might actually need some sleep or food.

Add to this the very real, very negative feelings created when you are trying to lose weight and eat things you know you shouldn’t. No matter how many times you repeat the process, you still crave more even though you know it isn’t going to make you feel better.

If you’re craving something, the worst thing you can do is try not to think about it – if you do that, all you’re going to do is think about not thinking about it. Now that might sound counter-intuitive, but the best way to beat a craving may be to spend a small amount of time with it and eventually move on to something else rather than ignoring it. Try to figure out what is driving the craving and take care of that rather than going for the ‘high-5’ from your brain.

Better yet, do something different - have a bowl of strawberries with cream instead of that candy bar, or go for a brisk walk - and start re-wiring your brain to give you a 'high-5' from a new, good for you, thing!

It’s important to remember that the mechanism that leaves us susceptible to cravings is also responsible for a lot of positives things too. All in all, we have a very well designed little system. But like anything, too much of a good thing can be bad, even dopamine. Cravings aren’t necessarily bad – they’re actually telling you that you do need something. Rather than just grabbing something sweet next time you have a craving, take some time to understand what is underlying your need for that ‘high-5’ from your brain and take care of that, or try a different thing for that reward, something healthy for you.

We know that it is not just food that provides the release of dopamine we need and desire – dopamine is also released when we’re happy, when we’re active and even when we sleep. If its sleep you need, take a nap; if you’re unhappy, go do something pleasurable, something you really enjoy; and if you’re just in a bad mood, call a friend and talk about it. Eating that sugary food you’re craving isn’t going to make you feel better – in fact, afterward, you may even feel worse!

Did I Mention?

Once or twice a week I review my blog stats and see who's linking to me that I may not know about. Today I had the surprise of learning my blog was mentioned by Jeremy Likeness, in his blog Natural Physiques!

He included this about Weight of the Evidence:

In the spirit of cross-blogging, I encourage you to check out Weight of the Evidence, a very interesting blog. I love the slogan, "Health = Lifestyle, Nutrition, and Activity." You'll find some great links and well-written information about the positive benefits of low-carb nutrition.

Thanks Jeremy!

For my readers, Jeremy's blog is rich with information and complements my own belief that healthy living involves the mind, body, and spirit. Each day he provides commentary on a variety of topics related to health and well-being that I think you'll enjoy!

In the same spirit of cross links and mention, have you noticed I've added more links in my sidebar?

When you have some time, take a moment to head over to and read...

Connie Bennet's Sugar Shock!
Levi Wallach's 12-Black Code Monkeys
Katherine Prouty's Low-Carb Freedom

...each has a unique style and perspective, offering some great ideas and insights into eating well.

Wednesday, August 10, 2005

C is for Cookie...

O is for Obesity...
P is for Parent...

Q is for Quick....think about how...

R is for Ridiculous if you think...
T is for Television....
S is for educating your kids about healthy eating!

Recently, in the news at ABC News, it was reported that Sesame Street Workshop is now promoting their "Healthy Habits" program in order to combat the epidemic of childhood obesity. By introducing this new health focus into their programming, they hope to educate children about the benefits of eating healthy and making good food choices.

In fact, they are using the beloved muppet, Cookie Monster, and reducing his cookie intake. Cookie Monster has also changed his tune from "C is for Cookie" to "Cookie is a Sometimes Snack."

Sacrilege you say?

I grew up watching this lively program and now I have my own child; he too will watch this program as he enters toddlerhood. While Cookie Monster was not my favorite - I was partial to Oscar the Grouch - don't ask! - I did enjoy seeing this cookie eating monster delight in his love for cookies. Hey, haven’t we all?

Let's be honest though, I was a 3-year old and at any opportunity, a cookie monster wannabe as well. But it was not because of the show or the furry blue muppet. No, the truth is, I was a kid and kids love cookies!

Lucky for me I wasn't allowed cookies whenever I wanted them. You see, I credit my parents with having the sense to know when to say "no" to my childhood whims and desires for a large assortment of less than healthy foods. Children simply make eating decisions based on one main thing - does it taste good? Good for them or not, if it tastes good, it appeals to a child.

While it might be comforting to think that the childhood obesity epidemic is caused by the giddy song of the Cookie Monster, the fact remains it is parents who decide what a toddler (the audience for Sesame Street) eats.

A television show is simply not the reason our children are growing fatter - what we're feeding them is the direct cause!

To be honest, I think the producers of Sesame Street are doing a good job, putting together solid programming for small children. I also believe they have good intentions with their decision to try to encourage a greater awareness of healthy eating habits. The problem is and remains however, that parents are typically not watching these programs with their children to reinforce the messages.

Add to that the fact that a televsion does not dispense cookies to a child - it is the parents who are the ones bringing the food into the house and feeding it to their children. Does anyone really think a 3-year-old will tell mom, who has just offered up a cookie, "No, I don't want a cookie, I want some broccoli florets with dip," at snacktime?

Sesame Street didn't cause obesity in children thirty years ago, or twenty years ago, or even ten years ago - to think that suddenly today, the Cookie Monster, who has been an integral part of the show for decades, is now somwhow responsible for causing obesity is silly - to think that Cookie Monster, not parents, will motivate children to eat less cookies in favor of fruits or vegetables is ridiculous.

After all, parents are the ones who buy the food and make the snack decisions for their little ones, not Cookie Monster!

Maybe Big Bird can come up with a tune for parents - P is for Parent, you've got a lot at stake...R is for Responsibility, that's what you need to take...

A Challenge to the Fructose Study

The Corn Refiners Association has challenged the findings of a University of Cincinnati study that asserted the body processes fructose differently, thus leading to greater fat storage. I wrote about that study on July 29th with my blog article Fructose and Obesity.

As Food Navigator reported, [t]he Corn Refiners Association has claimed that a recent study linking fructose in soft drinks with added body fat “mischaracterizes high fructose corn syrup."


“This study unfortunately confuses pure fructose with HFCS,” she [Audrae Erickson, director of the CRA] told

“HFCS used in US caloric soft drinks is either 55 percent fructose or 42 percent - not the mixture of pure 100 percent fructose dissolved in water that was used in this study.”

This contention, that researchers and those who reported on the results of the study somehow confused the ingredient used, fructose, with high-fructose corn syrup is not only laughable, but also a clever ruse to confuse.

As evidenced by the above statement, high-fructose corn syrup does indeed contain fructose and no matter how much the CRA tries to claim that the glucose component somehow offers magical properties to the mix, it cannot deny the fact that HFCS contains fructose!

Numerous studies have shown fructose stimulates fat storage. Unlike the fructose found in fruits, where nutrients and fiber are also present, fructose sweeteners offer no nutrients, just calories. Not only that, they also are metabolized on a different pathway than sucrose or glucose, which may help explain why they stimulate fat storage - fructose, even fructose in fruit, is metabolized in the liver into triglycerides.

“The absence of glucose makes pure fructose fundamentally different from HFCS,” she said. “This is because glucose has been shown to have a tempering effect on specific metabolic effects of fructose."

What's this "tempering effect"? Ah, yes, insulin is released to handle the glucose while the fructose heads over to the liver. Personally I don't conside that a good alternative, instead I call that 'spin' to take your attention off the fact that the fructose is metabolized by the liver to churn out triglylicerides in your blood.

Let's not forget what the study found.

Researchers at the University of Cincinnati allowed mice to freely consume either water, fructose sweetened water or soft drinks. They found increased body fat in the mice that drank the fructose-sweetened water and soft drinks - despite that fact that these animals decreased the amount of calories they consumed from solid food.

This, claimed author Matthias Tschöp, MD, associate professor in UC's psychiatry department and a member of the Obesity Research Center at UC's Genome Research Institute, suggests that the total amount of calories consumed when fructose is added to diets may not be the only explanation for weight gain.

Instead, he said, consuming fructose appears to affect metabolic rate in a way that favors fat storage.

Now, while I can hear the 'calories-in -- calories-out' crowd sighing, here's a possible explanation for this metabolic puzzle...we ate fructose in our evolutionary history when it was available in the various sweet fruits and vegetables we could find during the warm season. This allowed us to pack on some fat for the inevitable lean times to come as the weather cooled and our access to fructose containing foods waned. The body fat stored from the fructose-containing foods we ate enabled us to survive those lean times. At least that's what I think.

And it's a theory held by others too. If you recall, back in June I wrote about Nature and Obesity, and how researchers at the Leeds Institute of Genetics, Health and Therapeutics (LIGHT), at the University of Leeds in the UK, are exploring the relationship between obesity in humans and our departure from our relationship with the environment, or nature. Those researchers are investigating hibernation in animals and why and how they store fat to explore how such mechanisms may work in humans who do not hibernate.

As one researcher, Professor Grant, from LIGHT said "We have fractured our relationship with our environment - we no longer respond to seasons and we don't have a fluctuating food supply. As a result we get obese and what should be a short term protective response to help us over winter becomes chronic, harmful and leads to diabetes and cardiovascular disease.”

Whether the Corn Refiners Association wants to admit it or not, we simply did not eat the volume of fructose, in any form, natural or processed, in the past as we do today. And never before in our history have we suffered the level of obesity as we do today.

While this alone is not "causation," it certainly is a correlation!

Tuesday, August 09, 2005

Brain Food

WebMD had an article yesterday, Obesity Today, Alzheimer's Disease Tomorrow?, that presented evidence to readers about the detriments of high insulin on brain function as we age. We know that people with diabetes are at a higher risk of developing Alzheimer's Disease. But now there's strong evidence that people with high insulin levels -- long before they get diabetes -- already are on the road to Alzheimer's disease.

As the body becomes more and more overweight, it becomes more and more resistant to the blood-sugar-lowering effects of insulin. To counter this insulin resistance, the body keeps making more insulin. If it continues, this escalating cycle of insulin resistance and insulin production end in type 2 diabetes.

It is over time, as insulin is increasing to keep up with the demand on the body and the ever increasing insulin resistence that inflammation comes into play. You may remember I wrote recently about the detrimental effects of inflammation in the body.

Inflamed tissues send off chemical warning signals. These warning signals set off an avalanche of tissue-damaging effects. But insulin doesn't just cause inflammation in the lower body. It also causes inflammation in the brain, find University of Washington researcher Suzanne Craft, PhD, and colleagues. One dangerous effect of this insulin-caused brain inflammation is increased brain levels of beta-amyloid. Beta-amyloid is the twisted protein that's the main ingredient in the sticky plaques that clog the brains of people with Alzheimer's disease.

So just how bad is high insulin? That is the question researchers wanted to try to answer, so they recruited 16-volunteers, aged 55 to 81, who agreed to allow the researchers to infuse their system with glucose and insulin for two hours to measure the short-term effects through spinal tap analysis. The results were startling!

Just this brief rise in insulin levels had what Craft calls "striking" effects:
  • It set off inflammation in the brain.
  • The spinal fluid had increased levels of a compound called F2-isoprostane. Alzheimer's patients have unusually high brain levels of F2-isoprostane.
  • Brain levels of beta-amyloid increased.

Each day millions of Americans engage in a similar experiment (minus the spinal tap) with their bodies - they're overweight, have the start of insulin resistance or are already insulin resistant and eating in a way that maintains high levels of insulin in their bodies.

Because they are overweight and inactive -- and because they may have genetic risk factors -- many people have high insulin levels. It's not good for their hearts. And it's not good for their brains, says Samuel Gandy, MD, PhD.


"Controlling blood sugar and body weight -- all those things we know are good for your heart health are also really good at preventing Alzheimer's disease. So there are more and more reasons not to be slouchy about getting these things under control."

Controlling blood sugar, and thus insulin levels, is much easier if you're controlling your carbohydrate intake by eating real, whole foods, and engaging in activity each day. In the US we have a problem with over-consumption of carbohydrates, especially refined carbohydrates. Our bodies are not designed to effectively metabolize the level of refined carbohydrate we currently eat. Simple modifications in your daily menu can mean big changes in how your body works - and how nimble your brain is!

Is It Food?

Yesterday Dr. Joseph Mercola mentioned an article in his blog - Is It Food? - from the Animal Times Newsletter, a feature of the GoAnimal website. This is a must read!

The article takes readers through a series of witty "rules" for eating a nutritional diet - rules as simple as "Food First!," "Eat Old," and the "Grandfather Clause." Each rule is designed to have you think about what is real food versus what is processed food products. The goal - to have you understand the importance of real food and the detrimental effects food products may have on your health.

The two main culprits of food corruption are trans-fat laden hydrogenated oils and high fructose corn syrup. While these ingredients in food products help maintain shelf life, they do little to enhance your health.

In a to-the-point visual the article shows:

This is food:

This is Food Product:

See the difference? Food looks biological, like living tissue, something you might see outdoors, in a natural environment. Food products look like nothing you've ever seen before.

I hope you'll take a few moments and visit the site and read the article!

Monday, August 08, 2005

The Future is Now

Many months ago researchers took it on the chin when they suggested that children today will will suffer greater incidence of disease and possibly die five years sooner in adulthood than previous generations.

The idea was simply too horrifying to consider. Who can say, in all honesty, they really want to even think it is possible that our children may not live long and healthy lives?

Consider this - research published in the journal Archives of Paediatrics and Adolescent Medicine this month looked at the waist-circumference of 84-children (40 boys and 44 girls), aged six to thirteen and found that:
  • Only 16 of the children were of normal weight (19%)
  • 28 children were overweight (33%)
  • 40 children were already obese (47%)
  • Overweight-obese children accounted for 70% of the children surveyed

More disturbing was the incidence of Metabolic Syndrome and other disorders in those children with the largest waist measures when compared with:

  • Height
  • BMI
  • Systolic BP
  • Diastolic BP
  • High-density lipoprotein [HDL] cholesterol level
  • Triglyceride level
  • Proinsulin level

Waist circumference [WC] and systolic BP were significant independent predictors for insulin resistance.

Multiple linear regression analysis using HOMA-IR as the dependent variable showed that WC and systolic BP were significant independent predictors for insulin resistance adjusted for diastolic BP, height, BMI, acanthosis nigricans, and high-density lipoprotein cholesterol level.

The researchers concluded that [w]aist circumference is a predictor of insulin resistance syndrome in children and adolescents and could be included in clinical practice as a simple tool to help identify children at risk.

If findings like this do not set off alarm bells for parents, I'm not sure what will. I do know that results like these speak volumes that something is very wrong when 70% of the children surveyed are already overweight or obese with a good number of them already presenting Metabolic Syndrome and/or insulin resistance.

As my headline says, the future is now and if we do nothing to reverse this trend of childhood obesity, I fear the researchers who predicted our children will die younger will may be right - and sadly their estimates of living five years less than our current life expectancy estimates may be too conservative.

New Low-Carb News Site Launched

Just when you thought low-carb was dead along comes, a new site dedicated to the low-carb and controlled-carb lifestyle; designed to provide insight, commentary, reviews and news about the lifestyle millions have adopted in their quest for weight management and health.

Launched by my fellow blogger Jimmy Moore of Livin' La Vida Low-Carb, who lost 180-pounds following the Atkins diet (in collaboration with the Worthwhile Company), the site has already brought together a community of recognized of writers in the genre, including yours truly.

The site offers some features you won't find elsewhere - a community forum to comment on the headlines, the ability to add headlines you feel are important for others to read, and if you have a blog - the ability to increase your exposure within the low-carb community via the sites "blogs pot" where your blog can be seen each day!

I hope my readers will mosey on over to, take a peek and add it to their daily reading!

Saturday, August 06, 2005

What’s the Next Diet Craze?

No sooner are the headlines dying down that low-carb is dead and already the media is asking ‘what’s next’ in the line up as the leading fad-diet de jour!

Please tell me why the never-ending quest for a “quick-fix diet” is so prevalent in our society?

Never mind that going on a trendy diet usually results in a temporary weight-loss that rebounds with interest when you return to the eating habits that caused the weight gain; never mind that the science is clear that one must make a permanent change in their eating habits for the long-term to realize sustained weight management; and heck, never mind the inconvenient fact that there is no such thing as a “quick-fix” when it comes to losing weight.

I’ll tell you this – the media loves a good headline, especially when it can sensationalize and tantalize! Pay no mind to the fact that none of this speculating about the next big diet trend will help anyone lose weight and optimize their health for the long-term; the media has newspapers, magazines and advertising slots to sell.

Do you want to lose weight? If you do, you’re not going to find the solution in the headlines, so ignore the hype and look at the evidence to find what works.

Here are the cold hard facts:
  • To lose weight and keep it off, you need to find a dietary approach you can live with for the rest of your life. Losing weight and successfully maintaining your weight-loss requires a permanent change in your eating habits.
  • Low-fat diets, portion control diets, calorie-restricted diets and even low-carb and controlled-carb diets all work for losing weight. Each of these dietary approaches is supported by good scientific data that also clearly shows that a one-size-fits-all diet, one that will work effectively for everyone and anyone, simply does not exist.

With this in mind, your challenge is to find a dietary approach that will not only help you lose weight, but will also allow you to keep it off while enjoying good health for the long-term. After all, that is what matters at the end of the day, isn’t it?

The only diet you need is the one that will work for you. So while the media is speculating about what diet will make the best headlines in the future, you still are left searching for the diet that you can live with and love.

In our fast-paced frenzy we call life, it’s time to step back for a few moments and take stock of the big picture that is too often lost in the small, day-to-day details. We are in the midst of an obesity epidemic in the United States, one where two out of every three adults is overweight, with one of them obese. The solution to this crisis will not be found in any new weight-loss scheme, pill or potion.

In fact, here’s the kicker - we already know exactly how to reverse this health-damaging trend – it’s called “whole foods.” You might remember them, they’re found in the produce section, dairy case, meat & seafood counters and select aisles in your neighborhood grocery store. They’re also very easy to identify – they lack packaging, processing, chemicals and preservatives and they won’t keep on a shelf for years and years.

While it is certainly easier and less time consuming to pop a frozen dinner in the microwave or drive up to a window and have a meal handed to us in a bag that we can eat on the way home, such an approach usually has an unfortunate downside – weight gain, coupled all too often with declines in health. As I've written before in Cheap Food or Health - It's Your Choice, such convenience today may cost more in terms of health and healthcare costs later.

Not only that, but can you honestly say that you really savor such meals - you know, really enjoy them because they’re so tasty and well-prepared? I didn’t think so.

Here’s a plan you don’t have to pay for – eat real, whole foods that appeal to you following a dietary approach you can stick with for the long haul – low-fat, low-carb, controlled-carb, whatever you can make a permanent lifestyle - and I promise you, not only will you lose weight, but your body will also thank you!