weight loss

500th Issue Celebration

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Nutrition Breakthroughs Over The Last Two Years

Author: Dr. Stephen Chaney 

celebrationIn the nearly ten years that I have been publishing “Health Tips From The Professor”, I have tried to go behind the headlines to provide you with accurate, unbiased health information that you can trust and apply to your everyday life.

The 500th issue of any publication is a major cause for celebration and reflection – and “Health Tips From The Professor” is no different.

I am dedicating this issue to reviewing some of the major stories I have covered in the past 100 issues. There are lots of topics I could have covered, but I have chosen to focus on three types of articles:

  • Articles that have debunked long-standing myths about nutrition and health.
  • Articles that have corrected some of the misinformation that seems to show up on the internet on an almost daily basis.
  • Articles about the issues that most directly affect your health.

Best Ways To Lose Weight

weight lossSince it is almost January, let’s start with a couple of articles about diet and weight loss (or weight gain). I have covered the effectiveness of the Paleo, Keto, Mediterranean, DASH, vegetarian, and Vegan diets for both short and long-term weight loss in my book “Slaying The Food Myths”, so I won’t repeat that information here. Instead, I will share a few updates from the past 100 issues.

My Tips On The Best Approach For Losing Weight: Every health guru has a favorite diet they like to promote. I am different. My book, Slaying the Food Myths, is probably the first “anti-diet” diet book ever written. Based on my years of research I can tell you that we are all different. There is no single diet that is best for everyone. In this article I have summarized my tips for selecting the weight loss diet that is best for you.

The US News & World Report’s Recommendation For the Best Diets: Each year US News & World Report assembles some of the top nutrition experts in the country and asks them to review popular diets and rank them for effectiveness and safety. In this article I summarize their ratings for 2022.

Does Intermittent Fasting Have A Downside? In previous articles in “Health Tips From the Professor” I have reported on studies showing that intermittent fasting is no more effective for weight loss than any other diet that restricts calories to the same extent. But does intermittent fasting have a downside? In this article I reported on a study that suggests it does.

Can A Healthy Diet Help You Lose Weight? Most investigators simply compare their favorite diet to the standard American diet. And any diet looks good compared to the standard American diet. In this article I reported on a study that compared two whole food diets that restricted calories by 25% to the standard American diet. One calorie-restricted diet was more plant-based and the other more meat-based. You may be surprised at the results.

Omega-3s

Omega-3s continue to be an active area of research. Here are just a few of the top studies over the past two years.omega3s

Do Omega-3s Oil Your Joints? In this article I reviewed the latest information on omega-3s and arthritis.

Do Omega-3s Add Years To Your Life? In this article I discussed a study that looks at the effect of omega-3s on longevity.

The Omega-3 Pendulum: In this article I discuss why omega-3 studies are so confusing. One day the headlines say they are miracle cures. A few weeks later the headlines say they are worthless. I discuss the flaws in many omega-3 studies and how to identify the high-quality omega-3 studies you can believe.

Do Omega-3s Reduce Congestive Heart Failure? In this article I review a recent study on omega-3s and congestive heart failure and discuss who is most likely to benefit from omega-3 supplementation.

Plant-Based Diets

Vegan FoodsWill Plant-Based Proteins Help You Live Longer? In this article  I review a study that looks at the effect of swapping plant proteins for animal proteins on longevity.

Can Diet Add Years To Your Life? In this article  I review a study that takes a broader view and asks which foods add years to your life.

Is A Vegan Diet The Secret To Weight Loss? This is an update of my previous articles on vegan diets. This article asked whether simply changing from a typical American diet to a vegan diet could influence weight loss and health parameters in as little as 16 weeks. The answer may surprise you.

Is A Vegan Diet Bad For Your Bones? No diet is perfect. This article looks at one of the possible downsides to a vegan diet. I also discuss how you can follow a vegan diet AND have strong bones. It’s not that difficult.

Anti-Inflammatory Diets

What Is An Anti-Inflammatory Diet? In this article  I discuss the science behind anti-inflammatory diets Inflammationand what an anti-inflammatory diet looks like.

Can Diet Cause You To Lose Your Mind? In this article  I discuss a study looking at the effect of an inflammatory diet on dementia. The study also looks at which foods protect your mind and which ones attack your mind.

Do Whole Grains Reduce Inflammation? You have been told that grains cause inflammation. Refined grains might, but this study shows that whole grains reduce inflammation.

Nutrition And Pregnancy

pregnant women taking vitaminsHere are the latest advances in nutrition for a healthy pregnancy.

The Perils Of Iodine Deficiency For Women. In this article I reviewed the latest data showing that iodine is essential for a healthy pregnancy and discuss where you can get the iodine you need.

Do Omega-3s Reduce The Risk Of Pre-Term Births? You seldom hear experts saying that the data are so definitive that no further studies are needed. In this article I reviewed a study that said just that about omega-3s and pre-term births.

Does Maternal Vitamin D Affect ADHD? In this article I reviewed the evidence that adequate vitamin D status during pregnancy may reduce the risk of ADHD in the offspring.

How Much DHA Should You Take During Pregnancy? In this article I reviewed current guidelines for DHA intake during pregnancy and a recent study suggesting even higher levels might be optimal.

Is Your Prenatal Supplement Adequate? In this article I reviewed two studies that found most prenatal supplements on the market are not adequate for pregnant women or their unborn babies.

Children’s Nutrition

Here are the latest insights into children’s nutrition.Obese Child

Are We Killing Our Children With Kindness? In this article I reviewed a recent study documenting the increase in ultra-processed food consumption by American children and the effect it is having on their health. I then ask, is it really kindness when we let our children eat all the sugar and ultra-processed food they want?

Is Diabetes Increasing In Our Children? In this article I reviewed a study documenting the dramatic increase in diabetes among American children and its relationship to ultra-processed food consumption and lack of exercise.

How Much Omega-3s Do Children Need? In this article I reviewed an study that attempts to define how much omega-3s are optimal for cognition (ability to learn) in our children.

Diabetes

diabetesHere are some insights into nutrition and diabetes that may cause you to rethink your diet.

Does An Apple A Day Keep Diabetes Away? You may have been told to avoid fruits if you are diabetic. In this article I reviewed a study showing that fruit consumption actually decreases your risk of diabetes. Of course, we are all different. If you have diabetes you need to figure out which fruits are your friends and which are your foes.

Do Whole Grains Keep Diabetes Away? You may have also been told to avoid grains if you are diabetic. In this article I reviewed a study showing that whole grain consumption actually decreases your risk of diabetes. Once again, we are all different. If you have diabetes you need to figure out which grains are your friends and which are your foes.

Heart Disease

Here is an interesting insight into nutrition and heart disease that may cause you to rethink your diet.

Is Dairy Bad For Your Heart? You have been told that dairy is bad for your heart AND that it is good for your heart. Which is correct? In this article I discuss some recent studies on the topic and conclude the answer is, “It depends”. It depends on your overall diet, your weight, your lifestyle, and your overall health.

Breast Cancer

Here are some facts about breast cancer every woman should know.breast cancer

The Best Way To Reduce Your Risk Of Breast Cancer In this article I review two major studies and the American Cancer Guidelines to give you 6 tips for reducing your risk of breast cancer.

The Truth About Soy And Breast Cancer You have been told that soy causes breast cancer, and you should avoid it. In this article I review the science and tell you the truth about soy and breast cancer.

Supplementation

Vitamin SupplementsSome “experts” claim everyone should take almost every supplement on the market. Others claim supplementation is worthless. What is the truth about supplementation?

What Do The 2020-2025 Dietary Guidelines Say About Supplements? Every 5 years the USDA updates their Dietary Guidelines for foods and supplements. In this article I discuss what the 2020-2025 Dietary Guidelines say about supplements. Yes, the USDA does recommend supplements for some people.

Who Benefits Most From Supplementation? Not everyone benefits equally from supplementation. In this article I discuss who benefits the most from supplementation.

Should Cancer Patients Take Supplements? Doctors routinely tell their cancer patients not to take supplements. Is that the best advice? In this article I review a study that answers that question.

Can You Trust Supplements Marketed on Amazon? Amazon’s business model is to sell products at the lowest possible price. But do they check the quality of the products marketed on their site? In this article  I review a study that answers that question.

Is Your Prenatal Supplement Adequate? In this article I reviewed two studies that found most prenatal supplements on the market are not adequate for pregnant women or their unborn babies.

The Bottom Line 

I have just touched on a few of my most popular articles above. You may want to scroll through these articles to find ones of interest to you that you might have missed over the last two years. If you don’t see topics that you are looking for, just go to https://www.chaneyhealth.com/healthtips/ and type the appropriate term in the search box.

In the coming years, you can look for more articles debunking myths, exposing lies and providing balance to the debate about the health topics that affect you directly. As always, I pledge to provide you with scientifically accurate, balanced information that you can trust. I will continue to do my best to present this information in a clear and concise manner so that you can understand it and apply it to your life.

Final Comment: You may wish to share the valuable resources in this article with others. If you do, then copy the link at the top and bottom of this page into your email. If you just forward this email and the recipient unsubscribes, it will unsubscribe you as well.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

 

Can Healthy Eating Help You Lose Weight?

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Who Benefits Most From A Healthy Diet?

Author: Dr. Stephen Chaney 

fad dietsFad diets abound. High protein, low carb, low fat, vegan, keto, paleo – the list is endless. They all claim to be backed by scientific studies showing that you lose weight, lower your cholesterol and triglycerides, lower your blood pressure, and smooth out your blood sugar swings.

They all claim to be the best. But any reasonable person knows they can’t all be the best. Someone must be lying.

My take on this is that fad diet proponents are relying on “smoke and mirrors” to make their diet look like the best. I have written about this before, but here is a brief synopsis:

  • They compare their diet with the typical American diet.
    • Anything looks good compared to the typical American diet.
    • Instead, they should be comparing their diet with other weight loss diets. That is the only way we can learn which diet is best.
  • They are all restrictive diets.
    • Any restrictive diet will cause you to eat fewer calories and to lose weight.
    • As little as 5% weight loss results in lower cholesterol & triglycerides, lower blood pressure, and better control of blood sugar levels.

Simply put, any restrictive diet will give you short-term weight loss and improvement in blood parameters linked to heart disease, stroke, and diabetes. But are these diets healthy long term? For some of them, the answer is a clear no. Others are unlikely to be healthy but have not been studied long term. So, we don’t know whether they are healthy or not.

What if you started from the opposite perspective? Instead of asking, “Is a diet that helps you lose weight healthy long term?”, what if you asked, “Can healthy eating help you lose weight?” The study (S Schutte et al, American Journal of Clinical Nutrition, 115: 1-18, 2022) I will review this week asked that question.

More importantly, it was an excellent study. It compared a healthy diet to an unhealthy diet with exactly the same degree of caloric restriction. And it compared both diets to the habitual diet of people in that area. This study was performed in the Netherlands, so both weight loss diets were compared to the habitual Dutch diet.

How Was The Study Done?

clinical studyThis was a randomized controlled trial, the gold standard of clinical studies. The investigators recruited 100 healthy, abdominally obese men and women aged 40-70. At the time of entry into the study none of the participants:

  • Had diabetes.
  • Smoked
  • Had a diagnosed medical condition.
  • Were on a medication that interfered with blood sugar control.
  • Were on a vegetarian diet.

The participants were randomly assigned to:

  • A high-nutrient quality diet that restricted calories by 25%.
  • A low-nutrient-quality diet that restricted calories by 25%.
  • Continue with their habitual diet.

The study lasted 12 weeks. The participants met with a dietitian on a weekly basis. The dietitian gave them the foods for the next week and monitored their adherence to their assigned diet. They were advised not to change their exercise regimen during the study.

At the beginning and end of the study the participants were weighed, and cholesterol, triglycerides, and blood pressure were measured.

Can Healthy Eating Help You Lose Weight?

Vegetarian DietTo put this study into context, these were not healthy and unhealthy diets in the traditional sense.

  • Both were whole food diets.
  • Both included fruits, vegetables, low-fat dairy, and lean meats.
  • Both restricted calories by 25%.

The diets were designed so that the “high-nutrient quality” diet had significantly more plant protein (in the form of soy protein), fiber, healthy fats (monounsaturated and omega-3 fats), and significantly less fructose and other simple sugars than the “low-nutrient-quality” diet.

At the end of 12 weeks:

  • Participants lost significant weight on both calorie-restricted diets compared to the group that continued to eat their habitual diet.
    • That is not surprising. Any diet that successfully restricts calories will result in weight loss.
  • Participants on the high-nutrient quality diet lost 33% more weight than participants on the low-nutrient-quality diet (18.5 pounds compared to 13.9 pounds).
  • Participants on the high-nutrient quality diet lost 50% more inches in waist circumference than participants on the low-nutrient-quality diet (1.8 inches compared to 1.2 inches).
    • This is a direct measure of abdominal obesity.

When the investigators measured blood pressure, fasting total cholesterol levels, and triglyceride levels:Heart Healthy Diet

  • These cardiovascular risk factors were significantly improved on both diets.
    • Again, this would be expected. Any diet that causes weight loss results in an improvement in these parameters.
  • The reduction in total serum cholesterol was 2.5-fold greater and the reduction in triglycerides was 2-fold greater in the high-nutrient quality diet group than in the low-nutrient-quality diet group.
  • The reduction in systolic blood pressure was 2-fold greater and the reduction in diastolic blood pressure was 1.67-fold greater in the high-nutrient quality diet group than in the low-nutrient-quality diet group.

The authors concluded, “Our results demonstrate that the nutrient composition of an energy-restricted diet is of great importance for improvements of metabolic health in an overweight, middle-aged population. A high-nutrient quality energy-restricted diet enriched with soy protein, fiber, monounsaturated fats, omega-3 fats, and reduced in fructose provided additional health benefits over a low-nutrient quality energy-restricted diet, resulting in greater weight loss…and promoting an antiatherogenic blood lipid profile.”

In short, participants in this study lost more weight and had a better improvement in risk factors for heart disease on a high-nutrient-quality diet than on a low-nutrient-quality diet. Put another way, healthy eating helped them lose weight and improved their health.

Who Benefits Most From A Healthy Diet?

None of the participants in this study had been diagnosed with diabetes when the study began. However, all of them were middle-aged, overweight, and had abdominal obesity. That means many of them likely had some degree of insulin resistance.

Because of some complex metabolic studies that I did not describe, the investigators suspected that insulin resistance might influence the relative effectiveness of the two energy-restricted diets.

To test this hypothesis, they used an assay called HOMA-IR (homeostatic model assessment of insulin resistance). Simply put, this assay measures how much insulin is required to keep your blood sugar under control.

They used a HOMA-IR score of 2.5 to categorize insulin resistance among the participants.

  • Participants with a HOMA-IR score >2.5 were categorized as insulin-resistant. This was 55% of the participants.
  • Participants with a HOMA-IR score ≤2.5 were categorized as insulin-sensitive. This was 45% of the participants.

When they used this method to categorize participants they found:

  • Insulin-resistant individual lost about the same amount of weight on both diets.
  • Insulin-sensitive individuals lost 66% more weight on the high-nutrient-quality diet than the low-nutrient-quality diet (21.6 pounds compared to 13.0 pounds).

The investigators concluded, “Overweight, insulin-sensitive subjects may benefit more from a high- than a low-nutrient-quality energy-restricted diet with respect to weight loss…”

What Does This Study Mean For You?

Questioning WomanSimply put this study confirms that:

  • Caloric restriction leads to weight loss, and…
  • Weight loss leads to improvement in cardiovascular risk factors like total cholesterol, triglycerides, and blood pressure.
    • This is not new.
    • This is true for any diet that results in caloric restriction.

This study breaks new ground in that a high-nutrient quality diet results in significantly better:

  • Weight loss and…
  • Reduction in cardiovascular risk factors…

…than a low-nutrient quality diet. As I said above, the distinction between a “high-nutrient-quality” diet and a “low-nutrient-quality” diet may not be what you might have expected.

  • Both diets were whole food diets. Neither diet allowed sodas, sweets, and highly processed foods.
  • Both included fruits, vegetables, grains, and lean meats.
  • Both reduced caloric intake by 25%.
    • If you want to get the most out of your weight loss diet, this is a good place to start.

In this study the investigators designed their “high-nutrient-quality” diet so that it contained:

  • More plant protein in the form of soy protein.
    • In this study they did not reduce the amount of animal protein in the “high-nutrient-quality” diet. They simply added soy protein foods to the diet. I would recommend substituting soy protein for some of the animal protein in the diet.
  • More fiber.
    • The additional fiber came from substituting whole grain breads and brown rice for refined grain breads and white rice, adding soy protein foods, and adding an additional serving of fruit.
  • More healthy fats (monounsaturated and omega-3 fats).
    • The additional omega-3s came from adding a fish oil capsule providing 700mg of EPA and DHA.
  • Less simple sugars. While this study focused on fructose, their high-nutrient-quality diet was lower in all simple sugars.

ProfessorAll these changes make great sense if you are trying to lose weight. I would distill them into these 7 recommendations.

  • Follow a whole food diet. Avoid sodas, sweets, and highly processed foods.
  • Include all 5 food groups in your weight loss diet. Fruits, vegetables, whole grains, dairy, and lean proteins all play an important role in your long-term health.
  • Eat a primarily plant-based diet. My recommendation is to substitute plant proteins for at least half of your high-fat animal proteins. And this study reminds us that soy protein foods are a convenient and effective way to achieve this goal.
  • Eat a diet high in natural fibers. Including fruits, vegetables, whole grains, beans, nuts, seeds, and soy foods in your diet is the best way to achieve this goal.
  • Substitute healthy fats (monounsaturated and omega-3 fats) for unhealthy fats (saturated and trans fats) in your diet. And this study reminds us that it is hard to get enough omega-3s in your diet without an omega-3 supplement.
  • Reduce the amount of added sugar, especially fructose, from your diet. That is best achieved by eliminating sodas, sweets, and highly processed foods from the diet. I should add that fructose in fruits and some healthy foods is not a problem. For more information on that topic, I refer you to a previous “Health Tips” article .
  • Finally, I would like to remind you of the obvious. No diet, no matter how healthy, will help you lose weight unless you cut back on calories. Fad diets achieve that by restricting the foods you can eat. In the case of a healthy diet, the best way to do it is to cut back on portion sizes and choose foods with low caloric density.

I should touch briefly on the third major conclusion of this study, namely that the “high-nutrient quality diet” was not more effective than the “low-nutrient-quality” diet for people who were insulin resistant. In one sense, this was not news. Previous studies have suggested that insulin-resistant individuals have more difficulty losing weight. That’s the bad news.

However, there was a silver lining to this finding as well:

  • Only around half of the overweight, abdominally obese adults in this study were highly insulin resistant.
    • That means there is a ~50% chance that you will lose more weight on a healthy diet.
  • Because both diets restricted calories by 25%, insulin-resistant individuals lost weight on both diets.
    • That means you can lose weight on any diet that successfully reduces your caloric intake. That’s the good news.
    • However, my recommendation would still be to choose a high-nutrient quality diet that is designed to reduce caloric intake, because that diet is more likely to be healthy long term.

The Bottom Line 

A recent study asked, “Can healthy eating help you lose weight?” This study was a randomized controlled study, the gold standard of clinical studies. The participants were randomly assigned to:

  • A high-nutrient quality diet that restricted calories by 25%.
  • A low-nutrient-quality diet that restricted calories by 25%.
  • Continue with their habitual diet.

These were not healthy and unhealthy diets in the traditional sense.

  • Both were whole food diets.
  • Both included fruits, vegetables, low-fat dairy, and lean meats.
  • Both restricted calories by 25%.

The diets were designed so that the “high-nutrient quality” diet had significantly more plant protein (in the form of soy protein), fiber, healthy fats (monounsaturated and omega-3 fats), and significantly less fructose and other simple sugars than the “low-nutrient-quality” diet.

At the end of 12 weeks:

  • Participants on the high-nutrient quality diet lost 33% more weight than participants on the low-nutrient-quality diet (18.5 pounds compared to 13.9 pounds).

When the investigators measured cardiovascular risk factors at the end of 12 weeks:

  • The reduction in total serum cholesterol was 2.5-fold greater and the reduction in triglycerides was 2-fold greater in the high-nutrient quality diet group than in the low-nutrient-quality diet group.
  • The reduction in systolic blood pressure was 2-fold greater and the reduction in diastolic blood pressure was 1.67-fold greater in the high-nutrient quality diet group than in the low-nutrient-quality diet group.

The authors concluded, “Our results demonstrate that the nutrient composition of an energy-restricted diet is of great importance for improvements of metabolic health in an overweight, middle-aged population. A high-nutrient quality energy-restricted diet enriched with soy protein, fiber, monounsaturated fats, omega-3 fats, and reduced in fructose provided additional health benefits over a low-nutrient quality energy-restricted diet, resulting in greater weight loss…and promoting an antiatherogenic blood lipid profile.”

In short, participants in this study lost more weight and had a better improvement in risk factors for heart disease on a high-nutrient-quality diet than on a low-nutrient-quality diet. Put another way, healthy eating helped them lose weight and improved their health.

For more details on this study, what this study means for you, and my 7 recommendations for a healthy weight loss diet, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Does Time-Restricted Eating Have A Downside?

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Are The Benefits Of Time-Restricted Eating An Illusion?

 Author: Dr. Stephen Chaney

intermittent fastingWeight loss is difficult. If you are like most American adults, you have tried at least 5 or 6 diets by the time you are 50, and all of them have failed. Or maybe you have found a diet that works reasonably well at helping you lose weight, but it’s difficult to stick with. And you worry that it may not be healthy long-term.

But hope springs eternal, and there are always new diets to try. One of the newer diet fads is something called intermittent fasting. The most popular form of intermittent fasting (because it is the easiest to follow) is something called time-restricted eating.

The concept is simple. You don’t change what you are eating. Instead, you restrict the time during which you are eating those foods. Typically, you restrict your time of eating to 8 hours a day and abstain from all food the rest of the day. Hence, the term “time-restricted eating”.

I won’t go into the supposed benefits of time-restricted eating. You have probably heard those already from advocates of this form of eating. But you may be wondering if those benefits are true and whether time-restricted eating has any drawbacks.

Fortunately, a recent study (T Moro et al, Medicine and Science In Sports & Exercise, 53, 2577-2585, 2021) answers those questions. It put a group of athletes on either a control diet or a time-restricted diet for an entire year and looked at the relative benefits and drawbacks of both diets.

How Was This Study Done?

Clinical StudyThis study recruited 19 healthy, resistance-trained males (average age = 29, average weight = 185 pounds) for the study. All the subjects had at least 5 continuous years of resistance training, no steroid use, and no known medical conditions.

The subjects completed a 7-day food diary prior to the study, at the end of 2 months, and at the end of 12 months. The participants were instructed not to change their usual caloric intake or diet composition. In addition, each participant received a personalized diet protocol based on the analysis of their food diary at baseline.

The results from the first two months have previously been reported (T Moro et al, Journal of Translational Research, 14: 290, 2016). This report covers the subsequent 10 months.

During the first two months, the participants were contacted weekly by a dietitian to ensure adherence to the diet. During the interviews, the dietitian asked questions about meal timing and composition, appetite, and any difficulties in maintaining the diet protocol. When necessary, the dietitian gave advice to improve adherence to the diet. During the subsequent 10 months, the participants were contacted less frequently, and the interviews were shorter.

The participants were divided into two groups. The selection was random except that the two groups were matched with respect to caloric intake at baseline (~2,900 calories/day).

The ND (normal meal distribution) group ate their meals over a 12-hour period, with meals at ~8AM, 1 PM, and 8 PM. The distribution of calories for this group was 25%, 40%, and 35% over the three meals.

The TRE (time-restricted eating) group ate their meals over an 8-hour period, with meals at ~1PM, 4 PM, and 8 PM. The distribution of calories for this group was 40%, 25%, and 35% over the three meals.

The training regimen consisted of strength training specifically designed to increase muscle mass. A standardized 3-times per week training regimen was established during the first two months of supervised training. The participants continued the same training regimen on their own for the next 10 months. Workouts were performed between 4 and 6 PM to fall within the eating window for both groups.

Finally, tests for inflammatory markers, cholesterol & other blood lipids, blood sugar control, hormones, body composition, and strength were performed before the program started, at 2 months, and again at 12 months.

What Are The Benefits Of Time Restricted Eating?

thumbs upWhen the investigators looked at health outcomes at the end of 12 months:

  • Inflammatory markers were significantly reduced in the TRE (time-restricted eating) group compared to the ND (normal meal distribution) group.
  • Blood sugar control was significantly improved in the TRE group compared to the ND group.
  • Lipid profiles were significantly improved in the TRE group compared to the ND group.

These results are consistent with the findings of earlier short-term studies on the benefits of time restricted eating.

The authors concluded. “Our results suggest that long-term time-restricted eating in combination with a resistance training program is feasible, safe, and effective in reducing inflammatory markers and risk factors.”

At this point you are probably thinking, “It sounds like everything I have heard about time-restricted eating is true. I can’t wait to get started.”

What Causes The Benefits Of Time-Restricted Eating?

SkepticBefore you jump on the time restricted eating bandwagon, let’s look more closely and ask what caused these apparent health benefits.

When the investigators looked at changes in caloric intake over the 12-month period:

  • The TRE group spontaneously decreased their total caloric intake by 6.4% in spite of being told not to change their diet.
    • The decrease in caloric intake was driven by a decrease in both carbohydrate and fat intake, while protein intake remained constant.
    • Most of this change occurred between 2 and 12 months when they were no longer being closely supervised by dietitians.
  • In contrast, caloric intake and macronutrient intake did not change significantly for the ND group.

The reason for the decrease in caloric intake is not known.

  • If you follow social media or blogs about time-restricted eating, you have been given some scientific-sounding mumbo-jumbo about how the 16 hours of fasting changes your metabolism and/or reduces your appetite. However, this is speculation. There is scant evidence for it.
  • A more likely explanation is that when you restrict the time you allow yourself to eat, you naturally eat less without thinking about it. You are simply less hungry when the second and third meals roll around. [This may explain why even these highly disciplined athletes required weekly coaching by dietitians to keep their caloric intake constant.]

And when the investigators looked at changes in body weight over the 12-month period:

  • The TRE group lost 3.4% of their body weight.
    • Most of that weight loss was due to a decrease in fat mass, but there was also a loss of muscle mass.
  • In contrast the ND group increased their total body weight by 3.4%.
    • In other words, at the end of 12 months the difference between the TRE and ND groups amounted to almost 7% of their body weight. This difference was highly significant.
    • Most of the increase in body weight in the ND group was due to a 2.9% increase in muscle mass.

These results are also consistent with the findings of earlier studies of time-restricted eating.

The observed decrease in body weight and fat mass is important because whenever you decrease body weight and fat mass, you:

  • Reduce inflammatory markers.
  • Improve blood sugar control.
  • Improve lipid profiles.

In the words of the authors, “…it is plausible that the caloric reduction observed in the TRE group may have contributed to the reductions in body mass and additional health benefits…”

Of course, that still sounds pretty good. Who wouldn’t want to lose weight and get healthier? But are the weight reduction and health benefits unique to time-restricted eating? That is the claim of those who promote this diet.

But is it true? To answer that question, we need to take a broader view of popular diets. We need to ask, “Is something special about time-restricted eating, or would other restrictive diets give similar results?”

Are The Benefits Of Time-Restricted Eating An Illusion?

The TruthThere are two diet truths that nobody is talking about:

1) Forget the metabolic mumbo-jumbo. The primary reason restrictive diets cause you to lose weight is that you unconsciously eat less while you are on these diets.

For time-restricted eating, you eat less because you have restricted the time when you can eat. With other restrictive diets, you have restricted the foods you can eat. The reason why that causes you to eat less is more subtle. I call it the “Bagels and Cream Cheese Effect”.

    • When you go on a low-fat diet, it sounds great to say you can eat all the bagels you want. But without the cream cheese, bagels become boring, and you eat less.
    • When you go on a low-carb diet, it sounds great to say you can eat all the cream cheese you want. But without the bagels, cream cheese becomes boring, and you eat less.

2) The proponents of fad diets make them look good by comparing them to the typical American diet. Anything is better than the American diet. However, when you make the comparisons based on the reduction in caloric intake or the amount of weight lost, the health benefits of popular diets are virtually identical. For example:

    • When you compare the Atkins diet and other low carb diets with the typical American diet, inflammation is lower on the low carb diets. However, one recent study compared people on the Atkins diet with people who had lost an equal amount of weight on a balanced diet that included all food groups. Guess what? Inflammation is much higher on the Atkins diet when you compare it to a healthy diet that gives equal weight loss.
    • This study reported that the time-restricted eating group ate less, lost more weight, and had better health parameters than the control group. However, previous studies that compared time-restricted eating with groups that reduced caloric intake to the same extent by simply counting calories have found the two groups had identical weight loss and improvement in health parameters.

In other words, there is nothing magical about time-restricted eating. Any diet that causes you to eat less will give identical results. There are only two questions left:

  1. Can you stick with time-restricted eating long term?

Time-restricted eating is not everyone’s cup of tea. But this study suggests that if you can stick with it better than with other restrictive diets, you are likely to lose weight and reap some health benefits.

2) Should you stick with time-restricted eating long term?

To answer this question, you need to know whether there are any downsides to time-restricted eating.

Does Time-Restricted Eating Have A Downside?

thumbs down symbolOf course, most people would consider weight loss and an improvement in health parameters as a definite plus. It’s all good. Or is it? Does time-restricted eating have any downsides? This study identified two potential downsides:

1) Decreased anabolic hormones.

    • Anabolic hormones (hormones that stimulate an increase in muscle mass) were decreased in the TRE group. Specifically:
      • Testosterone was decreased by 17% at the end of 12 months in the TRE group.
      • Insulin-like growth factor-1 (IGF-1) was decreased by 14% in the TRE group.
    • Both anabolic hormone levels were unchanged in the ND group.

2) Decreased muscle mass. Between months 2 and 12:

    • Muscle mass was decreased by 2.3% in TRE group and increased by 2.9% in the ND group.
    • The cross-sectional area of arm and thigh muscles was decreased by an average of 4.3% in the TRE group and increased by an average of 8.5% in the ND group.

In the words of the authors, “With our results, we confirmed that a long-term TRE protocol could impair the ability of maintaining muscle mass, possibly because of a reduction in caloric intake and a direct effect of fasting on the production of anabolic hormones.”

That is putting it mildly. The participants in this study were engaged in a rigorous 3-times/week strength training program specifically designed to increase muscle mass and were consuming over 100 grams of protein a day. So, a continuous increase in muscle mass and cross-sectional area would be expected. This was seen in the ND group but not in the TRE group, which actually lost muscle mass. The average “Joe” or “Jane” would likely lose even more muscle on this diet.

And continuous, long-term loss of muscle mass has significant health consequences including:

  • Decreased metabolic rate, which makes it more difficult to maintain a healthy weight.
  • Decreased insulin sensitivity, which increases the risk of diabetes.
  • Increased risk of osteoporosis.
  • Muscle weakness, which increases the risk of falling.

Dr. Paoli, the lead scientist on this study, was quoted as saying, “The main take home message is that there are pros and cons to prolonged time-restricted eating. Although time-restricted eating may produce some physiological advantages, it is not a miracle as often suggested in social media posts.”

The Bottom Line 

A recent study looked at the pros and cons of following a time-restricted eating (TRE) diet compared to a diet with normal meal distribution (ND) for 12 months.

  • The TRE group had reduced inflammation, better blood sugar control, and better lipid profiles than the ND group.

However, the improved health parameters were not caused by some magical metabolic changes due to fasting.

  • The TRE group unconsciously reduced their caloric intake and lost weight compared to the ND group. And any time you lose weight, you get reduced inflammation, better blood sugar control, and better lipid profiles.

In the words of the authors, “…it is plausible that the caloric reduction observed in the TRE group may have contributed to the reductions in body mass and additional health benefits…”

And there is nothing unique about time-restricted eating.

  • Any restrictive diet is likely to give similar results. (For more details, read the article above.)

Finally, there were some significant downsides to time-restricted eating.

  • The TRE group had a reduction in anabolic hormones and lost muscle mass.

In the words of the authors, “With our results, we confirmed that a long-term TRE protocol could impair the ability of maintaining muscle mass, possibly because of a reduction in caloric intake and a direct effect of fasting on the production of anabolic hormones.”

This is putting it mildly. The participants in this study were engaged in a rigorous 3-times/week strength training program specifically designed to increase muscle mass and were consuming over 100 grams of protein a day. They should have gained muscle mass. Instead, they lost it.

Continuous, long-term loss of muscle mass has significant health consequences including:

  • Decreased metabolic rate, which makes it more difficult to maintain a healthy weight.
  • Decreased insulin sensitivity, which increases the risk of diabetes.
  • Increased risk of osteoporosis.
  • Muscle weakness, which increases the risk of falling.

Dr. Paoli, the lead scientist on this study, was quoted as saying, “The main take home message is that there are pros and cons to prolonged time-restricted eating. Although time-restricted eating may produce some physiological advantages, it is not a miracle as often suggested in social media posts.”

For more details read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Can You Lose Weight Without Going On A Diet?

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8 Tips For Eating Less

Author: Dr. Stephen Chaney 

New Year DietYou have just made your New Year’s resolutions, and weight loss is probably near the top of the list. You may be considering the latest new diet fad – never mind that you’ve tried lots of diets in the past and have always regained the weight you lost.

Perhaps the very thought of going on a diet terrifies you. You are tired of struggling to follow strict “rules” and forgoing all your favorite foods. You are tired of constantly being hungry.

What if you could lose weight without going on a diet? What if you could learn just a few tricks that would help you eat less every day? Would that be of interest to you? Do you think it might help you lose some weight and keep it off?

This week I’m going to share 8 tips for eating less every single day from Professor Brian Wansink of Cornell University. He is Director of their Food and Brand Lab. He has devoted his career to studying how external clues influence our eating patterns. He is the author of the best-selling books “Mindless Eating” and “Slim by Design”. He is the world expert on this topic.

A few years ago, I had the pleasure of attending a seminar he gave. Here’s a quick summary of what I learned.

8 Tips For Eating Less

Tip #1: The Size Of The Container Matters

Popcorn bagsIn one of his research studies he gave moviegoers who had just eaten dinner either a big bag or a small bag of stale popcorn. Those given the big bag ate 34% more. Think about that for a minute. The subjects in his study weren’t hungry. They had just eaten dinner. The popcorn wasn’t particularly tasty. It was stale. Yet they ate 34% more based solely on the size of the bag!

The take home lesson is always to choose the smallest container when given a choice. This is also why you want to serve your meals on small plates and drink your beverages in small glasses or cups. If you want to snack while you watch TV, place your snack food in a very small container and store the rest out of sight.

Tip #2: Don’t Fall For Marketing Hype

He was asked to consult for a cafeteria serving health food because they weren’t attracting enough customers. He just advised them to change the names of their menu items (e.g. “Succulent Tuscany Pasta” instead of “Italian Pasta”). Sales increased by 27%.

The take home lesson is not to fall for the marketing hype. Restaurants and food manufacturers know all the tricks. They know how to make even ordinary foods sound delicious. Make your food choices based on the ingredients of the food, not on the marketing description.

Tip #3: Make Junk Food InconvenientCandy Dish

In another study he put clear glass dishes of candy either on a secretary’s desk or 6 feet away on a cabinet. The secretaries consumed 125 more calories/day from candy when it was on their desk. Think about that for a minute. 125 excess calories/day could amount to around one pound of weight gain/month, 12 pound/year, 60 pounds every 5 years, and a whopping 120 pounds over 10 years!

The take home lesson is to make high calorie snacks and junk foods inconvenient. Put them in the back of your refrigerator, on the top shelf of your cabinets, or other out of the way places. Even better, don’t bring them home in the first place.

Tip #4: Watch The Refills.

When he used a refillable soup bowl (it never goes below half full) people ate 73% more soup than those given a regular bowl of soup. When he asked the people with the refillable bowl if they were full, they replied “How could I be? I only ate half a bowl of soup”.

Of course, most of us will never experience a refillable soup bowl. However, if you are having a meal with friends and enjoying the conversation, it is easy to ignore the refills – either from your waiter at a restaurant or your favorite aunt at a family gathering.

Tip #5: Low Fat Doesn’t Mean “Eat More”

lowfatWhen he took a batch of trail mix and labeled some as “low fat” and some as “regular” people ate 21% to 46% more calories of the “low fat” trail mix. This was not an idle exercise. In fact, many low fat foods aren’t low calorie, but people assume that they are and use that as an excuse to eat more.

The take home lesson is to not assume you can eat more just because a food is labeled low fat, gluten free or some other healthy sounding description. In many cases, it has just as many calories as the full fat version. Even if it is, in fact, lower in calories, the only way you benefit from the reduced calories is when you consume the same portion size as you would for the full fat food it replaces.

Tip #6: Health Foods Are Not Necessarily Healthy

When he showed people an Italian sandwich and told them that it was from either “Jim’s Hearty Sandwich Shop” or from “Good Karma Healthy Foods”, people estimated the calories as 24% lower if they thought it came from Good Karma.

The take home lesson is that health foods are not necessarily healthier. Food manufactures know that health food is in, and they market their products accordingly. If you walk down the aisles of your favorite health food store, you will find “health” foods that are just as high in sugar, fat and calories as the junk food you can buy at the convenience store down the street. They may contain “natural” fats and sugars, but those have just as many calories as the “unhealthy” fats and sugars in the junk foods. You still need to read labels and choose unprocessed fruits, vegetables and whole grains whenever possible.

Tip #7: Don’t Call It ExerciseNature Walk

When he took students on a walk around a lake before dinner, they ate more calories at dinner if they were told that it was an exercise walk than if they were told that it was a sight-seeing walk – and most of the extra calories came from dessert. Think about that for a minute. It is a human tendency to reward ourselves for virtuous behavior, but when that reward involves eating, it becomes self-defeating.

The take home lesson is two-fold.

  • Reframe our virtuous behavior. If we call it exercise or a work-out, it implies that we have done something virtuous and deserve a reward. If we call it a nature walk or think of it as a sport, it becomes its own reward. If we think of substituting a salad for a dinner of fried chicken and mashed potatoes with gravy as virtuous behavior, we may think we deserve a dessert as a reward. If we think of the salad as a gourmet experience, it can become a reward in its own right.
  • Rethink our rewards. The reward doesn’t need to be food related. It could involve reading a book, watching a show, or whatever you favorite activity might be.

Tip #8: Knowing This Stuff Isn’t Enough.

The fascinating thing is that his research shows it doesn’t matter how intelligent or well informed you are.

He did a study with 60 graduate students. Just before winter break, he gave them a lecture on external eating cues in which he specifically told them that they would eat more from a big bowl of Chex Mix than from a small bowl. The students then spent 90 minutes in small group exercises designed to show them how to overcome external eating cues.

After winter break he invited those same students to a Super Bowl party in which he divided them into two rooms and gave them, you guessed it, either large or small bowls of Chex Mix. The ones given the large bowls ate 53% more!

He later gave the same lecture to a meeting of The American Diabetes Association (Those are the experts) and then repeated the same experiment with them – and they still ate more from the large bowls.

Can You Lose Weight Without Going On A Diet?

Question MarkThat brings us back to the original question, “Can you lose weight without going on a diet?” You can start by decreasing the amount of food you eat.

Dr. Wansink’s research clearly shows that overeating is mindlessly dependent on external eating cues, AND that you can’t avoid being influenced by those external clues even if you are intelligent and motivated! So what can you do?

Dr. Wansink recommends planning ahead. For example:

  • Serve your food on small plates and don’t leave food lying around where you can see it or get to it easily.
  • If you bring home a box or bag of snack food (hopefully healthy snack food), divide it up into healthy portion sizes as soon as you bring it home.
  • Put the healthy food choices in the front of your refrigerator or cupboard where you will see them easily and hide the unhealthy foods in the back (or don’t bring them home to begin with).

However, the most important thing is to realize most of this behavior is mindless. It is not enough to simply understand these external eating cues at an intellectual level. We need to be constantly vigilant for external eating cues, or we will find ourselves overeating without really understanding why.

Hopefully, these tips will help you eat less and attain a healthier weight next year than you did this year. However, these 8 tips are just the tip of the iceberg. If this article has piqued your interest and you’d like to learn more, I recommend you read one of Dr. Wansink’s books.

Finally, for best results I recommend that you also:

  • Make healthier food choices.
    • Whole unprocessed or minimally processed foods have a lower caloric density than the highly processed foods most of us eat.
    • People eating whole food, primarily plant-based diets generally weigh less than people eating the typical American diet or meat-based low carb diets.
    • Don’t overwhelm yourself. Simply substitute one healthy food choice for one unhealthy food choice every week or so. There are no “rules”. You choose which substitutions you want to make and how often you want to make them.
  • Exercise more.
    • Just don’t call it exercise. If you look forward to your sport, dance, etc., you are more likely to keep doing it.

The Bottom Line

If you are like most people. You want to lose weight but dread going on another diet. What if you could lose weight without going on a diet? What if you could learn just a few tricks that would help you eat less every day?

  • Brian Wansink’s research has shown that overeating, to a large extent, is mindlessly dependent on external eating cues, and that you can’t necessarily avoid being influenced by those external clues even if you are intelligent and motivated!
  • I have distilled his research into 8 simple tips to help you eat less and attain a healthier weight next year than you did this year.

For more information and other suggestions for losing weight without going on a diet, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

A Vegan Diet And Weight Loss

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Is A Vegan Diet The Secret To Permanent Weight Control?

New Year DietThe new year is here, and you, like millions of other Americans, have decided this will be the year to get your weight under control. But how to do that is the question.

You have tried lots of diets over the years. You have given up sugar, then high-fructose corn syrup, then carbs in general. You have eliminated whole food groups from your diet. You have restricted your eating to between noon and 4 PM. You have eaten cabbage on Tuesdays and grapefruit on Thursdays (Just kidding about that one, but some fad diets are almost that bizarre).

You lost weight at first, but none of those diets were sustainable. You started adding back your favorite foods. Then the pounds you lost came back – and brought their friends with them.

At this point you may be desperate. You may be tempted to try one of those “magic” supplements that promises to rev up your metabolism and make those pounds melt away. Resist that temptation! Those supplements are either dangerous or worthless – sometimes both.

Or you may be tempted to sign up for one of those expensive diet programs that sends you low calorie versions of all your favorite junk foods. Don’t waste your money. You don’t really need more highly processed food in your diet. And you aren’t learning healthier food choices.

But what if…

…you could rev up your metabolism just by eating a healthy diet?

…you could lose weight naturally without counting calories or reducing portion sizes?

…you could keep most of the weight off permanently?

The study (H Kahleova et al, JAMA Network Open.2020; 3(11): e2025454) I will review today says there is diet that does all of these things. It is not the latest, greatest fad diet. In fact, it has been around for years. It is called the vegan diet.

How Was The Study Done?

Clinical StudyThis was a small, but very well-designed, study. It enrolled 244 obese (average BMI = 33), middle aged (average age = 54) subjects (87% female, 48% white). They were randomly assigned to a vegan diet or control diet and followed for 16 weeks.

The control group was told not to change their diet and exercise routine.

The vegan group was also told not to change their exercise routine. In addition, they were given printed materials and attended weekly classes that provided detailed instructions and cooking demonstrations to help them follow a vegan diet.

The vegan diet consisted of fruits, vegetables, whole grains, and legumes with no animal products or added fats. 75% of the calories came from carbohydrate, 15% from protein, and 10% from fat.

The diets of both groups were assessed by a 3-day dietary recall at the beginning of the study and 16 weeks later, at the end of the study. In addition, dietitians made unannounced telephone calls at random times during the week and weekends to assess the participant’s adherence to the diet.

In the vegan diet group, mean intake of carbohydrate and fiber increased, while intake of fat, protein, and cholesterol decreased. There was no significant change in intake in the control group.

The other parameters measured at the beginning of the study and week 16 were:

  • Body composition:
    • Weight and BMI (a measure of obesity).
    • Fat mass and lean muscle mass.
    • Belly fat.
    • Fat stores in liver and muscle (accumulation of fat stores in the liver and muscle is associated with insulin resistance).
  • Parameters of blood sugar control and insulin resistance:
    • Fasting blood glucose and hemoglobin A1c levels were measured.
    • Insulin secretion and blood glucose levels were measured during a 3-hour oral glucose tolerance test. Insulin secretion was used as a measure of insulin resistance, and blood glucose levels were used as a measure of insulin sensitivity (Note: This is a very simple explanation of complex calculations.)
  • Lipid Levels:
    • Total cholesterol.
    • HDL and LDL cholesterol.

A Vegan Diet And Weight Loss

Vegan FoodsThe study results were impressive:

  1. The vegan group lost 14 pounds, while the control group lost only 1 pound. There were two reasons for the greater weight loss in the vegan group:
    • The vegan group decreased their caloric intake by almost 500 calories per day. This was most likely due to the lower caloric density (calories per serving) of plant foods.

In other words, the vegan group consumed fewer calories without focusing on weight loss or portion size. They ate until they were full and consumed fewer calories in the process. Isn’t this what everyone wants from a weight loss diet?

    • The thermic effect (calories burned due to digestion) of the food they ate increased by 14% in the vegan group. This is because it requires more energy to digest foods when your digestive system has to break down the cellular matrix found in unprocessed plant foods.

In other words, the vegan group burned more calories every day just by eating healthy foods. No other diet can promise this.

2) Fat mass decreased by 10% (9 pounds) in the vegan group but was unchanged in the control group

3) Lean body mass (muscle mass) decreased by 1 pound in the control group and 4.6 pounds in the vegan group. There are two important observations here:

    • All the weight loss in the control group came from muscle.
    • 33% of the weight loss in the vegan group came from muscle. This is the only negative outcome from this study and is likely due to the decreased protein intake in the vegan group. Previous studies suggest this loss of lean body mass could be prevented by increasing the protein content of the diet with a plant-based protein supplement.

4) Belly fat decreased by 15%, liver fat was decreased by 31%, and muscle fat was decreased by 19% in theBelly Fat vegan group. All three parameters were unchanged in the control group.

    • This is perhaps the most significant observation from these studies since these are the three deadliest forms of fat in our bodies. Any diet that significantly reduces these forms of fat is likely to dramatically improve our health.
    • These parameters have not been measured in most studies of other weight loss diets, so we have no idea whether other weight loss diets have this effect.

5) Fasting blood glucose decreased by 11%, insulin resistance decreased by 40%, and insulin sensitivity increased by 22%. These parameters were unchanged in the control group.

    • Note: While insulin resistance and insulin sensitivity are opposite ways of measuring the same phenomenon, they were measured in different ways in this study. That is why the percentage change was different for these two parameters. The important thing is that both parameters changed by a significant percentage in a direction that reduces the risk of type 2 diabetes.
    • These data show that just 16 weeks on a vegan diet is sufficient to significantly reduce the risk of developing type 2 diabetes. Previous studies have shown that a vegan diet can reverse type 2 diabetes for many people.

6) Total cholesterol decreased by 11% and LDL cholesterol decreased by 16%. Both parameters were unchanged in the control group.

Is A Vegan Diet The Secret To Permanent Weight Loss?

As I said, the results of this study are impressive. But you have probably heard similar claims for other diets like keto, paleo, etc. To put this into context for you I am going to discuss “The Truth (about weight loss diets) Nobody Talks About” and The Questions (about weight loss diets) Nobody Asks”.

truth signThe Truth Nobody Talks About: Why are there so many conflicting claims about weight loss diets? They can’t all work, or can they? Here is the truth nobody talks about.

If you just focus on short term weight loss and improvement in health parameters like cholesterol and blood sugar levels, the very low fat vegan diet and the very low carb keto diet give virtually identical results.

That statement is true for any restrictive diet, but I chose the vegan and keto diets because they are as different as any two diets can be. That means you can forget all the scientific-sounding mumbo-jumbo about why each diet is best and focus instead on what they have in common. Here is what they have in common.

  • They all compare themselves to the typical American diet. The American diet is high in saturated fat, high in sugar, high in refined carbs, and high in junk foods. Almost any diet is better than the typical American diet!

Unfortunately, none of these diets compare themselves to each other, so we don’t know which is best. We just know that all of them are better than the typical American diet.

  • All of them are whole food diets. Any diet that cuts out sodas, junk foods, and highly processed foods will result in weight loss and better health.
  • All of them are restrictive diets. Some restrict sugar. Others restrict fat. Some eliminate particular foods. Others eliminate food groups. Some restrict the time of day you can eat. When you do any of these things you are forced to focus on what you eat.

And when you focus on what you eat, you lose weight. That is why diets that force you to count calories, count carbs, or keep a food journal are successful.

Don’t misunderstand me. Although the vegan and low carb diets have not been directly compared in clinical trials, vegan diets may have some unique benefits that other diets do not. For example, this study shows that:

  • Because of the low caloric density of unprocessed plant foods, you can eat more food and consume fewer calories on a vegan diet. You don’t get this benefit from low carb diets. They are high in fat and have, therefore, a high caloric density.
  • Digestion of unprocessed plant foods increases your metabolic rate. This benefit also doesn’t exist for low carb diets. They contain less unprocessed plant foods than a vegan diet.
  • Belly fat, liver fat, and muscle fat are all decreased in just 16 weeks with a vegan diet. This may occur for other diets. But most studies of other diets have not looked at these parameters, so we don’t know if they have this benefit.

QuestionsThe Questions Nobody Is Asking: Since all these diets result in short-term weight loss, there are two questions we should be asking.

  1. Which of these diets are healthy long term? Numerous studies have shown people who consume vegan diets and other primarily plant-based diets for 10, 20, or 30 years weigh less and have a lower incidence of heart disease, diabetes, and some cancers than people who consume the typical American diet.

Although the Atkins diet has been around for more than 50 years, there is still no evidence that the Atkins diet or other meat-based low carb diets are healthy long term. I have summarized these studies in my book, “Slaying The Food Myths”.

2) What happens when you get tired of the restrictions in these diets and start adding back a few of your favorite foods? If you start with a vegan diet and add a little dairy, eggs, and meat to it, you end up with a semi-vegetarian diet. People following a semi-vegetarian diet weigh less and are healthier than people consuming the typical American diet.

Keto diets are high in meat and saturated fat. If you add carbs, even healthy carbs, to that diet, you end up with the typical American diet, which is characterized by weight gain and poor health.

Vegan BurgerOne Final Thought: Big Food has noticed that many Americans want to eat vegan but still crave the taste and convenience of their favorite foods. Big Food has been only too happy to oblige with a wide selection of highly processed “vegan” foods. Avoid these foods like the plague!

I have discussed the shortcomings of the “vegan” burgers found in your local supermarkets and fast food restaurants in a recent issue of “Health Tips From the Professor”.

The biggest problem with all these “vegan” food substitutes is that they are highly processed foods. The benefits of a vegan diet come from eating unprocessed plant foods. None of us need more highly processed foods in our diet.

Of course, it isn’t just vegan food substitutes. Any hope that the Atkins diet might have been healthy evaporated with the advent of “Atkins” processed foods. Now I am starting to see the same trend with “keto” and “paleo” foods.

The Bottom Line 

The new year is here, and you, like millions of other Americans, have decided this will be the year to get your weight under control. But how to do that is the question.

You have tried lots of diets over the years. You have given up sugar, then high-fructose corn syrup, then carbs in general. You have eliminated whole food groups from your diet. You have restricted your eating to between noon and 4 PM. You have eaten cabbage on Tuesdays and grapefruit on Thursdays (Just kidding about that one, but some fad diets are almost that bizarre.

You lost weight at first, but none of these diets were sustainable. You started adding back your favorite foods. Then the pounds you lost came back – and brought their friends with them.

But what if…

…you could rev up your metabolism just by eating a healthy diet?

…you could lose weight naturally without counting calories or reducing portion sizes?

…you could keep most of the weight off permanently?

We know people who eat a vegan diet for 10, 20, or 30 years weigh less and are healthier than people consuming the typical American diet. Could the vegan diet be the diet you have been looking for?

The study I review this week was designed to answer this question. The investigators randomly assigned obese, middle-aged Americans, to follow either a vegan diet for 16 weeks or to continue eating their typical American diet.

The study results were impressive:

  • The vegan group lost 14 pounds, while the control group lost only 1 pound. There were two reasons for the greater weight loss in the vegan group:
    • The vegan group decreased their caloric intake by almost 500 calories per day. This was most likely due to the lower caloric density (calories per serving) of plant foods.

In other words, the vegan group consumed fewer calories without focusing on weight loss or portion size. They ate until they were full and consumed fewer calories in the process. Isn’t this what everyone wants from a weight loss diet?

    • The thermic effect (calories burned due to digestion) of the food they ate increased by 14% in the vegan group. This is because it requires more energy to digest foods when your digestive system has to break down the cellular matrix found in unprocessed plant foods.

In other words, the vegan group burned more calories every day just by eating healthy foods. No other diet can promise this.

  • Fat mass decreased by 10% (9 pounds) in the vegan group but was unchanged in the control group
  • Belly fat decreased by 15%, liver fat was decreased by 31%, and muscle fat was decreased by 19% in the vegan group. All three parameters were unchanged in the control group.
    • This is perhaps the most significant observation from these studies since these are the three deadliest forms of fat in our bodies. Any diet that significantly reduces these forms of fat is likely to dramatically improve our health.
    • These parameters have not been measured in most studies of other weight loss diets, so we have no idea whether other weight loss diets have this effect.
  • Fasting blood glucose decreased by 11%, insulin resistance decreased by 40%, and insulin sensitivity increased by 22%. These parameters were unchanged in the control group.
    • These data show that just 16 weeks on a vegan diet is sufficient to significantly reduce the risk of developing type 2 diabetes.
  • Total cholesterol decreased by 11% and LDL cholesterol decreased by 16%. Both parameters were unchanged in the control group.

For more details and a more in-depth comparison of the vegan diet with other popular diets read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Is Losing Weight Getting Harder?

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Why Is Weight Loss More Difficult Than It Used to Be?

Author: Dr. Stephen Chaney

If you are one of the millions of Americans who set a New Year’s goal of losing weight and eating healthier, you are to be congratulated.

However, if you are like many Americans, you are probably asking yourself “Is losing weight getting harder, or is it just my imagination?”

If you are asking yourself “Is losing weight getting harder than the first time I went on a weight loss diet?”, the answer to that question is a clear yes. It has to do with the perils of yo-yo dieting.

But here is the question that most of you never thought to ask: “Is losing weight getting harder than it was for my parents and grandparents?”

If this study (RE Brown et al, Obesity Research & Clinical Practice, 10: 243-255, 2016) is correct, the answer to that question is also yes.

How Was The Study Done?

Clinical StudyThe authors used data from The National Health and Nutrition Examination Study (NHANES), which is conducted by the CDC on an ongoing basis. For those not familiar with this program, here is a description of the NHANES program from the CDC website.

“The National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the health and nutritional status of adults and children in the United States.

The survey examines a nationally representative sample of about 5,000 people per round, with 2-year data sets available for analysis. These people are located in counties across the country.

The NHANES interview includes demographic, socioeconomic, dietary, and health-related questions. The examination component consists of medical, dental, and physiological measurements, as well as laboratory tests administered by highly trained medical personnel.

All participants visit the physician. Dietary interviews and body measurements are included for everyone. All but the very young have a blood sample taken and have a dental screening. Depending on the age of the participant, the rest of the examination includes tests to assess various aspects of health. In general, the older the individual, the more extensive the examination.

Health interviews are conducted in respondents’ homes. Health measurements are performed in specially-designed and equipped mobile centers, which travel to locations throughout the country. The study team consists of a physician, medical and health technicians, and dietary and health interviewers.”

In short, the NHANES dataset represents a valuable source of data for this kind of study in that it provides a 2-year snapshots of the health and nutritional status of the American population over many decades.

The authors of this study looked at the association between total caloric intake and diet composition with BMI (body mass index a measure of obesity) at 2-year intervals between 1971 and 2008. There were 36,377 US adults in this part of the study.

Because physical activity was only part of the NHANES dataset between 1988 and 2006, the correlation of physical activity with BMI was measured at 2-year intervals between 1988 and 2006. There were 14,419 adults in this part of the study.

Is Losing Weight Getting Harder?

Question MarkThe study showed:

  • Between 1971 and 2008 total caloric intake, carbohydrate intake, and BMI increased between 10% and 14%.

Nobody was surprised by this result. Americans are eating more calories and more carbs (primarily refined carbs and sugar) than we did 30 years ago. It’s no wonder we weigh more.

  • Between 1988 and 2006 physical activity increased a whopping 47-120%.

This result was a little surprising. It raises the question: “Why isn’t all this extra physical activity paying off in keeping our weight under control.

However, when the authors compared people who had the same diet (same caloric intake and same amount carbohydrate) and same physical activity with their BMI over the years they found a very surprising result.

  • When they compared people eating the same diets in 1971 and 2008, the group in 2008 weighed 10% more! And this wasn’t a single data point. There was a relatively linear increase in weight between 1971 and 2008 for people consuming exactly the same diet.
  • When they compared people with the same amount of physical activity in 1988 and 2006, the group in 2006 weighed 5% more! Once again, there was a relatively linear increase in weight between 1988 and 2006 for people performing exactly the same amount of exercise.

In other words, people weigh significantly more today than they did 20 or 30 years ago, even if they follow the exact same diet and exercise plans. Nobody saw this one coming.

That means it is harder to maintain a healthy weight today than it was just a few decades ago. You may have suspected this, but now you know for sure. Life isn’t fair!

The authors concluded: “Factors other than diet and physical activity may be contributing to the increase in BMI [in this country] over time. Further research is necessary to identify these factors and to determine the mechanisms through which they affect body weight.”

In other words, the real question is: “Why is weight loss more difficult than it used to be?”

Why Is Weight Loss More Difficult Than It Used To Be?

WhyThe short answer is, “Nobody knows for sure”. However, the authors raised several possibilities.

  • We are increasingly exposed to persistent organic pollutants (such as pesticides, flame retardants, and chemicals in food packaging) that accumulate in our bodies and may affect how our bodies process food and store fat.
  • The use of prescription drugs has risen dramatically since the 70’s and 80’s. Antidepressants, for example, are now one of the most commonly prescribed drugs in the US, and many antidepressants have been linked to weight gain. However, it’s not just antidepressants. Allergy medications, steroids, and pain medications can also cause weight gain.
  • Just looking at caloric intake and diet composition (% carbohydrate, fat, and protein) obscures other major changes in our diet over the last few decades. We are eating more meat, more highly processed foods, and more artificially sweetened foods. Highly processed foods and artificial sweeteners have both been linked to weight gain.
  • Our microbiome (gut bacteria) appears to be changing as well. Meat, highly processed foods, and artificial sweeteners have all been shown to influence which gut bacteria inhabit our intestines. We also know gut bacteria can influence our tendency to gain weight.

In short, a lot of things have changed over the past few decades. And these changes may be making it more difficult for us to lose weight. Some of these things, like diet and the influence of diet on our microbiome, we can control. Other things may be beyond our control.

The Bottom Line 

A recent study has looked at the effect of diet and physical activity on BMI (a measure of obesity) over the past few decades.

When the authors compared people who had the same diet (same caloric intake and same amount carbohydrate) and same physical activity with their BMI over the years they found a very surprising result.

  • When they compared people eating the same diets in 1971 and 2008, the group in 2008 weighed 10% more!
  • When they compared people with the same amount of physical activity in 1988 and 2006, the group in 2006 weighed 5% more!

In other words, people weigh significantly more today than they did 20 or 30 years ago, even if they follow the exact same diet and exercise plans. Nobody saw this one coming.

That means it is harder to maintain a healthy weight today than it was just a few decades ago. You may have suspected this, but now you know for sure. Life isn’t fair!

For more details and to learn why it is harder to lose weight now than it was a few decades ago read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Which Weight Loss Diet Is Best For You?

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Tips For Choosing A Diet That Works

Author: Dr. Stephen Chaney

New Year DietDiet season starts in just a few days! Like millions of Americans you will probably be setting a goal to lose weight. But which diet should you choose? Vegan, Paleo, Keto, 360, Intermittent Fasting, low-carb, low fat – the list is endless.

And then there are the commercial diets: Meal replacements, low calorie processed foods, prepared meals delivered to your door – just to name a few of the categories.

You can choose to count calories, focus on portion sizes, or keep a food journal.

And, if you really want to live dangerously, you can try the latest diet pills that claim to curb your appetite and rev up your metabolism.

The advertisements for all these diets sound so convincing. They give you scientific-sounding mumbo-jumbo to explain why they work. Then they talk about clinical studies they say prove their diet works.

If you are like most Americans, you have already tried several of these diets. They worked for a while, but the pounds came back – and brought their friends with them.

But, as the saying goes, “Hope springs eternal in the human breast. Surely some diet you haven’t tried yet will work for you.

There is such a diet. But it will require a change of mindset. It will also require effort. There is no magic wand that will chase the extra pounds away forever.

If you are searching for the perfect diet to start the new year, let me be your guide. Here are:

  • 4 tips on what to avoid and…
  • 6 tips on what to look for…

…when you are choosing the perfect diet.

Tips For Choosing A Diet That Works

Things To Avoid:

Avoid1) Endorsements

Endorsements by your favorite athlete or public person are paid for. They don’t necessarily represent their opinion. Nor do they assure you that they follow that diet or use that diet supplement.

Endorsements by Dr. Strangelove and his buddies can be equally misleading. They usually tell you that the medical establishment has been lying to you, and they have discovered the “secret” to permanent weight loss and the “Fountain of Youth”.

Recommendations of the medical and scientific communities usually represent a consensus statement by the top experts in their field. I would choose their advice over Dr. Strangelove’s opinion any day.

2) Testimonials

Most of the testimonials you see on TV or in print are either paid for or are fake

Testimonials by your friends can be equally misleading. We are all different. What works for your friend or your trainer may not work for you.

For example, some of us do better on low-carb diets, and others do better on low fat diets.

[Note: Some DNA testing companies claim they can sequence your DNA and tell you which diet is best. However, as I reported in a recent article in “Health Tips From The Professor”, independent studies show that DNA testing is of no use in predicting whether low-carb or low-fat diets are better for you.]

3) Diets Based on “Magic” Or “Forbidden” Foods or Food Groups.

I have often said we have 5 food groups for a reason. Each food group provides a unique blend of nutrients and phytonutrients. And each plant food group provides a unique blend of fibers that support the growth of different types of friendly gut bacteria.

The bottom line is that each of us does better with some foods than others, but there are no “magic” or “forbidden” foods that apply to everyone.

4) “Magic” Diets.

Magic WandI have written perhaps the first diet book, “Slaying The Food Myths”, that doesn’t feature a “magic” diet that is going to make the pounds melt away and allow you to live to 100. Instead I recommend a variety of healthy diets and suggest you choose the one that fits you best.

However, I understand the allure of “magic” diets. Dr. Strangelove claims the diet will be effortless. He gives you some scientific-sounding mumbo-jumbo to convince you the diet is scientifically sound. Then he cites some clinical studies showing the diet will cause you to lose weight and will improve your health parameters (things like cholesterol, triglycerides, blood sugar, and blood pressure). It sounds so convincing.

Before you fall for Dr. Strangelove’s latest “magic” diet, let me share two things that may blow your mind:

    • The studies are all short-term (usually 3 months or less).
    • When you rely on short-term studies, the very low-fat Vegan diet and very low-carb Keto diet give you virtually identical weight loss and improvement in health parameters!

Those two diets are as different as any two diets could be. That means we can forget all the scientific-sounding mumbo-jumbo as to why each of those diets work. Instead, we should ask what these two diets have in common.

The answer is simple:

#1: The clinical studies are comparing “magic” diets to the typical American diet. Anything is better than the typical American diet! It is high in sugar, refined carbohydrates, saturated fat, and highly processed foods. No wonder the “magic” diets look so good.

#2: The diets are whole food diets. Anytime you eliminate sodas, fast foods, and highly processed foods, you will lose weight.

#3: The diets eliminate one or more food groups. Whenever you eliminate some of your favorite foods from your diet, you tend to lose weight without thinking about it. I call this the cream cheese and bagels phenomenon.

  • If you are following a low-fat diet, it sounds great to say you can eat all the bagels you want. But without cream cheese to go with the bagels, you tend to eat fewer bagels.
  • If you are following a low-carb diet, it sounds great to say you can eat as much cream cheese as you want, but without bagels to go with your cream cheese, you tend to eat less cream cheese.

#4: Because they eliminate many of your favorite foods, “magic” diets make you focus on what you eat. Whenever you focus on what you eat, you tend to lose weight. That is why food journals and calorie counters are effective.

#5: Finally, whenever you lose weight, your health parameters (cholesterol, triglycerides, blood sugar, and blood pressure) improve.

Things To Look For In Choosing A Healthy Diet For The New Year

Look For1) Choose whole food diets. Avoid sodas, fast foods, and highly processed foods.

2) Choose primarily plant-based diets. These can range from Vegan through semi-vegetarian, Mediterranean, DASH, and Nordic. All are healthy diets. I have discussed the evidence for this recommendation in my book “Slaying The Food Myths”. Here is a brief summary.

When we look at long term (10-20 year) studies:

    • Vegetarians weigh less and are healthier than people consuming the typical American diet.
    • People consuming semi-vegetarian, Mediterranean, and DASH diets are healthier than people consuming the typical American diet.

If you look at low-carb diets:

    • People consuming plant-based low-carb diets weigh less and are healthier than people consuming the typical American diet.
    • People consuming meat-based low-carb diets are just as fat and unhealthy as people consuming the typical American diet.
    • The Atkins diet low-carb diet has been around for more than 50 years, and there is no evidence it is healthy long-term

3) Choose diets that include a variety of foods from all 5 food groups. I have discussed the rationale for that recommendation above.

4) Choose diets that consider meat as a garnish, not a main course.

5) Choose diets that feature healthy carbs and healthy fats rather than low-carb or low-fat diets.

6) Think lifestyle, not diet. If you choose a restrictive diet so you can achieve quick weight loss, you will probably be just as fat and unhealthy next December 31st as you are this year. Instead, choose diets that teach healthy eating and lifestyle changes that you can make a permanent part of your life.

Tips For Keeping The Weight Off

Yo-Yo You know the brutal truth. Around 95% of dieters regain everything they lost and then some within a few years. You have probably gone through one or more cycles of weight loss and regain yourself – something called “yo-yo dieting”. You may even be asking yourself if it is worth bothering to try to lose weight this year.

Rather focusing on the negative statistics of weight loss, let’s look at the good news. There are people who lose the weight and keep it off. What do they do?

There is an organization called the National Weight Control Registry that has enrolled more than 10,000 people who have lost weight and kept it off. The people in this group lost weight on almost every diet imaginable. However, here is the important statistic: On average people in this group have lost 66 pounds and kept it off for 5 years.

The National Weight Control Registry has kept track of what they have done to keep the weight off. Here is what they do that you may not be doing:

  • They consume a reduced calorie, low fat diet.
  • They get lots of exercise (around 1 hour/day).
  • They have internalized their eating patterns. In short, this is no longer a diet. It has become a permanent part of their lifestyle. This is the way they eat without even thinking about it.
  • They monitor their weight regularly. When they gain a few pounds, they modify their diet until they are back at their target weight.
  • They eat breakfast on a regular basis.
  • They watch less than 10 hours of TV/week.
  • They are consistent (no planned cheat days).

Which Weight Loss Diet Is Best For You?

I have covered a lot of ground in this article. Let me summarize it for you.

If you are thinking about popular diets:

  • Primarily plant-based diets ranging from Vegan to Mediterranean and Dash are associated with a healthier weight and better health long term.
  • If want to lose weight quickly, you may want to start with the more restrictive plant-based diets, like Vegan, Ornish, Pritikin or semi-vegetarian.
  • If you do better with a low-carb diet, my recommendation is the low-carb version of the Mediterranean diet.
  • If your primary goal is rapid weight loss, you could also start with one of the healthier of the restrictive low-carb diets, like the Paleo or the 360 diet. I do not recommend the Keto diet.
  • No matter what diet you start with, plan to transition to the primarily plant-based diet that best fits your lifestyle and food preferences. This is the diet you will want to stick with to maintain your weight loss and achieve better health long term.
  • Plan on permanent lifestyle change rather than a short-term diet. Otherwise, you are just wasting your time.
  • Eat whole foods. Big Food keeps up with America’s favorite diets and is only too happy to sell you highly processed foods that match your favorite diet. Avoid those like the plague.

If you are thinking about commercial diets featuring meal replacement products:

  • Look for meal replacement products that:
    • Do not contain artificial sweeteners, flavors, or preservatives.
    • Use non-GMO protein. A non-GMO certification for the other ingredients is not necessary. For a more detailed explanation of when non-GMO certification is important and when it is unnecessary, see my article in “Health Tips From the Professor”.
    • Have stringent quality controls in place to assure purity. “Organic” and/or “non-GMO” on the label do not assure purity.
  • Look for programs that can provide clinical studies showing their diet plan is effective for weight loss and for keeping the weight off. Many programs have short-term clinical studies showing they are effective for weight loss, but very few have longer-term studies showing the weight stays off.
  • Finally, look for programs that teach permanent lifestyle change. This should include guidance on exercise and healthy eating.

I do not recommend most commercial diets that feature prepared low-calorie foods “shipped right to your door” as a major part of their program. The foods are highly processed. Plus, they include all your favorite unhealthy foods as part of the program. Even if they include lifestyle change as part of their program, they are undermining their message with the foods they are providing you.

I would be remiss if I didn’t mention that Weight Watchers is highly recommended by most experts in the field. Weight Watchers emphasizes journaling and counting calories, which is a plus because it makes you focus on what you are eating. They also have a good lifestyle program and support that can help you transition to permanent lifestyle change if you are willing to put in the effort. However, I don’t recommend their prepared low-calorie foods. They are no better than foods provided by the other commercial diet programs.

The Bottom Line 

Weight loss season is upon us. If you plan to lose weight and/or adopt a healthier diet in the coming year, you are probably trying to decide which diet to try this year. In this issue of “Health Tips From The Professor” I give you:

  • 4 tips on what to avoid when selecting your diet.
  • 6 tips on how to choose your perfect diet.
  • 7 tips on how to keep the weight off.

Then I put all this information together to help you choose the best diet, the best meal replacement product, and/or the best commercial diet program.

For more details read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Can DNA Testing Help You Lose Weight?

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How Does DNA Testing Work Best?

Genetic TestingGenomics (DNA testing) is hot. You are being told that if you just knew your genes, you could lose weight successfully, be healthier, be happier, leap tall buildings in a single bound (Actually, I haven’t heard the last claim, but it’s about the only claim that genomics marketers haven’t made). Which of these claims are true, and which are just hot air?

The experts agree that the benefits of DNA testing have been greatly oversold. As I said in a recent article on DNA testing, the idea that genes control our destiny is no longer considered valid. There are 3 reasons for this. I will start with the scientific term for each and then give you the non-scientific explanation.

  • Penetrance simply means that the severity of most gene mutations is influenced by our genetic background. Simply put, the same mutation can have a significant effect in one individual and a trivial effect in another individual.
  • Epigenetics refers to modifications of the DNA that influence gene expression. These DNA modifications are, in turn, influenced by diet and lifestyle.
  • Microbiome refers our gut bacteria. In many cases, our microbiome has just as much influence on our health as our genes. And our microbiome is influenced by diet and lifestyle.

Now you know the complexity of DNA testing, it is easy to see why experts feel that it is premature to use DNA testing to predict the best diet for either weight loss or health.

As an example, one recent study used DNA testing to predict whether study participants were more likely to lose weight on a low-carb or low-fat diet. The participants were then randomly assigned to low-carb and low-fat diets. At the end of 12 months:

  • There was no significant difference in weight loss for those on low-fat and low-carb diets. This has been reported in multiple previous studies but is an inconvenient truth that most low-carb enthusiasts tend to ignore.
  • DNA testing offered no predictive value as to whether a low-carb or low-fat diet was more effective for weight loss.

However, DNA testing may have one benefit that is overlooked by many experts. What if the DNA test results motivated people to do better? After all, most diet advice is generic. People feel it may or may not apply to them. Does personalized diet advice based on their genetic makeup motivate people to stick with the diet better?

Some studies have suggested that people may follow personalized diet plans based on their DNA more faithfully. However, most of those studies have been short-term.

That is why I have chosen today’s study (J Horne et al, BMJ Nutrition, Prevention & Health, 2020) to discuss. It is a very well-designed study and it lasted for a full year.

How Was The Study Done?

Clinical StudyThis was an extremely well-designed study. In fact, it was so well designed that it probably needs the “Results are not typical” designation the FDA requires when some diet companies make claims about weight loss success. Here are the details:

  • The study participants were highly motivated, college educated, middle-aged (average age = 55), obese (average weight = 216 pounds) Caucasian women who had a positive attitude about their ability to change what they ate. In case you weren’t counting, there were four characteristics of this group that might be considered atypical for the average American.
  • The participants volunteered for a highly structured weight loss program called the “Group Lifestyle Balance”, or GLB, program.
    • Participants were given a detailed calorie-controlled nutrition plan at the beginning of the program.
    • They were asked to track their daily food and beverage intake for the first 2-3 months of the program.
    • In the second week of the program participants were educated on how to count and track calories and nutrients such as total fat or saturated fat.
    • There were weekly meetings with dietitians the first 3 months and monthly meetings for the remainder of the 12-week program to provide the guidance and support needed to stick with their nutrition plan.
  • The plan also incorporated a behavior change program called Theory of Planned Behavior (TPB) that evaluates and influences attitudes, subjective norms, and behavioral control that are key to behavior change. During the regular meetings:
    • The participants were informed about of the health benefits associated with a healthy lifestyle.
    • They were educated on positive mindsets and mindfulness.
    • They were taken through a stepwise, goal setting approach designed to positively impact behavioral change.

In short, this is a gold standard diet program that provided the nutritional support needed to stick with the diet program and the psychological support needed to change eating behavior. Unfortunately, this is also atypical. Very few diet programs provide this level of support.

Everyone in the study participated in this program. However, the participants were divided into two groups.

  • Both groups were advised to follow a standard calorie-controlled, moderately low-fat (25% of total calories) nutrition plan.
  • In addition, the second group was put on a plan that was either high protein or low saturated fat (<10% of total calories) based on their DNA test results.
  • The nutritional support was identical except that the second group was told that their nutrition plan was specific for them, based on their DNA analysis.
  • The dietary intake of both groups was assessed with a 3-day dietary recall (2 week days and 1 weekend day) at baseline (before the program began) and at 3, 6, and 12 months to assess the participants adherence to their diet plan.

Can DNA Testing Help You Lose Weight?

Happy woman on scaleI hate to disappoint you, but the short answer to this question, is no. Both groups lost the same amount of weight, which is not surprising considering the comprehensive nature of the diet program that both groups were enrolled in.

However, the group given advice based on their DNA test were more motivated to stick with their personalized nutrition goals. Specifically:

  • Long-term adherence to reductions in saturated fat intake was significantly greater in the group that was told their diet plan was personalized based on their DNA analysis.
    • The control group reduced their saturated fat intake by 12% at 3 months, but only by 4% at 6 months, and 2.5% at 12 months.
    • The group with the personalized diet plan reduced their saturated fat intake by 14% at 3 months, 18% at 6 months, and 22% at 12 months.
  • Long-term adherence to reductions in total fat intake was also significantly greater in the group that was told their diet plan was personalized based on their DNA analysis.
    • The control group reduced their total fat intake by 18% at 3 months, but only by 4% at 6 and 12 months.
    • The group with the personalized diet plan reduced their total fat intake by 11% at 3 months, 13% at 6 months, and 16% at 12 months.
    • It is important to remember that both groups had been advised to reduce their total fat intake to 25% of calories and had received nutritional and psychological support to achieve that goal. The only difference was that the second group had been told that advice was based on their DNA test.

The authors of the study concluded: “Weight management interventions guided by nutrigenomics can motivate long-term improvements in dietary fat intake above and beyond gold-standard population-based interventions.”

How Does DNA Testing Work Best?

DNA TestingThere remain significant concerns about the validity of personalized weight loss advice based on DNA testing. However, this and other studies suggest that DNA testing may provide one valuable asset for weight loss programs. It appears that people are more likely to stick with a program they believe has been personalized for them.

There are, however, several caveats to this conclusion.

  • Participants in this study received nutritional and psychological support throughout the 12-month program. We don’t know how well participants would have stuck with the program if they had not been continually reminded that the program had been personalized for them.
  • Participants in this study were well-educated, highly motivated, Caucasian women. We don’t know whether these results apply to men and to other ethnic and socioeconomic groups.
  • This study only looked at personalized diet advice based on DNA testing. Some studies suggest that other methods of diet personalization may also improve adherence.
  • Personalization can be misused to recommend unhealthy dietary changes. It is not enough to follow personalized diet advice. You also need to ask whether it is healthy dietary advice.

For example, DNA test results consistent with reduced carbohydrate intake are sometimes used to recommend unhealthy diets that eliminate one or more food groups rather than low-carb versions of healthy diets like the Mediterranean diet.

The Bottom Line

There remain significant concerns about the validity of personalized weight loss advice based on DNA testing. However, DNA testing may provide one valuable asset for weight loss programs. Some studies have suggested that people are more likely to stick with a program they believe has been personalized for them.

However, most of these studies have been short term. A recent study asked whether the improvement in motivation lasted for 12 months.

Two matched groups of well-educated, highly motivated women were enrolled in a “gold-standard” weight loss program that provided both nutritional and psychological support for 12 months.

Both groups were given a diet plan that restricted total calorie intake and advised reducing fat intake to 25% of total calories. However, based on their DNA test results one group was given a personalized diet plan that also advised them to reduce their saturated fat intake to less than 10% of total calories.

  • The group receiving personalized diet advice did a better job of reducing both saturated and total fat intake and maintaining that change for 12 months compared to the group that just received a set diet plan.
  • These results suggest that personalization of diet advice may improve long-term adherence to healthy dietary changes.

The authors of the study concluded: “Weight management interventions guided by nutrigenomics can motivate long-term improvements in dietary fat intake above and beyond gold-standard population-based interventions.”

There are, however, several caveats to this conclusion.

  • Participants in this study received both nutritional and psychological support throughout the 12-month program. We don’t know how well participants would have stuck with the program if they had not been continually reminded that the program had been personalized for them.
  • Participants in this study were well-educated, highly motivated, Caucasian women. We don’t know whether these results apply to men and to other ethnic and socioeconomic groups.
  • This study only looked at personalized diet advice based on DNA testing. Some studies suggest that other methods of diet personalization may also improve adherence.
  • Personalization can be misused to recommend unhealthy dietary changes. It is not enough to follow personalized diet advice. You also need to ask whether it is healthy dietary advice.

For more details read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Does Intermittent Fasting Work?

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Will Intermittent Fasting Help You Lose Weight?

Author: Dr. Stephen Chaney

intermittent fastingIf you are like millions of Americans, one of your New Year’s resolutions is to lose weight. Now your dilemma is how to accomplish that. You have tried various diets before – Atkins, paleo, keto, Whole 30, etc. You lost some weight, but it came right back. You are looking for something new, something different from anything you have tried before.

What about intermittent fasting? It’s hot right now. It’s probably different from what you have tried in the past. It doesn’t require radical changes to what you eat. Some of your friends are singing its praises. Could this be the one that solves your weight problem forever?

A Primer On Intermittent Fasting

professor owlLet’s start by defining intermittent fasting and reviewing what we already know about it. There are several variations of what the mass media refers to as intermittent fasting, but the two most popular versions are:

  • Time-restricted fasting which limits daily intake of food to a 4 to 12-hour period. The most popular version of this restricts food intake to 8 hours followed by 16 hours of fasting.
  • Intermittent fasting in which there is a day or more of fasting or decreased food intake between periods of unrestricted eating. The most popular version of this allows 5 days of unrestricted eating followed by 2 days of fasting.

A major review (Di Francesco et al, Science, 362: 770-775, 2018) of time-restricted and intermittent fasting was published a little over a year ago. At the time that review was published, there were lots of studies comparing time-restricted fasting with continuous caloric restriction. I summarized those findings in a previous issue of “Health Tips From the Professor” last January.

Here is a brief summary of the key findings from that review:

  • If you read the blogs about time-restricted fasting, you will come across all sorts of metabolic mumbo-jumbo about ketone bodies, adiponectin, leptin, IGF-1, and blood glucose levels. It sounds so convincing. Don’t get sucked in by these pseudo-scientific explanations. At this point they are mostly speculation.
  • Although there is no conscious effort to control calories, time-restricted fasting result in an inadvertent reduction in food intake by restricting the time allowed for eating and by eliminating late night snacking. This reduction in caloric intake is likely responsible for most of the weight loss associated with intermittent fasting. When you control for calories, there is no difference in weight loss between time-restricted fasting and continuous caloric restriction (your typical reduced calorie diet).

However, at the time the review was published, far less was known about the relative benefits of intermittent fasting and simple caloric restriction. Since that time, two studies have rigorously compared the effectiveness of intermittent fasting and continuous caloric restriction on weight loss. I review those studies below

Will Intermittent Fasting Help You Lose Weight?

The first study (YM Roman et al, International Journal of Obesity, 43: 2017-2027, 2019) was a systematic review and meta-analysis of 9 clinical studies comparing intermittent fasting with continuous caloric restriction. Total caloric reduction was controlled and was the same for both intermittent fasting and continuous caloric reduction.

The studies ranged from 12 weeks to 52 weeks with most of them in the 20 to 30-week range. This meta-analysis found:

·       There was no difference between intermittent fasting and continuous caloric restriction in terms of weight loss, waist circumference, or body fat loss.

·       Loss of lean body mass, on the other hand, was greater for intermittent fasting than for continuous caloric restriction.

The authors concluded: “Since it is ultimately fat mass loss that improves health indices, and not the loss of muscle, the significantly greater loss of lean mass in the intermittent dieting group versus the continuous dieting group is concerning and needs to be further assessed.”

I would add, it is also concerning because lean mass muscle burns calories faster than fat mass. Loss of lean muscle mass could lead to a lower metabolic rate. That would make maintenance of the weight loss more difficult.

The second study (ML Headland et al, International Journal of Obesity, 43: 2028-2036) compared intermittent fasting versus continuous calorie restriction for 12 months in a group of 332 healthy overweight or obese adults. Again, total caloric reduction was the same for the two groups. In this study:

·       There was no significant difference between intermittent fasting and continuous caloric restriction for weight loss, body fat loss, and lean body mass loss. [Note: The retention of lean body mass in this study differs from the loss of lean body mass reported in the previous study. Additional studies will be required before we become overly concerned about potential loss of lean body mass with intermittent fasting.]

·       There were also no significant differences between the groups for blood levels of glucose, total cholesterol, triglycerides, HDL, and LDL.

Does Intermittent Fasting Work?

does intermittent fasting workThese studies make it clear there is no “magic” associated with either time-restricted or intermittent fasting.

·       If either time-restricted or intermittent fasting allows you to reduce your daily caloric intake by restricting the time that you are eating, you will lose weight and keep it off. However, if you compensate for the fasting periods by consuming additional calories when you are eating, all bets are off.

·       In clinical studies that restrict calories to the same extent in the various diets, neither time-restricted nor intermittent fasting results in greater weight loss than continuous caloric restriction (your typical reduced calorie diet).

o   In addition, neither time-restricted nor intermittent fasting results in better improvement in blood parameters (glucose, total cholesterol, triglycerides, HDL, and LDL) than continuous caloric restriction.

·       Intermittent fasting may result in greater loss of lean muscle mass than continuous caloric reduction. If confirmed by subsequent studies, this would be concerning.

This also means:

·       If you happen to read the blogs about time-restricted or intermittent fasting, you can forget all the metabolic mumbo-jumbo about ketone bodies, adiponectin, leptin, IGF-1, and blood glucose levels.

o   At this point this metabolic information comes mostly from animal studies. Its application to humans is purely speculation.

o   Since time-restricted and intermittent fasting offer no advantage over continuous caloric restriction, there is no evidence that changes in any of those metabolic markers has any effect on weight loss in humans.

Finally, you need to ask whether time-restricted and intermittent fasting are something you can maintain in the real world.

·       Your friends are unlikely to be on the same schedule. It won’t be easy to fit your diet around socializing, travel, and holidays.

The Bottom Line

There are several variations of what the mass media refers to as intermittent fasting, but the two most popular versions are:

  • Time-restricted fasting which limits daily intake of food to a 4 to 12-hour period. The most popular version of this restricts food intake to 8 hours followed by 16 hours of fasting.
  • Intermittent fasting in which there is a day or more of fasting or decreased food intake between periods of unrestricted eating. The most popular version of this allows 5 days of unrestricted eating followed by 2 days of fasting.

The latest studies make it clear there is no “magic” associated with either time-restricted or intermittent fasting.

·       If either time-restricted or intermittent fasting allows you to reduce your daily caloric intake by restricting the time that you are eating, you will lose weight and keep it off. However, if you compensate for the fasting periods by consuming additional calories when you are eating, all bets are off.

·       In clinical studies that restrict calories to the same extent in the various diets, neither time-restricted nor intermittent fasting results in greater weight loss than continuous caloric restriction (your typical reduced calorie diet).

o   In addition, neither time-restricted nor intermittent fasting results in better improvement in blood parameters (glucose, total cholesterol, triglycerides, HDL, and LDL) than continuous caloric restriction.

·       Intermittent fasting may result in greater loss of lean muscle mass than continuous caloric reduction. If confirmed by subsequent studies, this would be concerning.

Finally, you need to ask whether time-restricted and intermittent fasting are something you can maintain in the real world.

·       Your friends are unlikely to be on the same schedule. It won’t easy to fit your diet around socializing, travel, and holidays.

For more details, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Can Chocolate Help You Lose Weight?

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A Candy a Day Keeps The Weight Away?

Author: Dr. Stephen Chaney

chocolateSometimes you come across news that just seems too good to be true. The recent headlines saying that you can lose weight just by eating chocolate are a perfect example. Your first reaction when you heard that was probably “Sure, when pigs fly!”

But, it’s such an enticing idea – one might even say a deliciously enticing idea. And, in today’s world enticing ideas like this quickly gain a life of their own. Two popular books have been written on the subject. Chocolate diet plans are springing up right and left. A quick scan of the internet even revealed a web site saying that by investing a mere $1,250 in a training course you could become a “Certified Chocolate Weight Loss Coach” earning $50,000/year.

If you like chocolate as much as most people you are probably wondering could it just possibly be true?

Can Eating Chocolate Help You Lose Weight?

The idea that chocolate could help you lose weight does have some support. There are actually three published clinical studies suggesting that chocolate consumption is associated with lower weight (European Journal of Clinical Nutrition, 62: 247-253, 2008; Nutrition Research, 31: 122-130, 2011; Archives of Internal Medicine, 172: 519-521, 2012).

While that sounds pretty impressive, they were all cross-sectional studies. That means they looked at a cross section of the population and compared chocolate intake with BMI (a measure of obesity). Cross sectional studies have a couple of very important limitations:

1)    Cross sectional studies merely measure associations. They don’t prove cause and effect. Was it the chocolate that caused the lower weight, or was it something else that those populations were doing? We don’t really know.

2)    Cross sectional studies don’t tell us why an association occurs. In many ways this is the old chicken and egg conundrum. Which comes first? In this case the question is whether the people in the studies became obese because they ate less chocolate – or did they eat less chocolate because they were obese and were trying to control their calories? Again, we have no way of knowing.

If Pigs Could Only Fly

If Pigs Could FlyChocolate is relatively rich in fat and high in calories. It’s not your typical diet food. On the surface it seems fairly implausible that eating chocolate could actually help you lose weight.

Scientists love to poke holes in implausible hypotheses, so it is no surprise that a recent study (PLOS ONE, 8(8) e70271) has poked some huge holes in the “chocolate causes weight loss” hypothesis.

This study analyzed data from over 12,000 participants in the Atherosclerosis Risk in Community (ARIC) Study. This was also a cross sectional study, but it was a prospective cross sectional study (That’s just a fancy scientific term which means that the study followed a cross section of the population over time, rather than just asking what that population group looked like at a single time point).

The authors of the study assessed frequency of chocolate intake and weight for each individual in the study at two separate time points 6 years apart. The results were very interesting:

  • When they looked at a cross section of the population at either time point, their results were the same as the previous three studies – namely those who consumed the most chocolate weighed less. So the data are pretty consistent. Overweight people consume less chocolate. But, that still doesn’t tell us why they consume less chocolate.
  • However, when they followed the individuals in the study over 6 years, those who consumed the most chocolate gained the most weight. The chocolate eaters were skinnier than the non-chocolate eaters at the beginning of the study, but they gained more weight as the study progressed. And, the more chocolate they consumed the more weight they gained over the next 6 years. [No surprise here. Calories still count.]
  • When they specifically looked at the population who had developed an obesity related illness between the first and second time point, they found that by the end of the study those participants had:

– Decreased chocolate intake by 37%

– Decreased fat intake by 4.5%

– Increased fruit intake by 20%

– Increased vegetable intake by 17%

  • In short, this study is more consistent with the “obesity causes reduced chocolate intake” model than the “reduced chocolate intake causes obesity” model. Simply put, if you are trying to lose weight, sweets like chocolate are probably among the first things to go.

Of course, even prospective cross sectional studies have their limitations. Double blind, placebo controlled studies are clearly needed to resolve this question. The only published study of this type has reported a slight weight gain associated 25 g/day of dark chocolate, but the study was too small and too short in duration to draw firm conclusions.

In summary, more studies are needed, but the current evidence does not support the “miracle diet food” claims for chocolate.

The Bottom Line:

1)    Pigs still haven’t learned how to fly. As enticing as it may sound, the weight of current evidence does not support the claims that chocolate is a miracle diet food or that eating chocolate every day is a sensible strategy for losing weight.

2)    On the other hand, dark chocolate is probably one of the healthier dessert foods. There is no reason not to enjoy an occasional bite of chocolate as part of a healthy, calorie-controlled diet.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Health Tips From The Professor