Archive for the ‘Dieting’ Category

Vindication? Part 1

Thursday, January 5th, 2012

One way to get lots of protein

Since the late 1990s when I invented a diet, or perhaps I should say an eating pattern, I've relied on one principal concept: Eat Less; Do More. I came upon this simple idea after listening to a group of medical professionals who were discussing which diet they should go on while they were simultaneously consuming huge portions at our hospital cafeteria.

One of them, I recalled, had tried a high-carb, low-protein diet the past year; losing nearly twenty pounds, then regained it all and more in a few months. Now she was going to attempt  to lose twenty-five pounds with a different approach, this one with an emphasis on protein. I had seen weight-loss plans come and go and didn't believe any of them were the answer, at least not for everyone. I remember coming home and saying to my wife, "Lynn, I've invented a new diet"

I explained it was simply, "Never finish anything; No snacks between (meals); Nothing after eight." I added, "Get lots of exercise."

I lost the seven pounds I had gained on a two-week vacation and didn't need my strategy again until early in 2009. Then I weighed 177 one morning, up three pounds from my normal weight since 1991. I attributed that to eating out four times in the prior week. But when I tried on a pair of good suit slacks, I realized the weight hadn't changed much, but the distribution sure had.

I went back to my eating plan, lost five pounds easily, then coasted a while before resuming the diet. Lynn bought me a digital scale and I weighed myself daily. I also started going to our gym six days a week. Eventually I shed thirty pounds and five inches off my waistline. At 147 pounds I was twenty-five under my usual high school weight. This morning, nearly two years later, I weighed 148.

I allow myself a three-pound zone of weight fluctuation, thinking that would account for fluid shifts and the occasional big splurge. Whenever I exceed 150 pounds I go back on my plan.

Then I read a Wall Street Journal article titled "New Ways Calories Can Add Up to Weight Gain: Study Challenges Idea That Varying Amounts Of Fat, Protein and Carbohydrates Are Key to Weight Loss." It quoted the Journal of the American Medical Association, AKA: JAMA. I went online and found the JAMA article and an accompanying editorial.

I read both pieces in detail, even finding a wild typo, "...their diets were returned to baseline energy levels and diet compositions (15% from protein, 35% from fat and 60% from carbohydrate)." I called the AMA and suggested they correct the numbers since they added to 110%.

Is a high-carb, low-protein diet safer?

But the basic premise of the study's data intrigued me. It's something I've believed for years, calories count, as opposed to what form those calories come in. But there's one extra facet: low-protein diets can be dangerous.

I'll analyze that in detail in my next post.



Slim down those truckers

Wednesday, November 23rd, 2011

some truckers are relatively slender

I have two series of posts going, but couldn't resist the article I found in the New York Times while riding a recumbent bike in the gym. The title alone, "A Hard Turn: Better Health on the Highway," was enough to grab my attention.

The first story was typical, a trucker driving long hours every day, eating all the wrong foods, getting no exercise, gaining huge amounts of weight. I found the online abstract of a 2007 Journal of the American Dietetic Association article cited: long-haul truckers of necessity eat at truck stops and of 92 such truckers stopping at a Mid-eastern US truck stop nearly 86% were overweight and 56.5% were obese.

One of our family members used to be a truck driver and I've heard his stories of long days spent behind the wheel, eating greasy foods when he stopped. He's slimmer now and in better shape as his current employment allows him more exercise time and a choice of where and what to eat.

Now that insurance costs are rising sharply, the trucking firms are getting involved and the truckers themselves, there's over three million of them in the US, are coming to grips with the issue out of necessity. One group ran a blood-pressure screening clinic for 2,000 truckers at a truck show. Twenty-one were immediately sent to a nearby emergency room; one had a heart attack before reaching the hospital.

drive carefully around trucks like this

Trucks are involved in 400,000 accidents a year and 5,000 fatalities. I just watched a nearly eighteen minute video on how we, as drivers of passenger vehicles, contribute to those accidents; 70% are caused by the drivers of other vehicles (see link below). Yet many of the ones caused by trucker driver error occur because the trucker has a health problem or falls asleep.

Some truckers are taking steps to decrease their weight and its accompanying risks for themselves and those who share the roads with them. A number of companies are helping (and perhaps finding a lucrative new client group). I just looked at a website for "Rolling Strong," and found a gym in my area that offers fitness programs for truckers. Others are joining Weight Watchers, a solid organization that my slender wife has belonged to for many years (she says she was "chunky" in high school) or creating their own programs for fitness: one carries a fold-up bike in his 18-wheeler and uses it whenever he stops for a break. Many are cooking in their trucks or even hiring a trainer.

Others joined the Healthy Truckers Association of America, paying $7.50 a month to belong to an organization that is rapidly growing (see link below to Chicago tribune article). That group now offers truckers a prescription drug card enabling its members to save ~60% on meds.

I applaud all these moves; if I'm on the road with a large truck or a series of them, I'd like their drivers to be in shape and wide awake.

Saving $1T by losing pounds

Saturday, April 16th, 2011

whole-grain cereal and a banana

Mark Bittman's "Opinionator" column in the New York TImes April 12, 2011, was right on. He called the $36B that Congress has been haggling over (like two small boys) small potatoes compared to what could be saved if we ate less overall and ate more of the right things. He quoted a number of medical resources, so I went back to look at the originals.

In the January 24, 2011 online edition of the American Heart Association's journal Circulation, a panel headed by a Stanford Associate Professor, Paul Heidenreich, stated that cardiovascular disease (CVD) currently accounts for more than one sixth of all US health dollars spent. They went on to predict that by 2030 the direct costs of care for all forms of CVD would triple from a 2010 estimate of $273B to $818B .

CVD includes stroke, heart attacks, congestive heart failure and hypertension among other entities and they are often highly correlated. In fact the INTERHEART study which Bittman quotes (and I found in a seven-year-old copy of the journal Lancet), says lifestyle-related risk factors such as obesity, smoking and hypertension account for roughly 90+% of heart disease.

We haven't even started on Type 2 diabetes (DM) yet and Bittman noted that problem will cost roughly $500B per year  by 2020. And almost all of the cases of Type 2 DM are preventable.

If we want to reduce the deficit, one way would be to reduce our weights and trim our waistlines. Sure, we wouldn't get rid of all CVD and Type 2 DM, but a large share of the $1.3T per year we will be spending on them by 2020-2030 could be avoided.

We're spending over $2T a year now on healthcare and those costs are going up and up.

So how can we save a major chunk of that huge sum? How about Dr. David Ludwig's ideas? He's a Harvard doc who has worked with Marion Nestle, the PhD dietitian I've mentioned before. He published a very recent article in JAMA (the Journal of the American Medical Association) with both straightforward and complex/innovate modalities to improve our American diet.

I read something about Dr. Ludwig and his earlier concepts in his Harvard bio and a WebMD interview. He's a pediatric endocrinologist working at Children's Hospital in Boston, founding director of its Optimal Weight for Life (OWL) program and author of Ending the Food Fight:Guide Your Child to a Healthy Weight in a Fast Food/Fake Food World.

In the JAMA article he talks about better funding for school lunch programs, making breads with whole grains (non-refined) and research needed to improve food preservatives that are healthier than the current ones. His own studies appear to show a correlation between lower calorie intake and eating whole grain products.

I see two difficult issues: getting people to make healthy foods choices and avoiding bureaucratic costs as the British experienced from their NHS shift toward paying physicians for preventive measures (NB. WSJ article from 4-16-2011 p. C3).

But what a great way to save us money that Congress might even agree on.





Snacking: fried has to goeth before a small (size)

Wednesday, April 13th, 2011

Healthy snacks

To snack or not to snack, now that is the question. I read two articles on the subject, one in the Wall Street Journal and the other in the Mayo Clinic's online comments. Then I thought about Wednesday evenings, my own downfall.

The newspaper article was titled "The Battle of the Office Candy Jar" and detailed the travails of people whose bosses and office mates think that the workplace should always be stocked with a dish of candy bars. Then there are the tempters who are forever bringing cookies and birthday cakes in to work or selling candy bars for their kid's baseball teams or school fundraisers.

The WSJ calculated the effects of eating two pieces of candy a day, five days a week, assuming one didn't cut down other foood intake or decide they needed to increase their exercise regime. Wow, it's over seven pounds added a year. It's even worse when the candy is presented in a clear jar, rather than a covered and opaque dish.

I immediately thought, 'It's Wednesday!' That's when I go to a three-hour evening writers' critique group. My cohorts bring in stories to be read aloud and commented on (I have one for tonight on the Festival of Holi that our former graduate students from Mumbai brought us to recently). They also bring in cakes and cookies and I used to bring biscotti. Our leader always has a jar with Tootsie Pops and I invariably eat more than I intend.

The Mayo Clinic piece says snacks aren't always bad and their diet plan includes snacks that can help obviate hunger pangs and keep you from binge eating. But their choice of snacks is quite different: fruits and veggies make much more sense than doughnuts and candy.

Their website: can lead you to a healthy snack site which suggests 100-calorie snacks, e.g, 2 cups of carrots or, one of my favorites, air-popped popcorn.

I'd prefer to avoid snacking whenever possible, but I'm aware I need help in avoiding the tempting items I encounter on wednesdays or at parties. I've switched from bringing biscotti to fetching a sack of almonds. Mayo's cautions that even though nuts contain protein and thus can help you feel full for a longer time, they also contain calories, largely in the form of monosaturated fat (which is certainly a better variety than the polyunsaturated kind).

So I've made a game of it: I eat four almonds. No particular reason that I chose that number, but it works.

I also have a four by six card that says

My home-made snack barrier

So let's talk about supplements

Tuesday, April 12th, 2011

You don't need supplements to build muscles

I'm in the gym at least six times a week when we're in town and I've noticed the establishment sells very large containers of protein powders and other muscle building supplements. Well, unlike some of the young men who are constantly working on free weights building up their upper body musculature, I spend at least an hour on a recumbent bike and then do stretches and five machines at moderate weights. What I don't do is lift free weights or gulp down large quantities of strange looking liquids that supposedly help to make you look like Charles Atlas or some Olympic weight lifter.

But both The Redbook article I mentioned in my last post and the Tufts Health&Nutrition Letter (sic) I got in the mail and eventually subscribed to mentioned other supplements in some detail. Redbook, after discussing four newish diet pills and their pros and cons, moved on to "natural" weight-loss pills, powders and liquids. They quoted studies and experts from Harvard and UC San Diego and referred readers to, which appears to be a reasonable public-access website for medical information (though it also carries lots of advertisements).

One caution from Dr. Michael Steelman (I Googled him and he's the only weight loss specialist to receive the national society's Bariatrician of the Year award twice and is now the editor of a peer review journal in the field) is that "Dietary-supplement companies aren't required to show clinical data on the safety and efficacy to the FDA, which means we have no idea whether they work or if they're safe."

The Tufts article mentions a "voluntary recall" in 2009  of 14 diet-aid products sold as Hydrocut. This is a combination of several active components including caffeine and green tea plus at least three other ingredients. When I traced the history of the product I found the manufacturer had been reported by the New York Times in 2003 as burying studies showing it was ineffective and covering up evidence of cardiac side effects.

Later on there were 23 reports of major side effects with one person ending up with a liver transplant (and at least 17 cases of liver damage reported in the American Journal of Gastroenterology).

Yet when I Googled the drug I found ads for it online today. The company just reformulated the product and put it back on the market.

I went back to the Redbook which next mentioned bitter orange extract. I found university physician comments and reviews saying it doesn't help dieters lose weight and has significant side effects. But you can find lots of ads for the drug.

Brew tea leaves or drink milk; don't take supplement pills

The only two substances that may be effective and reasonably safe are green tea extract and CLA, conjugated linoleic acid (found in dairy products). But a Harvard medical school obesity specialist recommends that the best way to use them for weight loss is to drink some green tea and some skim milk, not to buy the unregulated and often costly supplements you can find advertised online or in magazines.

"Caveat emptor," the Romans used to say; let the buyer beware.

Diet pills and supplements, part one

Saturday, April 9th, 2011

Take two and call me in the morning

I've never used diet pills and have avoided supplements that are supposed to help you lose weight, but there's a great new article on them. It's in a distinctly non-medical source, but was as useful as the medical sites I found and the medical newsletters I received, so let's start there.

The article is in Redbook which I can state categorically I normally don't read. But I got in the mail yesterday, unsolicited, a health-related newsletter from a major university and saw an article in it on diet supplements and weight loss. That started my online search that circuitously led me to the Redbook article, also available online  at

The piece says it will update you on five of the newest diet pills (I counted four, but who's counting?). They walk through the pros and cons of orlistat, available OTC as Alli, which prevents digestion of a share of any fat you consume. The manufacturer of this drug did a study (I prefer totally independent sources) and found increased weight loss in subjects who took the med. What's the con? Well if you consume more fat than ~15 grams per meal, you can develop diarrhea and you may not absorb your daily vitamin intake as well (A, D, E, and K are fat-soluble).

The next drug is Merida (Silbutramine) which acts centrally, i.e., in the brain, altering two chemicals that tell you when you're full. It also can raise your blood pressure and has been assocaiated with strokes and heart attacks. This one is only for the obese or those seriously overweight with other rick factors (e.g., diabetes), is expensive and your healthcare insurance may not cover its cost.

Then there's a duo, Glucophage (metformin) and Byetta (exenatide) that are mostly used for diabetics with weight control problems. Therefore they are usually covered by insurance plans. They also can cause nausea and diarrhea, but have been effective in some fairly long-term studies.

I won't even start on the supplements in this post. What I do want to mention is that most of the medical specialists that Redbook consulted emphasize these drugs are not for the person who wants to lose five or ten pounds so they look good in party clothes or a swim suit. They're for the seriously overweight who preferably are under a doctor's care. And one medical expert said they only work if you are willing to make lifestyle changes.

Guess what? That means dieting and exercising.



You and your not-so-little dog too

Tuesday, February 22nd, 2011

the way for both man & dog to lose weight

The Wall Street Journal has an interesting article about obesity in pets this morning. That made me recall Blue, the fifty pound beagle I once had and, more recently Suzie, a cocker-springer mix who, as she got old clearly needed to diet, and her pack mate Dewawho was jealous of the special foods Suzie got to eat.

I'll come back to them in a bit, but let me return to the article first and the lessons it presents for us both as pet owners and, in some cases, as participants in the epidemic of obesity. Many pets eat "people food" which in itself is a bad idea. The example I read about was a dog that got steak and chicken and ice cream; not surprisingly that dog also became obese.

For pets, as well as for humans, obesity leads to multiple medical problems. One pet insurance company (yes some people do get health insurance on their dogs and cats) paid $25,000,000 in 2010 in claims for pet health problems related to obesity. Another said five of its most expensive insurance claims relate to weight issues.

Okay, lots of us don't own pets (we no longer do), so why does this relate to us?

The problem here is too much of the wrong food and too little exercise. Does that sound familiar?

So now companies are rolling out new low-calorie pet foods and even exercise equipment. The article showed a pet treadmill and a "tread wheel" with prices ranging from $375 to $999.

How about a nice walk instead? And while you're walking your dog, guess what? You too will be burning calories.

One pet resort is offering a contest for owners and their pets to simultaneously lose weight. Another had a "Fit and Spaw" retreat last month. None of these places, I'd bet, are inexpensive.

Somehow the wheels have come off, to use a phrase that comes from a totally different arena.

As a civilization we're eating too much, too frequently, too many of the wrong foods and getting far too little exercise. And guess what, now it's showing in our furry companions.

I seldom walked Blue, didn't do enough physical exercise myself in the days when he was part of the family, and both let him eat, and not infrequently ate myself, too much of the wrong things. With later pets I talked to our veterinarian and started a low-calorie diet that made sense for Suzie, an elderly dog with heart failure. That included carrots instead of dog treats. Her pack mate Dewa, younger and slimmer, wanted some of the carrots too and continued walking with me on a regular basis, including several mountain trails.

While this was happening I got back on the more veggies and fruits trend and pushed my exercise. Now dog-less, but slender, I'm continuing to eat more sensibly and exercise regularly.

So maybe this is a lesson for all of us; some have traditional pets, some have critters that don't fit the paradigm (chubby goldfish?), some of us currently have no pets.

All of us can look at our life patterns; eat less, eat the right things, do more.

Dietary supplements and scams

Friday, February 11th, 2011

and it isn't cheap

When I was at Langley AFB in th early 1970s, we had an opportunity to take a field trip to the Cayce Institute. Edgar Cayce was a supposed psychic who lived from 1877 to 1945. I came away from that trip with a healthy dose of scepticism, not so much about Mr. Cayce himself, whose work I never saw, but of those who inherited his mantle,

That scepticism has served me well over the years and today led to a prolonged web search on the supposed benefits of acia berries as a dietary modality and supplement. It started with a news article I found that claimed a Channel 10 employee had lost 25 pounds in 4 weeks on the "Optimal Acai" program.

I began tracing the story and found a number of websites that were pertinent: WebMD said acai berries are claimed by marketeers to be an "elite superfood with anti-aging and weight loss properties." They did note that the berry, which comes from a palm tree found in Central and South America, has lots of antioxidant capacity, even more than other berries (cranberry, raspberry, blueberry). It contains chemicals that are in the flavinoid and anthocyanin family, the latter being found in red wine for example.

But as to the claimed health benefits of this particular berry, who knows. Thus far there are no studies that show it's better than other similar fruits.

MedlinePlus, the National Library of Medicine's consumer information source, notes the acai berry has antioxidants, but says there is insufficient evidence thus far to show its effectiveness.

So how did the acai berry craze start? In November of 2004 a dermatologist, Dr. Nichoas Perricone, appeared on the Oprah show. Subsequently a post on touted his so-called superfoods, especially acai. The comment that struck me was "harvested in the rain forests of Brazil, acai tastes like a vibrant blend of berries and chocolate."

Well that sounds yummy, but who is Dr. Perricone and what's the data? And why do I connect this back to Edgar Cayce?

Dr. Perricone is a dermatologist who writes on weight loss and anti-aging. He's also an Adjunct Professor of Medicine at Michigan State's medical school. One of his books, The Perricone Promise, tells of neuropeptides and their role in aging and focuses on a particular diet. A three-month supply of a neuropeptide-based serum that his own company sells costs $570.

Subsequently there have been scams with emails sent off linking to supposed news reports on the acai berry diet; one was to a website which had an identical claim as the supposed website I saw today (reporter lost 25 pounds in 4 weeks). This was exposed as bogus in March 2010 and led me to reread the supposed Channel 10 health news article.

Part of the promise beside rapid weight loss is to eliminate bad toxins built up over many years and remove sludge from the walls of the colon. Now I was back at the Cayce Institute with a basic part of their program being so-called "High Colonics," enemas to lose weight.

I won't believe any of this kind of spiel until The NLM and other reputable medical organizations report controlled, double-blind, peer-reviewed, evidence-based studies.

When it gets tough

Tuesday, January 11th, 2011

My friend the digital scale

I've struggled to keep my weight where I want it recently. That's right, I'm writing posts on this blog telling others what to do or giving them ideas of what's new in the world of dieting, lifestyle, exercise and the science behind those fields, yet I'll freely admit some days it's been difficult for me also.

We've just finished the extended holiday season from Thanksgiving to New Years and, for some, a few days beyond. That should make the next ten months or so easier.

I weigh 150.4 pounds this morning, less than a pound over my goal of 149-150 and well under my upper limit of 153.

I started this diet in May of 2009 weighing 177 and 153 or under is about what I weighed in eighth grade and under my college wrestling weight of 155. So why aren't I complacent about my diet progress?

I guess the answer is that maintaining a goal weight, for me at least, is never easy, always a challenge. I've got my red 1/3 cup measuring container as a STOP sign on a glass cylinder of microwave popcorn and a 4 by 6 card on the refrigerator door with an acronym for those situations when I'm prone to overeat. I've got a 3 by 5 card that says in bold letters, "DON"T SNACK" leaning against the popcorn container. I even have a card in my automobile that says, "Don't eat/overeat at events."

I have identified my most likely situations for overeating, dinners at friends' homes and staying up later than 11:30 PM to read.

More than anything that simple step has helped. So my advice to myself and to you is twofold: work on those times when you are most prone to slip and be able to climb back on your diet wagon when you fall off. Many years ago I weighed 218 pounds; I firmly intend to never see that territory again.

The most I weighed in 2010 was 157.6 pounds. That was just after returning from a six-day trip to see old friends, all of whom wanted to feed us well, and to help celebrate a milestone (90th) birthday. I got up the morning after we flew back from Texas, weighed myself and went right back on the strict version of my diet plan. I went to the gym the next six days in a row and was down under 153 in two days.

But it took willpower and being able to say to myself, "Well it happened again, but you're not going to continue the upward slide (sic)."

My basic plan when I'm over that self-imposed upper limit (three pounds over my goal) is to go back to basics. Eat more veggies and fruit, less red meat; cut off a portion of each item on your plate and discard it; don't eat anything between meals; don't eat anything after eight PM; exercise every day (in a multitude of ways); let my wife know what's going on; weigh daily.

Maybe someday I'll get to the point where all this is on autopilot, but I doubt it. Maintaining a healthy weight requires thinking and willpower + a little help from your friends/spouse/family.

As they said in that movie many of us remember, "May the Force be with you."

I'm over 100

Friday, December 17th, 2010

Well I don't mean I'm that old (actually I'm 69), but I looked at my old posts in the process of extracting tidbits to go into the book I'm working on, Eat like the Doc Does, and realized this would be my 103rd post. On the over hand, if my brain and body hold out, especially the former, living past 100 might be okay.

This man is over 100

There's a Chicken Soup book coming out on December 28th with one of my stories included. The book has the subtitle "Shaping the New You," and is centered on diet and exercise and lifestyle topics. My story is titled "Life Changes." I got ten pre-print copies, kept two for myself and sent eight out to friends, writing mentors, relatives and former graduate students.

When I reflect on the changes I've made in my lifestyle and diet over the past year and a half, I come up with a few simple concepts. I eat less overall and lots more veggies and fruit. I exercise more, usually iding a recumbent bike for an hour and five minutes a day and sometimes hiking or snowshoeing. I fall off the diet wagon from time to time, but always get back on (I weigh twenty-five pounds less today than I did in May of 2009). And finally, I usually think before I eat...not always, but usually.

I came up with an acronym for my weak spots; I've mentioned it before, but will reiterate. it's TABLE, meaning my triggers for overeating and mindless eating come when I'm "ticked off," on "autopilot," "bored," at a "low energy/late night state" or at an "event," loosely defined.

I'm by no means perfect, but my progress keeps evolving. This week my wife identified an area where  I could short-circuit one problem area. I got a new Clancy book and instead of reading until eleven, which is my usual pattern, I stayed up until 12:30 devouring not only the book but also five different snacks.

The next day, after our discussing the issue, I read while I was on the bike and again from ten until eleven PM, then quit. My weight, which had ballooned up two plus pounds, was down three pounds today, back in my acceptable range.

I don't expct this to ever be easy, but I don't intend to be one of the 90% who regain their weight after losing it.

Find your own path and join me. It's time and past time.