Is it time to bring back the fat? 

In the last couple of days, there have been two media pieces that want us to ditch dietary guidelines, claiming that promoting ‘high carbohydrate, low fat diets’ is to blame for the ‘obesity epidemic’. The first is Channel 7’s news piece from ‘dietitian’ Christine Cronau (not actually a dietitian!) and The National Obesity Forum in Britain.
I have a lot to say but I’ll try to keep it to one or two (or four) points.

  1. These people are not using the best methods of looking at the science.
 Christine is using anecdotal evidence: ie, what works for her. We know that as long as you stick to a diet, you can lose weight for a few months. This includes very low carbohydrate diets like the Atkins diet. This is not news.
The National Obesity Forum looks a little more legit. It references studies! That’s scientific, right? The thing is when you look at individual studies, you can make claims about anything you like. The report looks at 43 studies, which sounds like a lot, but the dietary guidelines examine literally thousands of studies. These giant reviews are much more reliable.

  1. People aren’t following dietary guidelines.
 Less than 4% of adults in Australia are eating the recommended amount of vegetables. There is a great chart in this article. To claim the guidelines are to blame when practically no-one is following them is bizarre. Also, Australia’s Dietary Guidelines are moderate carbohydrate, not high!

  1. Weight is not a good measure of health.
To claim that all thin people are physically healthy and all fat people are not is ridiculous. What truly matters is health behaviours. And remember that there is more to health than physical health. Having a good social life and good mental health are extremely important, and if your way of eating is not helping your to see friends and be happy, it’s not healthy.

  1. There is not one diet that is the best diet for everyone.
 As I wrote in my take on high/medium/low carbohydrate diets, healthy diets do have common features: Lots of fruits and vegetables, high in fibre, has all the energy, vitamins, and minerals you need, and not dominated by highly refined grains, sugar or processed meats. Eat delicious food you love that makes your body feel good.

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We Are Being Lied To About Weight Loss

lies about weight loss

Nothing makes me quite as annoyed as the myths about weight loss. I went through some common ones on the science-side of things.

“It’s simple energy-in, energy-out.”

Our body isn’t an in-out energy machine. As soon as you start to eat less food than you need for your body and brain to work at their best, your brain starts to find ways to reduce your need for energy and increase how much you eat. Because it thinks you’re in a famine.

Things your body may do:

  • ramping up hunger (especially for high energy food)
  • reducing satiety (fullness) signals
  • reducing your metabolism (making you more tired)
  • increasing efficiency of muscles (so you use less energy doing everyday movement)
  • holding onto fat as much as it can
  • reducing adrenaline response (so you can’t run as fast in an emergency)

Which means that any efforts to lose weight by changing energy balance are counter-balanced by your body in an effort to maintain your weight.

“[insert fad diet of the week] is the answer”

Diet gurus try to claim that their diet is the best way to lose weight and keep it off: that somehow eating certain foods in just the right proportions, or cutting out the right food group will somehow overcome your body’s efforts to make sure you don’t starve.

A study found that of all the ‘named’ diets (think Atkins, Zone) worked pretty much exactly the same for weight loss at 12 months, as long as you can stick to them.

“If you fail at weight loss, you lack self-control”

Every single diet study shows that an overwhelming majority of people regain weight. Weight loss maxes out at six months and most is regained by 12 months. Less than 3% of people will have kept all their weight loss 5 years later, and most people will have regained at least 83% of the weight they lost. This is because as long as your body weight is lower, your body is putting in a lot of effort to get you back there. Being on a diet is a risk factor for weight gain. Diets are perceived by your body to be times of famine. And times of famine could come again, so your body stores fat to protect you.

“Diets don’t work, but lifestyle changes do”

This, of course, depends what you mean by ‘work’. Lifestyle changes can make you fitter, healthier and happier. They can also help you lose weight in the short term. However, the changes that your body makes to protect itself from weight loss still happen whether you call the changes a lifestyle change or a diet. It’s still less energy for your body to function.

“You can’t be ‘overweight’ and healthy”

So where does this leave us? Is it all a lost cause? Are we doomed to diet of obesity-related diseases? The answer is NO. Health and weight are not 100% linked. It is true that higher body weight seems to be associated with higher risks of certain disease – but this does NOT mean that they are caused by the weight itself.

Changing your lifestyle by increasing healthy behaviours will increase your wellbeing and increase the odds of living longer, regardless of your weight. Healthy behaviours include:

  • getting enough fruit and vegetables
  • doing some exercise
  • staying socially connected
  • seeing a doctor regularly
  • drinking moderately or not at all
  • not smoking

Good luck on your non weight-focused quest for health!

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Some sciencey reading if you’re interested in some facts behind all this:

Physiological defense of body weight.

All diets are the same.

Long-term weight loss.

Diets predict weight gain.

 

Why don’t diets work?

Today I’ve been reflecting on two pieces of information:
1. This article ‘Dieting must Die’ from Dr David Katz. “Dieting is a short-term, get-on-then-get-back-off approach to the permanent challenge of losing weight and finding health. It has been tested rather generously, and it does not work”

2. This spaghetti-like ‘obesity map’ explores the hundreds of factors that influence energy balance. Just look at it. It’s huge!

Diets are by definition restrictive. Restriction leads to weight loss, because reducing ‘energy in’ will cause weight loss. So as long as you keep that conscious ‘restrict restrict restrict’ mindset forever you’ll keep it off (Hooray…). Besides the fact that restriction is boring and psychologically damaging, it usually doesn’t work long-term. Studies show that most people on diets start to regain weight about the 6 month mark.

What diets fail to do is address the reasons WHY people have gained weight. Unless you remove the factors, or manage them, diets will not work.

The human body is quite well designed. We have excellent appetite signals – we get hungry when we need to eat, and we feel full when we do not. If we pay attention to these signals most of the time, we’d be right. The only exception is junk food- It’s hard for your appetite to keep up when you can inhale a large big mac meal (5000kJ – about 60% of your requirements for the day) in about 10 minutes.

Eating mostly whole, healthy foods to promote health, paying attention to appetite is not only a recipe for being a healthy and comfortable weight. It’s also an important part of a happy and calm life.

So why don’t people eat whole healthy foods? It varies for each person, but here are some factors I (and the spaghetti diagram) think are important:

  • cost and income
  • convenience
  • family preferences
  • personal preference
  • media pressure
  • peer group and social pressure
  • time restrictions
  • food literacy
  • habit

Why people eat when they’re not hungry, or keep going once they’re full?

  • Emotional eating
  • Habit
  • Social occasions
  • The food is just so delicious
  • Feeling deprived
  • Bored eating
  • Big portion sizes
  • Big plates
  • Eating too fast to register fullness
  • Not acknowledging hunger/satiety.
  • Pressure to finish everything on the plate / not wanting to waste food

So what can we do if we want to lose weight? It can be difficult to figure out what factors are having the biggest impact in your life. Taking time to consider WHY you are making certain food choices can be really helpful.

If you want to make a start, try asking yourself questions such as:

  1. Do I really want to eat this?
  2. Why do I want to eat this?
  3. Do I want to keep eating?

I hope you forgive some shameless self-promotion for dietitians here! A dietitian can help you figure out and manage your factors, and help with motivation and accountability.

Feel free to send me a message, or look for a dietitian in your area.

If you want to read book that address these topics, check out Don’t Go Hungry and Mindless Eating.

Review: Dr Libby’s Road to Sustainable Weight Loss

Last week I got together with the lovely people I did my Master of Nutrition and Dietetics with. We went to see Dr. Libby’s ‘Road to Sustainable Weight Loss’. I hadn’t heard of her before, but she’s a dietitian with quite a following in NZ.

Dr Libby is here in Australia promoting her books: the newest of which is ‘Calorie Fallacy‘. She’s a fantastic speaker, and she targeted her talk to individuals wanting to lose weight, but there was a lot for me to learn too!

As many people know, the ‘calorie-in/calorie-out’ equation does not always work.  One of my favourite phrases is ‘human bodies are such mysterious things!’ We definitely do not work like in/out machines. The human body is so complex, and there’s still so much to learn.

Dr Libby presents two basic ideas in her book:

  1. Toxin build up causes fat gain.
  2. Stress increases fat gain.

Dr Libby’s first theory is that our livers are overloaded from added sugar, trans fats, alcohol, caffeine and other toxins. She says that if there are just too many toxins, the liver will not be able to cope, and will dump excess toxins, which will have to be stored in fat cells.

While this does seem to make sense, I haven’t seen the research and cannot comment on the validity of this theory. Her solution to this is to consume less of what is bad for us: excess junk food, alcohol and caffeine. And more of what is good for us for optimum liver function: fruits and vegetables, and other whole, nutritious foods.

I think the label ‘toxins’ is interesting, because it’s all in the dose. Even things that we think of as harmless, such as cinnamon, can be toxic at higher doses.

So for alcohol and caffeine, I think to treat them as ‘to limit’ foods is a good idea.

Neither has been linked with weight gain, and moderate caffeine intake has been linked to weight loss. A moderate intake* of alcohol is linked with reduced mortality. If you think maybe caffeine intake is affecting your sleep, then it’s worth cutting down, to see if your wellbeing improves.

Her second theory is that stress causes fat gain: Having stress leads to high levels of cortisol, which messes with our metabolism. We do know that excessive cortisol causes weight gain – as in the case of Cushing’s Syndrome- although whether elevated cortisol plays a big factor in those without the syndrome remains to be seen.

Dr Libby recommends deep, slow breathing, such as meditation or tai chi, to reduce cortisol. There are many scientific studies that prove this. Reducing stress is good, whether it causes weight loss or not.

Although I haven’t seen all the evidence behind Dr Libby’s recommendations for weight loss, they are definitely good for health and wellbeing:

  • Eat whole foods.
  • Limit junk food, alcohol and caffeine.
  • Reduce stress.

 

*(no more than 1-2 standard drinks per day, and two alcohol free days per week)

 

References:

Better Health: Cushings Sydnrome

Buddhist Meditation reduces cortisol

Transcendental meditation reduces cortisol and CVD risk

The link between alcohol and weight is very confusing

Caffeine may in fact lead to lower body weight

Australian Alcohol Recommendations