Friday, September 12, 2014

Are Fruit Smoothies A Good Choice For Breakfast?

Life is pretty busy for most of us. We are all looking for quick and easy meals that will save us time. This seems to be especially true for breakfast. At first glance, a fruit smoothie seems like an awesome choice. It has fruit, yogurt or milk, maybe some flax seed, and some ice. These are all healthy ingredients.

However, fruit smoothies are definitely not a good choice for breakfast, especially if you are trying to lose weight. It all has to do with blending the fruit.

Whole fruits are one of the healthiest things that you can eat. They are loaded with vitamins, minerals, fiber, antioxidants and other biologically active phytochemicals. They are easy on the blood sugar because each sugar molecule is surrounded by a helix of fiber. This takes time for your digestive system to break down and results in an easy, gradual rise in blood sugar and a small release of insulin. 

When you blend fruit, you upset this healthy, natural package. Blending fruit separates the fiber from the sugar. This results in a higher spike in blood sugar and insulin, which has the potential to increase fat storage, decrease fat burning at the muscular level, and increase hunger a few hours later, which leads to snacking.

If weight loss is your goal, eat your fruit in its whole, natural form and never blend it.

Does Vitamin D Supplementation Enhance Weight Loss?

The Study
218 overweight women were randomly assigned to 2,000 IU of vitamin D or placebo for 12 months. Both groups received the same weight loss advice, which included comprehensive dietary change and 225 minutes of cardiovascular exercise per week. After 12 months, there was no significant difference in weight loss between the two groups. The vitamin D group lost 8.2% of their baseline body weight, while the placebo group lost 8.4% of their baseline weight. American Journal of Clinical Nutrition 2014; 99:1015-25.

Take Home Message
In some cross-sectional studies, vitamin D levels have been inversely associated with obesity. However, it appears that vitamin D supplementation does not increase weight loss. This was a very well designed study with good adherence and a long duration. Once again, another promising weight loss supplement fails to live up to the rigors of a randomized trial. I guess there is just no substitute for proper diet and exercise if weight loss is your goal.


Does Protein Really Help You Eat Less?

The Study
In a randomized trial with a crossover design, 30 men and 28 women consumed three different diets for 12 days on separate occasions: 5% of energy from protein, 15% of energy from protein, and 30% of energy from protein. The diets and exercise habits were identical in all three conditions with the exception of the amount of protein consumed.  All meals were consumed at the University that was conducting the study and food consumption was ad lib, subjects could eat as much as they wanted at a meal. When consuming the 5% energy diet, subjects averaged 2,264 calories per day.  When consuming the 15% protein diet, subjects consumed 2,221 calories per day.  When consuming the 30% protein diet, subjects consumed 2,085 calories per day. American Journal of Clinical Nutrition 2014; 99:1397-406.

Take Home Message
This study provides further evidence that higher protein consumption reduces energy intake.  Researchers are not quite sure why protein increases satiety, but it sure seems to in trials.  The difference in calories consumed between the high and low protein diets was 180 calories per day.  This has the potential to have a profound impact on body weight over time.  I have my clients shoot for about 20% of calories as protein, which is a safe level and can really have a positive impact on hunger and subsequent energy intake.

Thursday, September 11, 2014

Product Review: Nike Fuelband

If your goal is weight loss, the ability to measure your total physical activity is a powerful tool.

As a trainer, my client’s exercise activities are easy to track. I will issue a cardio goal, like 250 minutes of elliptical training per week, my client will keep a record of minutes completed, and we both know exactly what is going on.

What I have learned in the last few years, with the help of the technology that is described below, is that the amount of non-exercise physical activity varies wildly from person to person.

I have clients in the medical field that walk so much during their work day that they hit 9,000 steps from work alone. I have other clients who have more sedentary office based jobs that barely hit 2,000 steps during a workday. The Nike Fuelband is a simple tool that measures your entire physical activity, both your exercise activity and your activities of daily living.

The Nike Fuelband is a tiny device that you wear around your wrist like a watch. It contains a sports tested accelerometer that measures all varieties of physical activity. It gives you a number of useful measures: including the number of steps you walk per day, the number of calories you have burned from physical activity, and most importantly, your Nike Fuel for that day. 

Nike Fuel is a universal metric of physical activity. You set a goal for Nike Fuel points in a day, mine is 3000. Your Fuelband converts all of your physical activity into Nike Fuel points, including walking, running, weight lifting, basketball, and all other sports and activities. The band has a series of LED lights that turn from red to yellow and then to green as you progress toward your Nike Fuel goal for the day. When you hit your goal, the band lets you know.

1) This device measures all of your physical activity, not just your steps.

2) You wear the Fuelband like a watch. This is a huge upgrade over most pedometers that you have to clip onto your belt. I can’t tell you how many of my clients have lost their pedometer because it has fallen off of their waist at some point in the day. In most cases, it is never found.

3) The Fuelband plugs directly into your computer’s USB port to recharge and upload data.

4) You have free access to the Nike Fuel website, which keeps track of your activity and allows you to set goals. The website is awesome.

5) Very good battery life. In my experience, it lasts 5 or more days without a charge and once plugged in, recharges very quickly. 

6) It can store multiple day’s worth of data and then uploads automatically while charging. Therefore, you don’t have to connect it to your computer every day. Just charge it every week or so and your data will be uploaded.

7) It also tells the time.

8) It comes with a one year warranty. If it breaks, Nike is very good about sending you a new one within the warranty period. 

Would I Recommend the Nike Fuelband?
Absolutely! Many of my clients have picked one up and they all love it as much as I do. It will teach you a ton about your activity level. You will start to understand your patterns. You’ll be able to see which days of the week you consistently hit your goals, and which days you don’t. When you come up with a plan to improve on the days that you miss, you can easily measure your progress.

It is very motivating as well. Recently I set a goal of 100 days of 3000 fuel points, which I’m proud to say that I hit! More than once, I was doing a few minutes of jumping jacks before I went to bed to make sure I hit my goal for the day. My wife thought I was nuts, but once I set that goal; I wouldn’t go to bed until I hit it.

For my weight loss clients, I have them set a goal of 3,000 fuel points and a minimum of 7,500 steps per day.

The Nike Fuelband retails for $99 and you can pick it up on the website.

Click here for more information or to pick one up.

Friday, July 11, 2014

Questions and Answers

What weight loss supplement do you recommend?

The short answer: absolutely none!

The long answer requires a bit of a background. In October 1994, the Dietary Supplement Health and Education Act was signed into law by President Clinton. After this law was in place, manufacturers of dietary supplements did not need approval from the FDA to begin marketing and selling their supplement products. 

This is in direct contrast to pharmaceutical drugs which need to prove that they are both safe and effective before they can be brought to market. 

Following are some of the problems that this law created:
1) Nobody is checking up on the ingredients in these supplements. Often they don’t contain what they say they do, or contain little to none of the advertised active ingredients. 

2) For the same reason, sometimes they contain harmful ingredients like pharmaceutical drugs or even banned substances.  There is really no regulation until there is a report of illness or injury, then the FDA will look into it.  It is up to the FDA to prove that these substances are not safe and they don’t have the resources to test all of the tens of thousands of products on the market.   

3) They never stand up to scientific scrutiny. I read the nutrition literature every month, and whenever an independent university or research institution tests these weight loss supplements, they don’t increase weight loss when compared to a placebo in well-designed randomized controlled trials.

Stay away from weight loss supplements.  At best they are ineffective, at worst they can make you sick.  If weight loss is your goal, there is no substitute for a good diet, the right cardiovascular exercise program and a well-designed strength training routine. 


Research Update

Mediterranean Diet And Diabetes

The Study
In this randomized trial, 3,541 men and women aged 55-80 at high risk of cardiovascular disease were put on one of three diets: a Mediterranean diet supplemented with olive oil, a Mediterranean diet supplemented with nuts, or a low fat control diet. After 4.1 years of follow up, the pooled Mediterranean group had a 30% lower risk of type 2 diabetes when compared to the low fat control group. The authors believed that the Mediterranean diet contains components that decrease inflammation, oxidative stress, and insulin resistance. Annals of Internal Medicine 2014; 160:1-10.

Take Home Message                    
Yet again, the Mediterranean diet is shown to be extraordinarily health promoting.  It is a diet that is 35-40% healthy fat, high in nuts, fruits, vegetables, legumes and fish, and low in butter, sugars, and refined carbohydrate. This study also provides further evidence that a low fat diet is not the way to go.

Glycemic Load And Inflammation

The Study
This paper is a systematic review of the literature on the association between dietary glycemic index/load and markers of inflammation. Nine observational studies and 13 intervention studies were identified for this review. Markers of inflammation in these studies were C-reactive protein (CRP) and Interleukin 6 (IL-6). The researchers found that the majority of studies found a significant association between glycemic index/load and higher levels of inflammation. The authors of the study believe that higher glycemic load diets increase oxidative stress which leads to an inflammatory response by the body. American Journal of Clinical Nutrition 2014; 99:813-33.

Take Home Message
It appears that inflammation is very important in the development of a variety of chronic diseases, such as: type 2 diabetes, heart disease, stroke, dementia, and even some cancers. Swings in blood sugar can have a really powerful impact on our health. Do your best to keep your glycemic load low by substituting fruits, vegetables, legumes, and whole grains for refined grains like bread, pasta, white rice, and sugar.

Research Update: Are nuts health promoting or just fattening?

Association of nut consumption with total and cause specific mortality. New England Journal of Medicine 2013; 369:2001-11.

To examine the association between nut consumption and all-cause mortality.

76,464 women from the Nurses’ Health Study and 42,498 men from the Health Professional Follow up study were followed for 30 years. Nut consumption was measured every 4 years by means of a validated food frequency questionnaire. Risk of death was computed for increasing levels of nut consumption, while statistically controlling for potential confounding variables.

By the end of follow up, there were 16,200 deaths in the Nurses’ Health Study and 11,229 deaths in the Health Professional Follow-up Study. When compared to subjects who never consumed nuts, subjects consuming 7 or more servings of nuts per week had a 20% lower risk of dying. A serving of nuts was considered to be 1 ounce.

There was a statistically significant inverse association between nut consumption and death due to cancer, heart disease, and respiratory disease. The association between nut consumption and a lower risk of morality was actually stronger for subjects that were overweight or obese.

Nuts have long been vilified for their high fat content. Those looking to improve their health or lose weight were told to strictly limit consumption. This was the wrong advice. First of all, nut consumption does not have a major impact on body weight. In both the Nurses’ Health and Health Professional cohorts, less weight gain was seen among subjects with more frequent nut consumption.

Nuts are also an extremely healthy food. They contain unsaturated fatty acids, fiber, vitamins, minerals, antioxidants, protein, and other beneficial phytochemicals. The authors noted that the combination of these components has been shown to be cardio-protective, anti-carcinogenic, and anti-inflammatory.  That is likely why those who consume nuts frequently have a lower risk of dying.

Take Home Message
Nuts are a very important part of a healthy diet. Do not fear them, but appreciate them and enjoy them on a daily basis.