Sunday, March 13, 2016

If I Am Not Hungry, Is It OK To Skip Breakfast?

It has been a really big surprise to me as a nutritionist to learn just how many people don’t eat breakfast in the morning.  I, for one, am starving when I wake up and have been ever since I have been a little kid. I don’t know how anyone can wait until lunch for their first calories of the day. Either way, I am often asked if it is OK to skip breakfast, particularly by those looking to lose weight.

Will skipping breakfast impact one’s ability to lose weight?
The research goes back and forth on this one and I don’t think we really do know for sure. I have seen evidence of a decreased weight loss in breakfast skippers and I have seen evidence that there is no difference in weight loss when comparing breakfast eaters to those who skip breakfast.

I can tell you this anecdotally, in the last 15 years, every one of my clients who hits their goal weight eats breakfast. Here is my theory as to why it is important:

Since humans evolved in times of famine and food scarcity, I feel that over the years our bodies developed defense mechanisms to protect us from these events.

When food starts to get in short supply, I believe that our body tries to prevent fat stores from dropping too low. This is accomplished 2 ways. #1) Our metabolism slows down so it takes fewer calories to get through a day. #2) In an effort to preserve fat stores, we start to burn muscle for energy. There is evidence of this in the research literature. When people lose weight by really restricting their calories, you start to see a lower metabolic rate and a significant loss of lean body mass.

Say you eat dinner at 6:30 PM, go to bed, skip breakfast and eat at noon the next day. You have gone 17½ hours without eating food, almost a full day. I believe that this does bad things to your metabolism and makes it harder to lose weight. It is also my opinion that when the body notices a steady and consistent supply of calories every few hours, it is more likely to release its fat stores, and that is why I don’t like my clients to skip breakfast. Again this is my theory, I don’t think there has been enough research on these defense mechanisms to prove or disprove them.

Some other reasons to eat breakfast:
1) It will help keep your blood sugar stable, which has a very nice impact on your energy, mood and ability to focus.

2) When you skip breakfast, you tend to make up the calories by snacking. In general, snack foods aren’t as healthy as planned meals.

3) I don’t think it is possible to get all of the good nutrition your body needs in a day in just two meals. Eating three meals makes it much easier to hit goals for fruits, vegetables, protein, vitamins, minerals, fiber, anti-oxidants, etc.

So in conclusion, everyone should eat a healthy breakfast. This is especially important if you are trying to drop a few pounds.


Prebiotic Consumption And Risk Of Weight Gain

The Study
Prebiotics are fermentable carbohydrates that our body can’t digest. They have the ability to alter the composition of our gut microbiota and are thought to confer a number of health benefits. However, most studies on prebiotics have been on animals and research in humans is sparse.

In this investigation, 8,569 normal weight subjects from the Spanish Sun Project cohort had their diet measured by a food frequency questionnaire and self reported their weight every two years. The subjects were split up into 4 groups according to their consumption of prebiotics. After 9 years of follow-up, the group consuming the most prebiotics had a 13% lower risk of becoming overweight when compared to those consuming the least. American Journal of Clinical Nutrition 2015; 102:1554-62.

Take Home Message
The connection between our gut bacteria and our weight is fascinating and is still in the process of being elucidated. There really does seem to be a connection. Prebiotics are used as an energy substrate by healthy bacteria in the gut that convert them into short chain fatty acids. These short chain fatty acids are thought to influence levels of certain hormones, like peptide YY and glucagons-like peptide 1, that may influence satiety and decrease food consumption. 

In this cohort, most of the prebiotics that were consumed came from fruits, vegetables, legumes and whole grains. If you need yet another reason to eat these healthy foods with regularity, here you have it.

Diet Soda Vs. Water For Weight Loss

The Study
Sixty-two obese and overweight women initiated the same weight loss plan, which included a low calorie diet and 300 minutes of moderate exercise per week.  Half of the women were told to drink at least one diet beverage after lunch and the other half were told to eliminate diet beverages and drink only water. Body weight and several metabolic indicators were measured both before and after the 24 week intervention. Both groups lost a significant amount of weight. The diet soda drinkers lost an average of 16.7 lbs., while the water drinkers lost 19.4 lbs. Furthermore, the women drinking the water had a statistically significant improvement in insulin sensitivity when compared to the diet soda drinkers. American Journal of Clinical Nutrition 2015; 102:1305-12.

Take Home Message
This was a very well designed trial that taught us a few things: 1) Water is, far and away, the beverage of choice for weight loss. 2) Drinking diet soda regularly does not prevent weight loss, if the diet and exercise program is strong. A couple of studies I have read in the past few years hypothesized that consistent diet soda consumption interfered with the ability to lose weight. This study shows evidence that this is not true. However, the water drinkers lost more weight over the 24 weeks and had an improvement in insulin sensitivity, which translates to a lower risk of type 2 diabetes.

If weight loss is your goal, make water your primary beverage. If you love diet soda, have a couple a week as a treat.  If you are drinking a lot of regular soda now, switching to diet can be a nice and easy option to start the scale moving in the right direction as you transition yourself to water as your go to beverage.


Prodcut Review: Bowflex SelectTech Dumbbells

Working out at home makes a lot of sense. Most of us are busy, and not having to drive to a gym, park the car and get changed can save us some serious time. Exercising at home can also can save you a lot of money. You can take one year’s worth of gym dues and make a really nice little home gym that will last you a decade or longer. When deciding on the type of weights to include in your home gym, there is a lot to think about, including; the price of the system, the space you have available, and what exercises you want to be able to do. 

Bowflex SelecTtech Dumbbells are a great choice for any home gym. These are dumbbells that have a dial on the side that allow you to change the resistance from 5 to 50 pounds in 5 pound increments (and even 2½ lbs. increments for the first 20 lbs.). If you want them to be 20 lbs, you simply turn the dials to 20 and you’re ready to go. I’ve had a set of these for years and have been really happy with them. Following are some of the pro’s and con’s of these dumbbells.

1) Very easy to change the resistance. If you have plate loaded weights with collars, it can take you a few minutes between exercises to adjust the weights. This can disrupt your work/rest interval and add significantly to your workout time. With the Bowflex weights, the change is instantaneous.

2) Look and act like regular dumbbells. Other adjustable dumbbell systems have an unusual shape with a handle in the middle of the dumbbell. This makes it hard to do exercises like overhead back or triceps presses. The Bowflex system can be held like a regular dumbbell, so you can do anything with them.

3) A Serious space saver. This adjustable dumbbell set takes the place of an entire wall of individual dumbbells. This is important if you are in an apartment or only have a small amount of space to devote to your home gym.

4) Very well made. These dumbbells are very durable. I’ve had mine for years and they look like they just came out of the box. There are no signs of wear and tear at all.

5) Do not roll when you place them on the floor. This may be a minor issue for some, but there is nothing worse to me than laying down your dumbbells in between sets and having to chase them around the room. The Bowflex dumbbells lay flat and don’t roll around.  

6) You can increase the weight by 2.5 lbs. increments all they way up to 22.5 lbs. with these dumbbells. Sometimes an increase from 10 lbs. to 12.5 lbs., rather than to 15 lbs. is appropriate and this is a nice option to have.

1) The only con I can come up with is the price. Right now on Amazon, they are $290.67 for the set that goes from 5 to 52 lbs. Now, if you bought pairs of 5, 10, 15, 20, 25, 30, 35, 40, 45 and 50 lb dumbbells individually, you’d spend a lot more than $290. However, if you bought plate loaded dumbbells with collars, you’d spend a lot less.

Would I Recommend the Bowflex SelectTech dumbbell system?
Absolutely. They are a bit on the pricey side, but they have really changed the way I can workout at home. I can switch weights in between exercises and even in between sets, with ease. My workouts are now more fluid and overall quicker to get through. I love the space saving aspect as well. I recommend them highly. Several of my clients over the years have purchased these and they have all been just as happy with them.

If you are interested in picking these up, they are available all over, but currently has the best price and free Prime shipping.


Tuesday, January 12, 2016

How much weight do we really gain during the holidays?

I have been reading for years that the typical American gains 7-10 lbs. between the holiday season of Thanksgiving and New Year’s Day. However, the sources were never research based, so I have always wondered if this is really true. 

So, I decided to do a scan of the nutrition research literature to see what I could find. I was surprised that there is almost no research in this area. I found one well designed study on holiday weight gain from the New England Journal of Medicine, but it was published way back in March of 2000.

This was a simple study conducted at the National Institutes of Health in Bethesda, Maryland. In this investigation, 195 adults were weighed 4 times throughout the year: Before Thanksgiving, right after the holidays in early January, a bit after the holidays, in late February/early March and the following September.

At first I was surprised by the results, and then they made more sense. The average weight gain between Thanksgiving and New Year’s Day was about 1 pound, which was the surprising part. However, 10% of the subjects gained 5 or more pounds. As the subject’s starting weight increased, there was a trend of an increased risk of gaining at least 5 lbs. In other words, if you were overweight at the start of the study, your risk of gaining 5 lbs was higher than those with a normal weight, and if you were obese, the risk was even higher than that. 

A disturbing finding was that by the following September, the one pound weight gain remained. So, if you gain a pound every holiday season and don’t lose it, you’re looking at 5 lbs. every 5 years. This, obviously, can really add up and become a problem.

While this is just one study, it was very well done. It appears that most of us don’t gain much weight at all during the holidays, but we never seem to lose the pound or so that we do gain. The overweight and obese have a higher risk of gaining significant weight.  Generally, we don’t average the commonly referenced 7-10 pound holiday weight gain, but we do add a little and all need to be especially vigilant now that January is here!

New England Journal of Medicine 2000; 342:861-67

Animal protein vs. vegetable protein for heart health

The Study
The metabolic syndrome is a cluster of symptoms that is strongly associated with risk of heart disease, stroke, type 2 diabetes, and all cause mortality. It is diagnosed when at least three of the following are present: 1) A Waist circumference higher than 40 inches in men and 35 inches in women. 2) Blood glucose higher than 100 mg/dl. 3) Triglycerides higher than 150 mg/dl. 4) HDL cholesterol below 40 mg/dl in men and 50 mg/dl in women. 5) Hypertension. 

The researchers of this investigation wanted to see if the type and amount of protein in the diet influences symptoms of the metabolic syndrome. Sixty-two overweight men and women with metabolic syndrome were randomized into one of 3 heart healthy DASH (Dietary Approach to Stop Hypertension) diets: 1) 18% protein with two-thirds of the protein coming from plant sources. 2) 18% protein with two-thirds of the protein coming from animal sources, including lean beef. 3) 27% protein with two-thirds of the protein coming from animal sources, including lean beef. The initial goal of this 6 month intervention was weight loss followed by weight maintenance.

The results were interesting. All groups lost similar amounts of weight (about 5% of initial weight). All metabolic syndrome criteria decreased similarly independent of protein type and amount. American Journal of Clinical Nutrition 2015; 102:757-70.

Take Home Message
Many authors of diet books claim that animal protein increases risk of heart disease, and that a vegetarian diet is the only way to heart health. This study provides strong evidence against this theory. According to this study, if you choose animal proteins that are low in saturated fat, like chicken, turkey, fish, and even lean beef now and again, your ability to reduce symptoms of the metabolic syndrome are similar to eating a diet high in plant proteins. It appears that weight loss was the big driver of metabolic syndrome symptom reduction in this study.

So do not be afraid of lean animal proteins. They certainly have a place in a heart healthy diet. The big take home message here is to get your weight down to a healthy level.

Sugar and the metabolic syndrome

The Study
In this investigation, 43 overweight adolescents reduced the sugar in their diet from 28% of calories to 10% of calories for a period of nine days. The sugar was replaced with fruit, bread, pasta and cereal grains. The subjects all had at least one risk factor for cardiovascular disease at the start of the study.

The researchers wanted to study the effects of sugar on risk of heart disease, not weight loss, so they did their best to keep the participants weight stable throughout the study. The subjects were given all of their food for the 9 days and had risk factors for heart disease measured both before and after the intervention. 

The results were shocking. After just 9 days of consuming less sugar, the subjects had a statistically significant decrease in their blood pressure, triglycerides, LDL cholesterol, and had improvements in glucose tolerance. Obesity 2015: doi:10.1002/oby.21371

Take Home Message
This is a really important study. For decades, nutritionists thought of sugar as largely empty calories and only a problem if it caused weight gain. This article shows that sugar can impact risk of heart disease independent of any effect it has on body weight. 

Even though these adolescents had no appreciable change in their weight (they lost on average just 2 lbs.), there were dramatic reductions in blood pressure, blood lipids and glucose tolerance in just 9 days. And they were still consuming 10% of calories as sugar, which in my opinion, is a ton of sugar!

The message is now crystal clear. Sugar is not just empty calories, it has the potential to make you very sick. Do your best to strictly limit sugar, or even better, swear it off altogether.