Well, at long last I've put <ahem> e-pen to e-paper and come up with a second life treatise. This one gives the straight poop about the state of our public health. I hope that it will clarify and simplify what is otherwise a large and confusing issue.
At the heart of any sound strategy for good health is a diet plan. "We are
what we eat" is a well-worn adage because it is ultimately true. However,
what does eating sensibly mean nowadays? We are bombarded by so many
conflicting messages: recommendations from the USDA, "the latest" health
findings every week, new diet plans galore, and the overwhelming advertising
program of consumerism from food companies themselves. What should we
believe? The first third of this document is aimed toward practical advice
about the diet of Eating Sensibly, showing a straightforward picture
and giving no nonsense recommendations. We further describe a practical
weight loss program whose heart is the Fat Loss diet, synthesized
from the advice of a variety of dietary experts. Physical activity is also
an important factor in weight loss, where the right timing is more
salient than sheer sweat.
Diet is such a vital and basic human concern that most of us want to understand what effect different foods have on us, and why. The second third of this treatise addresses these concerns with an in-depth description of Nutrition. We'll cover only the well-substantiated scientific evidence at the level of our metabolic and digestive biochemistry, and then condense the information into a useful understanding of what happens when we eat. We'll also expose the most harmful myth around today, the Fat Myth, as well as explain some typical patterns we fall into.
The last third of this page will be devoted to trying to give a clear overview of the forces at work in Our Public Health, why they are the way they are, and how we can deal with them. In particular, we'll focus on being overweight, a health condition that affects two-thirds of American adults (in 2002). The United States Center for Disease Control has classified obesity and diabetes as twin epidemics. I am perhaps the least alarmist person in the world, but when the CDC gets uppity about something, I listen. In fact, I'm rather puzzled by the lack of public response. The CDC announces that AIDS is an epidemic, and there is an enormous public response; AIDS today affects less than 1 million people. In 2002, 44 million people were obese, 17 million were diabetic, and an equal number pre-diabetic. What's going on? Why have we suddenly been afflicted with obesity and diabetes in the last couple decades? Why are we so blase about the most damaging preventable health issue of our times? And most importantly, what can we do about it now?
Eat Sensibly and Drink Water
What Everyone Needs To Do For A Healthy Diet
Follow the US Dietary Guidelines
After slogging through thousands of web-pages, hundreds of studies, and
dozens of books, I have found that the United States Department of Health and
Human Services (DHHS) is the best source of sound advice about diet. That's
right. Those little pamphlets that kids get with the gaudily colored food
pyramid on them is the most accurate distillation of the most advanced
nutritional findings known to man. Freaky, isn't it? Here are the
States Dietary Guidelines for the year 2000. Read it thoroughly,
carefully, and then take it to heart.
Sadly, the dietary message of the US government is unheard, treated with suspicion, and misunderstood. First, most people know about the Food Pyramid but not about the Dietary Guidelines. I personally didn't know about the Guidelines until age 31, after a friend of mine in the public health industry kindly pointed them out to me. That was five years after I first became interested in diet and health issues. The very sound, incredibly useful message of the US DHHS just isn't getting out there to people like us, because it is swamped out by the maelstrom of other information that we are presented with. (More on that later.) A more explicit reason why their message is unheard is because people don't even read the guidelines. They assume they already know what the Food Pyramid and the Guidelines are about, and they don't even read the damn thing. Have you clicked on the link above and carefully read the guidelines? Do it now! (Hyperbole aside, you really do have to read the Dietary Guidelines or otherwise a great deal of this page won't make any sense. Take your time; I'll wait for you until you're finished reading them. ;-)
Second, there was a period around 1980 or so where the United States Department of Agriculture (USDA) became little more that a stooge for the interests of large agricultural conglomerates. At the time, The USDA was responsible for the Dietary Guidelines and conflict of interest occurred, because its fundamental mandate was basically to promote US agriculture. Considerable favoritism happened and the official government diet message drifted away from being for the public health and toward the sales of large food corporations. As a consequence, many people (quite rightly) began to call into question the integrity of the recommendations (at the time being the Four Food Groups). With the advent of the DHHS all that changed, vastly for the better. It is an organization with a mandate solely for the public health... but sadly, still not completely free from the subtle influence of large food companies.
Which brings us to part of the reason why the message is misunderstood even when it is heard and trusted. Much of the official language the US DHHS uses is couched in ambiguity ("Be moderate in...", "Reduce your intake of...") because it is still susceptible to the pressure exerted by food lobbyists, who fight tooth and nail over commas. Altogether, it leads to a rather wishy-washy set of guidelines that is easily misinterpreted. If you carefully read the guidelines "between the lines" the message is clear; but on a casual reading it can easily be misunderstood.
Fortunately, I have no affiliation with anyone and can tell it like it is, in no uncertain terms. The Dietary Guidelines are the soundest basis to start from; here are the specific amendments we should make to them.
AVOID SUGAR. Added Sugar is Evil. It is The Enemy. Excess Dietary
Sugar is an Anathema to All That Lives
The single smallest change that we can make in our diets with the greatest
overall benefit is to eliminate added sugar. The first benefit is an
immediate and noticeable one. When combined with the recommendation below
(to replace carbs with protein), we shed overweight pounds like magic. The
second benefit is a hidden one but no less important. We recorrect
our insulin response and dramatically reduce the risk of acquiring Type II
Diabetes. Too much dietary sugar is the primary cause of weight
gain, and by extension a key risk factor for diabetes.
So what do we mean when we say "added sugar"? First, it includes all processed sugar, that is, sugar distilled from natural sources. Something many manufacturers are doing nowadays to mislead buyers is putting ingredients like "evaporated cane juice" or "all natural citrus extract" on their labels. These are basically just ways of saying added sugar, but without using the word sugar. Second, added sugar can also take the form of foods naturally high in sugar. "Honey" and "molasses" are two good examples in this category. Third, and perhaps most subtle, is artificial concentration. Apples contain naturally occurring sugar and applesauce is typically partially evaporated, thus artificially raising the concentration of sugar in the final product. It is important to keep in mind that the source of added sugar makes no difference to its effect; most processed sugar ultimately comes from natural sources. From a sugar perspective, it's just as bad to drink freshly-squeezed all-natural orange juice as it is to eat sugar from a bag. It's the unnatural concentration of sugar in food processing that is harmful, not whether the source is "natural" or "processed" itself.
Why do food manufacturers even bother with all this? The reason is obvious but bears stating: sugar tastes good and sells more products. Adding sugar to any food product is a cheap and easy way to increase its taste appeal, and thus its sales and profitability. One of the most stable and profitable companies in the world is Coca-Cola. Their main product? Caffeinated sugar water. With their acquisition of Minute Maid orange juice around 1960 and their release of decaffeinated drinks they solidified their focus on: just sugar water. Even the Altria Group (formerly Philip Morris) adds sugar to their cigarettes. Here are a few other companies they own; notice the trend toward sugary snack foods? Sugar is big money and will continue to be added to food products because it is highly profitable. So added sugar is obviously good for food companies; is it any good for our health?
Added sugar is completely unneeded in our diet. There are six essential nutrients: 1) water, 2) protein, 3) fat / oils, 4) carbohydrates, 5) minerals, and 6) vitamins. Sugar is a form of carbohydrate; however, every carbohydrate gets broken down into simple sugar by the body, making any sugar that we intake unnecessary. The only reasonable use of dietary sugar is for the tactical, immediate regulation of blood glucose levels. That might apply to, say, a sprinter or vigorous athletes who dangerously deplete their bioavailable sugar; or alternatively, to diabetics who need to micro-manage their blood glucose and other people with similar medical conditions. I don't know about you, but those are categories that a) I don't belong to and b) I don't want to fall into. Let me even go so far as to make a bold, inflammatory statement that I'm certain I'll get sued for: there is mounting evidence of real health risks posed by the repeated excessive intake of added dietary sugar, specifically: obesity and diabetes and all the consequent problems they entail. So not only do we not need sugar in our diet, when taken in excess it is harmful to us. Sugar today is where nicotine was 30 years ago, and sugar manufacturers will bitterly protest that sugar is harmless, the same way that cigarettes manufacturers did. Too much sugar is bad for your health.
Drink Water Instead of Sugary Drinks or Alcohol
Enough harping; let's talk brass tacks recommendations. The primary source
of added sugar in our diets is sugary drinks. So,
we'll get the most bang for the buck by if we replace sugary drinks with
water. That means:
fruit juices /
milk / milkshakes,
and many artificial drinks (like Kool-Aid, Gatorade, et al). We also want to
avoid alcoholic beverages because of their
high caloric content (and other obvious reasons); they don't taste
sugary, but they eventually become sugar in our blood, and represent a
significant source of calories. In fact, if you remember only one thing from
this whole page, it should be drink water instead of sugary drinks or
alcohol. The increasing assortment of calorie-rich drinks we imbibe is
single greatest adverse factor in our change of diet. We are becoming less
what we eat and more
we drink every day. I personally know a great many people who eat very
sensible meals... and sabotage their diet with sugar and calorie laden
drinks. Drinks have somehow "fallen under our radar"; when we think diet, we
think food, instead of both food and beverages. Drink water, and lots of it,
and you'll be much healthier. [For ye true optimizers out there, drink water
away from meals, preferably hot or warm; it helps digestion kinetics.]
Milk is a special case worthy of mention. Many Americans are surprised to hear that dairy products are a major source of both sugar and fat in our diet. We are brought up to believe that milk is the perfect drink and it doesn't even occur to us that there might be tradeoffs involved with its consumption. Milk is the primary source of calcium in our diet, and it is also the most readily bioavailable one. As such, it does indeed promote the growth of strong bones and do all the wonderful things we've been told. However, there are many other excellent sources of calcium that do the exact same thing. So, if you are going to drink milk, drink skim milk only and avoid products with added sugar (like chocolate milk). There are also other milk options available since people became aware of lactose intolerance. Most of the common types of milk (rice, soy, wheat, etc.) are calcium fortified, though sadly most brands add sugar to enhance the taste. The verdict on milk is: it does a body good, as long as it's not filled with sugar and fat. For men, target two (2) dairy servings a day, which can be one tall glass of milk, the milk in your bowl of cereal, or the cheese on a pizza. For women, target the same but take extra care to supplement your calcium with other calcium-rich foods. For older people, increase the target to at least three (3) dairy servings a day and take explicit supplementation like multi-vitamins.
Beware falling into the "fortification hype" that many food advertisers are pushing today. It goes something like this: "Vitamin C is Good For You! It is a natural antioxidant that the American Antioxidant Association says everyone needs! Orange Juice is plentiful in Vitamin C! So, you Must Drink More Orange Juice!" This type of rhetoric is invariably one-sided and doesn't show a complete picture of a product; how many bacon products have you seen that say: "The American Heart Association says that Cholesterol and Saturated Fat is the leading Risk Factor of Heart Disease! Bacon is plentiful in these Bad Fats! You must Eat Less Bacon!"? Virtually everything we eat has some small amount of something that is good for us, but that doesn't make a food healthy overall. Make food decisions on the basis of the complete health picture, including both benefits and drawbacks. The way to guarantee that we have enough nutrients in our diet is to eat a diverse variety of healthy foods. If you are really concerned about getting enough vitamins and minerals in your diet, take explicit supplementation. Don't suck down gallons of sugary drinks in order to get them, because the huge drawback of bioavailable sugar well outweighs the benefits of exceeding your daily requirement of a couple vitamins and minerals.
Returning to the topic of sugar, another useful habit we can get into is to replace snack foods with fresh fruits. Just the other day I had a grape/cherry that was just as tasty as any snack food I've ever had! Fruits have a significant amount of natural sugar in them, so this strategy is aimed more at reduction than elimination. It also incorporates more fresh fruit into our diet, which is a desirable end for other reasons. Remember, sugar is evil no matter what the form; it's just that in the case of fruits, the several healthy benefits of vitamins, minerals, antioxidants, and fiber outweigh the single drawback of sugar. (And we'll also see that eating the actual fruit, filled with cellulose and fiber, slows down the uptake of the sugar and thus dramatically reduces its damaging effects.)
As a final note, added sugar is everywhere and is difficult to avoid. Added sugar pervades even the most innocuous of foods, things that we might not even think contains it, like bread or peanut butter. (In fact, read the label of any processed food and you can bet dollars to donuts that sugar is one of the first three ingredients.) And sugar is the key component in most modern drinks that make them a) so incredibly tasty and b) so incredibly bad for us. So completely eliminating added sugar won't be easy; in fact, it's downright impossible. However, striving to do so reduces our intake to a more reasonable level, which is what counts. There are many obvious forms of sugar (sugary drinks, candy, dessert, and sugary snacks) that if we avoid make a huge difference in our health.
Follow Your Mother's Advice: Eat More Vegetables
I don't think anyone needs convincing that vegetables are healthy for us.
We just need to do it. So, just do it and eat more vegetables.
Along with fruits, they are the primary source of the diverse variety of
essential nutrients that we require in our diet. A lot of focus has been
placed on the macronutrients recently: fat, protein, and
carbohydrates. The micronutrients (vitamins, minerals, and water) are
just as essential to our diet, if not moreso, since there is solid
incontrovertible evidence that the lack of just a single micronutrient
(vitamin C, say) causes a wide variety of nutritional diseases (mange,
rickets, etc.) Vegetables are packed with different micronutrients; most
with carbohydrates; some have proteins, and a few have fat. Vegetables
alone provide everything we need for a healthy diet, as vegetarians have
amply demonstrated. So let's change a big portion of our carbohydrate and
protein intake to vegetable form, instead of just starches and meats.
As I've been reading more about diet and nutrition I've noticed a lot of stereotypes we have about food. To illustrate:
|When We Hear||We Immediately Think||But It Also Means|
|Carbohydrates||Bread, Cereal, Pasta, Rice||Sugars, Sugary Drinks, Candy, Milk, Cheese, Vegetables, Potatoes, Alcohol, Baked Goods, Confections, Processed Foods, Snacks|
|Protein||Meat||Fish, Eggs, Nuts, Legumes, Soy, Whole Grains|
|Fat||Meat Fat, Grease, Fried Foods, Butter||Oils, Cream, Margarine, Baked Goods, Non-Skim Milk, Processed Cheese, Nuts, Peanut Butter, Avocado, Salad Dressing, Mayonnaise|
|Fiber||Wheat, Oats, Bran||Fruits, Vegetables|
Replace Some Carbohydrates with a Variety of Proteins (more than just Red
I think it's safe to say that we are in the era of the Atkins Revolution.
The Atkins Diet Plan (as well as
plans like the Zone diet by Sears) has become immensely popular over the
last decade or so, fueled by a groundswell of mounting anecdotal evidence of
the plan "working" for people. Well, I've been on a variant of the Atkins
Plan myself and it "worked" for me; it's also "worked" for everyone I know
that has tried it. By that I mean that we actually lost weight, we didn't
feel hungry at all, and we had an increase in our level of energy. Too
much dietary carbohydrates is the second major factor in weight gain,
coming in a close second behind sugar.
However, that might be enough to recommend a radical weight loss plan but says nothing about whether it is actually healthy in the short or long term. We could lose weight by drinking nothing but concentrated citric acid all day, but we'll ruin our health as a side effect. Let's take a closer look at Dr. Atkins' fundamental propositions:
|What Atkins proposes||What a doctor / nutrionist would respond||My take on the situation|
|Lowering carb intake is the key to weight loss.||Excessive intake of any kind has been conclusively linked to weight gain. The American diet has both too many carbs and too much fat.||Hmmm... all the statements seem true and not really in contradiction.|
|By replacing carbs with proteins we can lose weight.||The evidence is as yet inconclusive as to what the specific relationship between the caloric intake profile and weight gain or loss might be.||Actually, I think Dr. Atkins is dead on here. We eat way too many carbs in our diet, and carbs make us get fat, just like fat does.|
|So to lose weight adopt an extremely low-carb diet. "No-carb" is best.||The US DHHS recommends a minimum 45% carb intake because low-carb diets have been shown to be harmful under some circumstances.||Whoa! I'm siding with the nutritionist on this one. We need a balanced diet, and a too "low-anything" diet seems suspicious to me.|
|Feel free to eat lots of meat...||Bad fats, found in high quantities in red meat, are a major risk factor in coronary heart disease.||Hmm... protein doesn't just mean meat. We can replace carbs with a lot more than just red meat.|
|... any fats you want...||All bad fats (LDL, saturated fats, and trans fatty acids) have been conclusively linked to increased risk of coronary heart disease. The US DHHS recommends no greater than a 35% fat intake.||Once again, I'm firmly siding with the nutritionist on this one. Good fat is good, and bad fat is bad, and way too much fat overall is also clearly ungood.|
|... and don't even worry about calories!||Overall caloric intake is the primary indicator of weight loss or gain.||Okay, now I think Atkins is just trying a sell here. Though he can probably get away with it, since a low-carb, high-protein, high-fat diet will make us feel full, and therefore eat less calories anyway.|
Along these lines we should also eat a variety of proteins, more than just red meat. Dr. Atkins himself would be unlikely to caution you; however, droves of cardiac surgeons would. There are many diverse sources of protein: other meats (like pork and lamb), poultry (like chicken and turkey), fish (of endless varieties), eggs, nuts and nut butters, soy (and the growing ranks of soy products), legumes (i.e. beans), seeds (like pumpkin and squash), cream cheese, brewer's yeast, whey, and specific whole grains (like quinoa, spelt, and brown rice). Virtually every other source of protein has negligible health risk relative to red meat; some, like fish with essential omega-3 fatty acids, are downright wholesome. ;-)
A Note on "High" and "Low" Carbs I'd like to draw attention to what I feel is the single biggest misinterpretation of the Food Pyramid, namely what counts as one serving of grains. One serving is much smaller than what people think. It's a single slice of bread, a cup of cereal, or a half cup of pasta. Let's get even more specific. For the standard 2,000 calorie diet, no more than 1,200 calories should come from carbohydrates. That means one serving is around 120 calories or 30 grams of carbs. So a Big Mac (45g of carbs), Large Fries (50g of carbs) and Soft Drink (42oz Super Size has around 560 calories from sugar) is ~7 servings, most of which came from the sugary soft drink alone. In one meal we've met three-quarters (75%) of our entire recommended daily intake of carbohydrates! Assuming we want each meal to have around one-third (33%) of our carbohydrate requirement, that means fast food has over twice the carbs than is good for us. I know that visually having grains at the base of the pyramid seems to be free license to eat as much as you want of it, but that's not what's the Food Pyramid is proposing. It's suggesting no greater than 1,200 calories / 300 grams of carbs a day, comparable to what you get from a single fast food meal.
The DHHS does not recommend a "high-carb" diet, even though it might look that way from the food pyramid. By the same token, the dietary guidelines don't recommend a "low-carb" diet, either, even though we are told to reduce our carbohydrate intake. This imprecision, over what constitutes a "high" or "low" anything diets, is what I believe to be the number one point of confusion among diet recommendations today.
Change Your Fat Intake to Vegetable and Fish Oils and Target a 55g / day
Fat has gotten a bad rap in the last few decades, and undeservedly so. The
last couple decades has seen the formation of an unfounded myth that has
clouded people's minds: namely, that "the way to lose weight is to
eliminate our fat intake". This Fat Myth, plus our current crisis
with obesity, has led to a situation of continual frustration for most
people. Many well-intentioned people eat fat-free diets, exercise regularly,
and then are puzzled when they don't lose any weight. Dietary fat is
not the crucial factor in weight loss, though it is often a caloric
factor in weight gain. As you've probably already surmised: sugar and
carbohydrates are the main culprits in obesity; ingested fat is at worst an
accessory that aids and abets with some excess calories. We'll expand on
this a great deal in the fat loss section that follows. For now let's
untarnish the reputation of fat and set the record straight:
Let's <ahem> chew the fat about fat. There are many different types of fat, some good, some bad. Let's review them more carefully:
|GOOD FATS||BAD FATS|
|High Density Lipoprotein (HDL) - The so-called "good" cholesterol||Low Density Lipoprotein (LDL) - HDL's evil twin brother|
|Mono / Poly Un-Saturated Fats - Basically all vegetable oils, including nut and seed oils||Saturated Fats - Basically all animal greases and meat fats; palm and coconut oils|
|Omega Fatty Acids - Most fish and fish oils; flaxseed, canola, and soybean oil||Trans Fatty Acids - Formerly "hydrogenated" or "partially hydrogenated" oils. Usually found in shortenings and margarines (and the products made from them).|
In any event, the course of prudence suggests that we make decisions on the basis of the best well-established facts, not optimistic speculation. What is known is that: a) all fats provide us with essential benefits to our health and b) bad fats increase the risk of coronary heart disease. Said differently, bad fats don't seem to provide us with any unique benefit over good fats, and good fats actually reduce relative coronary risk. So, we should eat good fats and avoid the bad. That means change our ingested fat primarily to good oils, specifically fish, olive, flaxseed, canola, and soybean oils. When cooking, favor these oils over butters and margarines, and avoid greasy foods in general, since meat fat is a major source of saturated fat in our diet. We also want to target a 55g / day overall intake of fats. Our fat intake can't be too low, and it can't be too high. It should always be around one-quarter of our overall caloric intake (around 25% +- 5%) for a person of optimal weight.
A Note On Sodium. By the way, the situation with sodium parallels that of fat. It is known to raise blood pressure, and high blood pressure is a major risk factor for heart disease. Salt is also an essential mineral that we need in trace quantities every day, but we eat way too much of it. So the essence of the message "reduce sodium" does not mean eat no sodium, it means reduce our intake to the recommended level ( less than 2.4g = 2,400mg daily). Unlike the case of bad fats, this doesn't even imply sodium is bad for us in any way; it's not. Too much sodium is bad for us, because it increases the risk of heart disease.
You may have already noticed a pattern among the way the Dietary Guidelines are misinterpreted. The guidelines say something like "eat less of", which people misunderstand to mean "eat none of". So why do they phrase it that way? One reason is that large agencies are conservative. They like to accumulate overwhelming evidence about something before making definitive statements. The Surgeon General's Office and cigarettes is a good example; the SGO's official proclamations were perpetually about five years behind the generally accepted evidence about the cancerous hazards of cigarettes. Even then, the agencies still make honest mistakes: the American Heart Association reversed its previously hard-lined stance against eggs once the discovery of two different forms of cholesterol had been established. Another reason for the relative phrasing is cultural timeliness. In the 1930s, the amount of fat the average citizen received in their diet was too low, and thus the message at the time was "Eat more fat!". Nowadays, we eat too much fat, and so the message has changed to "Eat less fat!". So bear that in mind when you hear an official "Eat more of" or "Eat less of" message; it's always relative to the statistically averaged diet. Always refer to the actual quantities being suggested and compare it to your personal intake.
The Optimal Caloric Intake Profile is 53C:20P:25F:2A +- 10:10:5:2% for BMI 22
Let me show you a little chart that is behind pretty much everybody's
recommendations but up until recently we rarely saw in a simple form.
It's called the Caloric Intake Profile, and basically describes how much of
each type of energy source we should be eating every day. It's massively
useful, and personally, I wish I had seen it ten years ago. It can be
thought of as a rough measure of what we mean by "high" or "low"-something
diets, though as we will see even it falls short of giving a completely
accurate picture. Here's the
Recommended Caloric Intake Profile (for Adults) from Officially Trustworthy Sources
Suggested RDI for
2000 Calorie Diet
|Carbohydrates||< 60%||4 cal/g||1200 cal = 300g||45%-65%||Note Carb range includes Alcohol|
|Protein||> 10%||4 cal/g||200 cal = 50g||10%-35%|
|Fats||< 30%||9 cal/g||600 cal ~ 65g||20%-35%|
|Alcohol||~0%||7 cal/g||0 cal = 0g||0%-5%||Note Alcohol is "considered" a Carb|
Let's take a closer look at this chart. The first thing that you should notice is that there are ranges for each one of the categories. The US DHHS has always recommended a balanced diet, and one of the ways they've quantified what that means is by giving a range of intake for each of the macronutrients. Something that surprises most people is that there is a minimum intake of fat. No one recommends a no-fat diet; a no-fat diet is unhealthy for us, the same way a no-anything diet is unhealthy. Another popular misconception is what the carbohydrate and protein allowances mean. In the case of carbohydrates, the Recommended Daily Intake (RDI) is near the high end of the range, and thus is a maximum allowance. In the case of proteins, the RDI is at the low end of the range, and thus is a minimum requirement. Let's be more clear and create a Ideal Weight profile, smack dab in the middle of the recommended ranges:
Recommended Ideal Weight Caloric Intake Profile (for Adults) from The Kimster :-)
Suggested RDI for
2000 Calorie Diet
|Carbohydrates||53%||4 cal/g||1,060 cal = 265g||Avoid Sugar. Favor slow (low Glycemic Index) and light (low Glycemic Load) in vegetable form. (See below for more info on GI and GL.)|
|Protein||20%||4 cal/g||400 cal = 150g||Eat a diverse range of protein|
|Fats||25%||9 cal/g||500 cal ~ 55g||Eat mainly good fats. Favor vegetable and fish oils|
|Alcohol||2%||7 cal/g||40 cal ~ 6g||A token glass of (red) wine every day (for men) / every other day (for women) taken with a meal has many health benefits|
It might be helpful to discuss in finer depth how confident we are about each of the percentages. The main point of dietary contention in our times is the exact proportion of carbohydrates to proteins necessary for fat loss that is reasonably safe for the dieter. Now, despite the humorous bravado of my recommendation above, I honestly couldn't say whether the precise numbers used above are the absolute best ones to use. However, they are definitely in the right ballpark. The exact numbers are in question, but the confidence in the range is high (55% +- 10% for Carbs, and 20% +- 10% for Proteins). My suggestion is to try the profile, tweak them a bit within the range, and see what works best for you.
On the other hand, everyone is in complete agreement about fats and alcohol. 25-30% of our calories should come from fat, and a small daily drink is good for our health. The US government is a sober bunch with respect to alcohol (the US once put Prohibition right into its constitution!) and it is only in the face of overwhelming evidence that the DHHS grudgingly admits that a token amount of wine per day with a meal is good for our health. On the other hand, the confidence of the fat guideline is rock solid and hasn't changed in the last hundred years; it was numerically quantified in 1990. No-fat diets are dangerous to your health. Don't do them, because no official source endorses it as a good thing under any circumstance.
As a word of caution, all profiles should be considered as a guideline only. Our dietary needs change significantly over the course of our lives. Infants have different needs than children, than teenagers, than adults, than older people. Athletes have different concerns than the average person, and pregnant women are in a class all their own. Medical conditions can also dramatically affect our intake profile, as well as impose specific dietary constraints (like allergies). In all cases, make sure that you are meeting your needs and instead of the "average" person's. Stay informed, consult your doctor or nutritionist, and most of all: use common sense.
Now the astute reader will notice that I put a qualifier in the title of this section, namely "for BMI 22". The BMI is an objective measure of our weight called our Body Mass Index. Roughly speaking, a BMI of 19 or under means you are underweight, from 20 to 24+ is ideal, 25-29+ is overweight, and 30 or over is obese. So "BMI 22" means a person of ideal weight, and the profile above is optimal just for those people. But wait. If this profile is healthy for a person of ideal weight, shouldn't it be healthy for everyone? NO! This is the main point of confusion that pervades every health recommendation today. The optimal caloric intake profile changes with our overall caloric intake; said differently, it's different for people of different BMIs. Restated yet again, if you are overweight or obese, you need a substantially different intake in order to be healthy. So, since weight loss is the topic of our times, let's talk about the subject in more depth.
What To Do To Lose Fat
A Survey of the Confusion
We are getting a great many seemingly conflicting messages about what we
should be eating. In 2000, the USDA hosted the
Nutrition Debate, bringing together the (then) leaders among popular diet
plans as well as some leading authorities on nutrition. Here's a survey of
the panel and their fundamental positions:
|Who, What||Known For||Their Position in a Nutshell|
|Atkins Diet||Carbohydrates are the key factor in weight gain. Extremely low-carb high-protein diets are the best path to weight loss; they have the added benefit of reducing hunger.|
|Zone Diet||Insulin levels are the key indicator in weight gain. Keeping our insulin in "the zone" is the best path to weight loss, which is achieved through a low calorie diet heavy on fruits and vegetables with a careful balance between protein and carbs.|
|Sugar Busters! Diet||Sugar is the primary factor in weight gain. Avoiding sugar, eating low glycemic index carbohydrates, and lean and trimmed meats is the best path to weight loss, because of its moderation of insulin and glucagon levels.|
|Professor, AECM||Calories are the primary factor in weight gain. Periodic fasting is a viable alternative to crash diets. Long-term weight management through lifestyle choices is the real issue.|
|President, ASBP||There are many factors to weight gain. No one diet is universal, and each diet plan needs to be tailored to the individual. Permanent changes in lifestyle are the only effective path to weight loss.|
|McDougall's Right Foods||Fat is the primary factor to weight gain. A diet low in fat and high in complex carbohydrates is the key to weight loss. Exercise is an essential component to an overall weight loss program.|
|Eat More, Weigh Less||Diet composition is the key factor to weight gain. Plant-based diets low in fat are the key to weight loss. They have the further benefit of making you feel full.|
Each of the dieting authorities had exceptionally compelling evidence on their side. After pondering their different positions for a very long time and weighing the evidence they presented, I've come to the conclusion that they are all essentially correct and mostly in agreement. Each view contains a vital aspect to the total weight loss and health equation that we need to take into account. Furthermore, while they seem contradictory at first glance, they are complementary in execution. I propose the safest course is to focus on the 90% area that the different nutritional authorities are in full agreement, and to ignore the 10% of contention for them to figure out at a later date. So we have our work cut out for us, namely, how we are going to integrate the "low-carb" and "high-carb" messages we are being given, and what "low-fat" really means.
From Chaos, Order
The very first thing to realize about diet recommendations is that people use
the word "diet" itself in three completely different ways. The
classical meaning of the word diet comes from the Greek word "diaita", which
means "way of living". In this sense, diet is the long-term lifestyle that
you've adopted, and it includes not only the food that you eat and the
beverages you drink but also your activity and approach toward fitness. In
recent times the word diet has accumulated a different meaning, namely, the
prescription for "weight loss". In this connotation diet is a short term
change we make in the food we eat, designed solely toward losing body fat.
I'm going to dub these our Ideal Weight diet and our Fat Loss
diet. There is also a third very important diet to consider, called
the Fat Gain diet. If you are overweight, it's your current diet,
even if you aren't gaining weight any more. It's the diet that got you to
where you are right now.
Now, looking at the survey above the first few speakers were talking about what our Fat Loss diet should look like, whereas the latter speakers were addressing what our Ideal Weight diet should be; all of them made reference to the Fat Gain diet. The three diets are not the same. However, they are crucially related to one another in that our Fat Loss diet must look like our Ideal Weight diet once we've reached our ideal weight. Our weight loss won't be effective otherwise. A different way of looking at it is that our weight loss plan should be a gradual and permanent movement from the Fat Gain diet we are currently on, through the Fat Loss diet, finally ending up at the Ideal Weight diet. Temporary "crash" diets have temporary results, because if we return to our previous Fat Gain diet, we'll gain back the weight. Our long term diaita determines what our weight will be. We must permanently change our lifestyle in order to permanently change our weight.
The fundamental confusion regarding diet recommendations is because everyone jumbles the three diet contexts together. For example, suppose I were a sedentary 30 year old male, 5'9", and I were taking in a constant rate of 650 calories = 73g of fat a day. Depending upon my total caloric intake, I'll have a different weight. Consider:
"Average" Male with 650 calories = 73g / day
|Weight||149 lbs||183 lbs||217 lbs||250 lbs|
So here's the question. Is 73g of fat a day a "low-fat" diet or a "high-fat" diet? If we were coming from the perspective of an Ideal Weight diet (for BMI 22), then clearly this is too high-fat. It's 34% of our intake, well above the recommended 30%. Whereas, the BMI 37 person on their Fat Gain diet would feel proud that they reduced their fat intake down to 20%, as low-fat as they could go and still be within the DHHS ranges. A Fat Loss dieter could be anywhere in between. But wait, it gets worse! Our caloric intake also changes depending on our activity. So a fat intake that would be reasonable for a moderately active person would be "higher-fat" for a sedentary person of the same weight but "lower-fat" for a vigorously active one.
Do you see the problem? When people refer to "high-fat" diets or "low-fat" diets it is inherently imprecise unless we know which type of diet they are referring to and the specific conditions under which it applies. The dieticians come from different perspectives and thus give apparently contradictory advice. What ends up happening, of course, is that we are left confused and wondering what we should actually be eating. This is one of the reasons why the US Recommended Daily Intake (RDI) is stated in absolute numbers. It doesn't matter who you are on what weight loss plan, you need at least a certain amount of some things in your diet. However, in some cases the RDI is a minimum requirement and in others a maximum allowance, and it isn't always clear which is which. So let's see if we can start clearing up the confusion.
Perhaps the most important thing to realize is the that the "low-carb" of the Fat Loss diets is around the same intake of the "high-carb" of the Ideal Weight diets. It's about 200g-350g daily (depending upon your gender, height, age, and activity) of low-glycemic index carbs, which are mainly vegetables like legumes and pulses. Everybody agrees on that part: sugar and "fast" carbs like candy, snack foods, sugary cereals, and processed breads are key ingredients of the Fat Gain diet and should be avoided. Another thing that everyone is in agreement about is that too high a fat intake (over 65g-85g depending) is bad for you. Note that these numbers are absolute intakes. The confusion arises because 250g of carbs is "low-carb" to a Fat Loss diet but "high-carb" to an Ideal Weight diet; similarly for fats. As we shall see, when we take a close look at the actual intakes different sources recommend, the "high" and "low" messages are more in agreement than they are in opposition.
Overview of an Effective Fat Loss Approach
Let me say this in the strongest of all possible terms: the only long-term
effective way to lose fat is to make a permanent change in your
lifestyle. It's a bitter pill to swallow, I know. But it's true. And
the fact that so many diet plans are just "quick-fixes" is what fuels a 15
billion dollar per year weight loss industry filled with fad diets.
Fad diets are alluring because many of them do, in fact, make you lose
weight. But most are onerous and people revert to their previous Fat Gain
diet once they've finished their quick fix, and thus gain back all their
weight (the so-called "yo-yo" effect). Even more seductive are weight loss
drugs that promise that you can lose weight "easily" with "no effort" on your
part, or "eat anything you want" solutions. I believe Robert Heinlein said
it best: "There Ain't No Such Thing As A Free Lunch." Everything
worthwhile in life comes only with sincere effort. If you strive for the
quick fix, the fast and easy pill, and you keep your diaita the same, you
will always be overweight. But if you accept that health only comes with a
complete reorientation toward food, activity, and living, then you've won
half the battle already. The rest is just implementing a practical approach
to get there from here.
What does this approach look like? Let's take a broad look at what we need to do to lose fat and eat healthier:
|Diet Type||Fat Gain||Fat Loss||Ideal Weight|
|Total Calories||High = 3,000+||Reducing from 3,000 to 2,000||Ideal ~ 2,000|
|Carbs: % = cals||55% =||1650+||27% to 40% =||800||55% =||1100|
|Proteins: % = cals||15% =||450+||53% to 30% =||1600 to 600||20% =||400|
|Fats: % = cals||30% =||900+||20% to 30% =||600||25% =||500|
|Has Rich Foods||Often||Sometimes, but decreasing||On Special Festive Occasions|
|Intake Focus is...||Calorie-dense Food (Carbs/Fats) and Drink (Sugar/Alcohol)||Hunger-satiating protein-rich Foods and Water||Highly-filling calorie-sparse Foods (Vegetables/Fruits/Whole Grains) and Water|
(Large quantities Daily)
|Sugary Drinks, Fast Food, High-Carb Snacks, Breads, Pastas, Red Meat, Dairy, Creamy Sauces / Soups, High-Calorie Dressing, Bad Fat||Fish, Poultry, Non-Red Meat, Legumes, Lentils, Nuts, Pulses, Hummus, Hearty Soups, Good Fat||Water, Vegetables (Carb and Protein), Fruits, Salads, Whole Grains, Fish, Tasty Low-Carb Sauces / Soups / Dressings, Good Fat|
(Moderate quantities Daily OR Every few days)
|Fried Foods, Alcohol, Non-Red Meat, Poultry, Salads, Low-Carb Sauces / Soups / Dressing, Good Fat||Red Meat, Breads, Pastas, Fruits, Dairy, Carb-Vegetables, Fast Food, Creamy Sauces / Soups, Bad Fat||Dairy, Breads, Pastas, Poultry, Non-Red Meat, Hearty Soups|
(Small quantities Daily OR Every few weeks)
|Fruits, Vegetables, Fish, Legumes, Lentils, Nuts, Hearty Soups||NO Sugar, NO Alcohol, Fried Food, High-Carb Snacks||Sugar, Alcohol, High-Glycemic Carbs, Fried Foods, Fast Food, Red Meat, Creamy Sauces / Soups / Dressings, Bad Fat|
The general dietary approach we will adopt is gradual reductions or replacements undertaken in tactical campaigns. Many people will propose that the best way to lose weight is to make drastic alterations to your lifestyle. The rationale behind it isn't that unreasonable, namely, that we need to "shake up the box" in order to get different results. I heartily endorse a completely different path, namely the successive incremental improvement of your lifestyle. Small changes give your body time to adjust to new conditions, making the likelihood that the weight you lose will stay off. I suggest a steady weight loss of 1 pound every 5-10 days; too fast, and you might yo-yo; too slow, and you aren't making enough changes that make a difference. This philosophy of making small, frequent changes also increases the probability that you can successfully implement your diet plan. Focus on only one, tactical change per week. The general that fights a battle on too many fronts loses the war. Whereas, if you keep your focus on one thing at a time, you are almost guaranteed to make the changes you want. Make small changes, each one a net improvement in your life, and make them frequently, and within a year they will have accumulated to a major health benefit that pays off for the rest of your life. So what if you "only" lose 36 lbs a year; you've lost that fat forever.
Let's illustrate why gradual reductions are more effective than drastic changes with an example. If you currently drink regular milk then you'll want to move to skim milk. If you took the drastic approach and switched abruptly one day, then skim milk will be horrible. It's like drinking chalky blue bile, and you will forever after have the association of ickiness with skim milk. Whereas, if you staged down to 2% milk for awhile, then to 1% after you get used to it, and then finally to skim milk, each stage will seem like a minor change. In fact, when done gradually over a few months by mixing the milks together (regular, 1/2 regular + 1/2 2%, 2%, 1/2 2% + 1/2 1%, 1%, 1/2 1% + 1/2 skim, skim), most people don't even notice the difference. If you get used to skim milk in this way and then drink a glass of regular milk, you'll be in for a surprise. Regular milk is like choking on liquid lard; it's repugnantly rich and caustically creamy. So the question is: which association do you want? Personally, I believe it is more useful to associate good tastes with the foods that are healthy for us and bad tastes with the ones that aren't. No small part of the reason why it is so difficult for us to change our diet is because we've associated such good tastes with unhealthy foods (high-sugar, fast heavy carbs, high-fat). In any event, we should favor gradual replacements over drastic change for no other reason than it is more likely to work. So don't worry about switching the worst foods to the healthiest ones right off the bat: focus more on gradual replacements each of which is a small improvement.
Here's the outline of the overall weight loss campaign we'll be following:
Let's take a closer look at each phase.
Preparation: Recon, Planning, Logistics, And Mobilization
I'm sure that you are eager to get started and start losing weight; let's
talk about the preliminary steps to do so. The first thing you need to do is
arm yourself with information. More specifically, you'll want to take
a close look at your own eating habits and come up with the sources of sugar,
high carbs, and high fat in your diet. You'll need those later on when you
start your campaign to alter your carbohydrate intake. And excellent little
program that gives you a better feel for your intake profile is BalanceLog by
HealthETech. It's simple, works
both on Palm PDAs and your PC, and gives some revealing insight into what
foods actually contains what. Other good solutions are to use calorie cards
or similar logging aids. Any strategic campaign begins with reliable
intelligence. For the first month or so you'll want to carefully track
your intake and activity; you'll also want to keep a careful daily log of
your weight until you reach your target weight. Initially this is a hassle,
but it has to be done, and the information you gain from these careful
observations will be invaluable later.
Something we can start doing right now is to construct your individual Ideal Weight diet profile and find two key Fat Loss parameters: your Target Fat Intake (TFI) and Target Carb Intake (TCI). Here's how you find them:
The last preliminary step we'll want to take is to involve your close friends and loved ones in your weight loss program. In fact, if you know someone else that also wants to lose weight you may want to consider a "buddy system". You could share information with one another, support each other, and keep the other strong when one's will is weak. Buddy systems are very effective for exercise programs, and diet programs are no different. Forming a support network of any kind for your weight loss project is a significant factor in improving its chance of success. It's almost a catch-22. Those people who keep their diets secret almost expect them to fail... and those same dieters might have succeeded had they made their intentions public and gotten support from their loved ones. Enlist aid. Make no mistake, the first couple steps that you will have to take will be a battle, and it always helps to have allies on your side. If you have a persistent medical condition, one of your indispensible allies is your doctor; always make sure to consult your physician before undertaking any major change in diet.
Test your Liquid Mettle and Drink Water
The general technique we'll be employing in our complete dietary change is to
replace highly bioavailable calorie-dense foods with slow digestion
calorie-sparse foods. We want to move away from sugar and fat and toward
fibrous vegetables with a low caloric content per volume. One of the major
reasons why we can get so fat so quickly nowadays is because of the abundance
of calorie-dense foods. We can stuff ourselves with them, quickly and
easily, and reach caloric intakes that would have been rare in a previous
age. Whereas, when we move to more sparse foods, we literally become
full before we can reach dangerous levels of caloric intake. Without
doubt, the highest density "foods" in our modern diet are calorie-laden
drinks like sugary drinks and alcohol.
There are further hormonal reasons why eliminating these two specifically are
to our advantage in fat loss. So, they've got to go first.
Drink water instead.
As a practical guide to implementation, I'd suggest a draconian phase-out staged over three weeks. Roughly estimate how much you drink in sugary drinks and alcohol. No need to break out calorie charts; a ballpark is fine. This week, drink one-third less than that. Next week, another third less. The third week, you should be sugary drink and alcohol free. Make sure that you approach the phase-out from as many angles as possible. When you shop don't buy any sugary drinks or alcohol. During the third week, give away all your stashes of sugary drinks and alcohol to friends (who will understand because you've already told them about your weight loss program). If you live with others who drink sugary drinks, see if you can convince them to join you; if not, physically separate their drinks from yours. Once you've taken the plunge to replace sugary drinks and alcohol with water, make no exceptions. Don't order combo meals anymore. Don't take social drinks no matter what the pressure. Even small amounts will inhibit weight loss.
Most people do not drink enough fluids in general and water in particular. The average person in a temperate clime should be drinking at least eight (8) 12-oz glasses of water a day. That number is further modified upwards for weight and activity, or for a dryer climate. To give you a good feel for what 96oz means, that is almost 3 Liters of water, or one and a half 2 Liter bottles per day. As a good test of your own intake, fill up a 2L bottle at work in the morning and see whether you finish it over the course of the workday. Another good rule of thumb is the hikers test of hydration: the darker your urine, the more you need water. Properly hydrated urine is clear or tinged yellow at worst; moreover, when fully hydrated it is common to urinate every 2-3 hours. In our quest for weight loss it is better to have too much water than too little; it makes us feel more full and helps in other ways. The only stipulation is to drink water away from meals, i.e. avoid drinking water while you are eating and immediately before or after. If you are comfortable with it, drink hot or warm water away from meals; much of the therapeutic effects of tea on digestion are from the hot water by itself. It's also no accident that the practice of having a hot soup before a main meal was independently developed all over the globe.
Now, just because you are drinking water instead of calorie-laden drinks doesn't mean that you have to drink only water. Many herbal teas are very tasty, as well as different coffees. (Save the war on caffeine for a later date. One thing at a time.) Vegetable juices like fresh carrot juice have little or no sugar, though be wary of store-bought brands that might blend the carrot juice with other sugar-rich juices. Just among water there are several different classical types: mineral, spring, seltzer, soda. Today there is a wide assortment of new water products, like oxygen or vitamin enriched, distilled water, or filtered water. My personal suggestion is to go the filtered tap water route. It is the most economical in the long run, and there is a certain convenience to being able to filter large quantities of water instead of having to carry around gallon jugs.
Depending upon your particular situation, drinks may or may not be the major factor in your caloric intake. If they aren't, accounting for, say, a mere 200 calories per day, then keep your food intake steady during the phase-out. However, if calorie-rich drinks account for more than 500 calories per day of your Fat Gain intake, then eat more foods as you switch to water (i.e. don't exceed a 500 calorie change in intake at any given time). In all cases, make sure your total caloric intake from start to finish doesn't increase. You can expect a rate of return over the next 2-3 months of a couple pounds of fat lost for every 100 calories you decreased, just from these initial changes alone. So if you were a heavy sugar or alcohol drinker, you should lose about ten pounds from drinking water alone.
Declare Open War on Sugar and All Fast Heavy Carbs
Now, as much as caloric intake influences our fat loss, it is not the only
factor that does so. Every calorie is the same amount of energy, but
foods with equivalent calories can have different effects on our body,
in particular with respect to fat. The foods we will
want to favor are those with both a low Glycemic Index and low Glycemic
Load. The GI is a measure of how quickly carbohydrates become sugar in
the blood; thus, higher GI foods are "faster" and lower GI foods are
"slower". The GL is a measure of carbohydrate density per serving and
overall impact on blood sugar; thus, higher GL foods are "heavier" and lower
GL foods are "lighter". We'll want to focus on trading fast heavy carbs for
slow light ones. In all cases, net improvement is the key. So if you can
trade a fast heavy carb for a fast light one, do it; you should also trade up
for slow heavy carbs. The ultimate goal is to be mainly eating
calorie-sparse, slow, light carbs, and that means: Vegetables. Fruits
are also a good choice, with some notable exceptions (like dates and
Let's try to get a feel for carbohydrates from a glycemic perspective. The ultimate resource on the web is hands down Rick Mendosa's Site; here's the most comprehensive glycemic list I've seen yet. Sadly, the picture is pretty complex. For some foods, it's clear that they are good or bad for us (beans: good, sugary cereals: bad). For other types of food, the GI and GL seem crucially dependent on the specific species of food and its special preparation. For example, American Russet baked potatoes are ludicrously fast and heavy carbs (GI 85, GL 25). However, Type NS8 White Potatoes boiled and then baked are much better for us (GI 50, GL 13) as mediumish carbs. So are baked potatoes good for us or bad for us? The answer: some types are, and some types aren't, and how you prepare them makes a difference. There's a similar situation with white rice. Some types and preparations are very bad for us, while others are quite good. So in many cases we must carefully scrutinize exactly what we are eating and how we are eating it in order to be able to make a firm statement about how fast or heavy the carb is.
That being said, we can still come up with some general guidelines. Here's a simpler (though less accurate) picture of things:
|Glycemic Index (Glucose = 100)||Glycemic Load|
|Type||GI||Example Foods||Type||GL||Example Foods|
|Fast||90+||Simple Sugar, Sugary Cereals, Cornflakes||Heavy||20+||Confections, Most Candy / Snacks, Pasta, White Bread, Sugary Cereals, Cornflakes, Bagels, French Fries|
|Med Fst||75-89||Most Candy / Snacks, French Fries, Donuts, Waffles||Med Hvy||16-19||Most Cereals|
|Medium||60-74||Most Cereals, Most Baked Goods, Bagels, White Flour, White Bread||Medium||12-15||Most Baked Goods|
|Med Slw||46-59||Pasta, Rye Bread, Wheat Bread||Med Lgt||8-11||White Flour, Waffles|
|Slow||<=45||Beans, Lentils, Nuts, Fruits, Skim Milk, Bran Cereals||Light||<=7||Beans, Lentils, Nuts, Fruits, Skim Milk, Bran Cereals, Rye Bread, Wheat Bread|
Replacing calorie-dense, fast, heavy carbs in your diet is the central crux of fat loss. On this point, every nutrition authority agrees, including those diet gurus that propose a low-fat high-carb diet. Now, some approach it from a calorie perspective and say we must reduce our overall intake. Others approach it from an insulin perspective and say we must reduce our fast heavy carbs. Still others focus just on carbs themselves and say we should limit all carbs. However, they are all saying essentially the same thing: Favor sparser, slower, lighter carbs, which invariably means vegetables and fruits. Now, each measure (calories, GI, GL) gives a useful picture but only a partial one. However, it's illuminating when you combine the three and find the area where they overlap. The worse thing imaginable for us? Sugar. Sugary drinks are high calorie and calorie-dense. Sugars have the highest GIs and are the fastest carbs. Sugar-rich foods tend to have high GLs and are generally too heavy. Declare open war on sugar. It is the crucial supply for your body fat, and you need to cut the supply lines to win your War on Fat. Eliminate added sugar from your diet in all its various forms. This is almost the verbatim message of the Sugar Busters! diet.
Keep in mind that we really want to be replacing _all_ our fast heavy carbs, not just sugar alone. Sugar just happens to be the best "poster child" to focus on, since it epitomizes all that is bad for us from a Fat Loss perspective. So let's talk about what we are trying to accomplish in this phase. The goal is to change the composition of our carbohydrates by embracing a plant-based diet. So, we want to trade carb calories from fast heavy carbs and replace them with slower, lighter carbs. Keep doing that, and make sure your overall caloric intake doesn't increase. Remember, the replacements you are making are ones you are going to be eating for the rest of your life. So weigh the considerations carefully. If something you really really want is too fast and heavy, eat it half as often. Don't worry about making huge sweeping changes to your diet: make small changes, each a net positive benefit. Now, for those of you out there like myself with a mean sweet tooth, make the transition using fruits. Don't go cold turkey on sweets all at once; trade them up for healthier sweets like fruits. Eventually, we want our diet to be extremely low in sugars and other fast heavy carbs, and plentiful in slow light carbs. If your overall caloric intake reduces during this phase, fine; but don't be concerned if it stays the same because you are gorging yourself on fruits and vegetables. Even with the same caloric intake you are bound to lose another 5-15 pounds from just this change in carb composition.
Now, in this quest to eat healthier I want to caution you about a fundamental flaw we have in our dietary reasoning. It goes something like this: "If some is good, then more faster must be better.". Let me give you a perfect example. Oranges are a great healthy fruit. They are generally slow (GI 31-51) light (GL 3-6) carbs filled with vitamins and important fiber. Oranges are good for us. Oranges concentrated in the form of orange juice is a completely different story. Orange juice is a faster (GI 46-63) heavier (GL 9-15) carb, usually without the fiber. Orange juice is worse for us that oranges, NOT better. Get out of the mindset that condensing things down into a little pill is the optimal form of nutrient delivery. Juices and pills give us concentrated forms of vitamins and minerals, it is true, but that is a one-dimensional view of diet. Actually eating the foods that were vitamin-rich to begin with has other tangible benefits, not the least of which is forcing us to slow down and pace our caloric intake. "More faster" is worse for us, not better. Accept bulk and inconvenience as a part of your diaita. Slow down, stop wolfing your calorie-dense food, and enjoy the stuff you are eating more. This is where Ornish is coming from in Eat More, Weigh Less.
Now, along these lines we should begin adopting permanent changes in the way we eat. First, stop eating when you are full. If you were to take in all your calories in eight small meals over the course of the day, it will be much better for your blood sugar than three walloping meals. Moreover, it gets you used to smaller portions. Eventually what will happen is you will eat fewer small meals a day, until you are left with something resembling three square meals. Second, dine with company. The ancient Greeks believed the highest form of civilization was community dining. Get a lunch buddy. Go out with friends. Dine with your family more (if you can pull that off). Talking with other people during meals naturally slows down the pace at which we eat. More to the point, it's fun, and that's precisely what we want our life to be filled with. Third, chew your food thoroughly. Many people are surprised by how many benefits we get from simply chewing our food until it becomes a mushy paste. We reduce indigestion and gas, promote the production of salivary enzymes, feel more full with less food, and slow down our caloric intake. I'm not proposing that we psychotically count to 32 for each mouthful. However, I would suggest taking smaller bites and giving ten more chews. It feels weird at first, but it's well worth the effort. And there are other reasons why the "four-chew wolf-it-down" method is less healthy for us than taking time to chew our food.
Get Off Your Fat Ass And Enjoy Life More
Let's talk about another counterproductive attitude that pervades our
culture: more convenience is always better. We have the idea that
anything that saves us time or effort Must Be a Good Thing. We're infected
with the need to be busy, busy, busy... we don't have enough _time_ to do
what we want to do... I've got to _keep up_ with the rat race... I wish I
had time to do all the things I want. The number one reason people cite why
they prefer fast food is: it's convenient. The number one reason why
physical activity in the United States has declined over the last century is
the emergence of mechanical and electronic conveniences (foremost among them:
number one reason why people don't exercise more is: it's inconvenient. We
are so obsessed with reducing time and effort that we forget that
sometimes time and effort has value on its own, even when it's
Let's adopt a completely different approach. Do the things that are really important to you Now! and accept that the most enjoyable parts of our life are inconvenient. True enjoyment comes at the cost of time and effort. Consider the afternoon picnic with a loved one. It takes a lot of time to prepare. It wastes hours of time. It's inconvenient to get to a good spot. And you know what? If you stayed focused on the quality time you are spending instead of what you aren't "getting done", it's a truly pleasurable human experience that you'll remember for years to come. The time pressure to "get things done" is only in our minds. A lot of us are worried about the world passing us by. We should be more worried about what's actually happening, namely, that our lives and the chance to enjoy them is daily passing us by. Seek to enjoy life.
So what does all this philosophizing have to do with our weight loss? We need to spend more time on enjoyable physical activity. The recommended daily activity was recently doubled to a full hour per day. Does this mean we should all start hitting the gym? Well, not really, not unless you are one of the fortunate few like my brother (read: freaks :-) that actually enjoys going to the gym all the time. What we should do is make time for activities that we enjoy doing. Perhaps the gravest problem with our convenience-ridden lifestyle is that we've forgotten how tremendously pleasurable it is to move our bodies when we are fit and healthy. And when we couple our activity with human social contact, we have a potent recipe for sheer enjoyment. The reason why we aren't more active is usually a mental one, not a physical one. We have to reorient our attitude toward exercise to become more active. "Exercise" doesn't mean a boring, repetitive, exhausting thing you force yourself do in the gym; it means the pleasant, engaging, active things you enjoy doing in your life.
So, let's talk recommendations. First, the timing of our activity is important. We'll get the most benefit by doing some light exercise ten minutes after we've eaten. The recommendation of the American Diabetes Association is to take a fifteen minute walk after every meal. This can be a light constitutional; the benefit we get is from the timing, not the intensity. Now, since you are going to be doing a lot of walking, I suggest coupling it with something you really enjoy doing. For me, I like reading, so I've trained myself to read while walking. Maybe you really like music but don't have the time to listen to it in your "hectic schedule". Buy a CD Walkman and now you can immerse yourself in a whole CD every day. Perhaps you haven't been able to spend quality time with your family. Take walks with your spouse and / or children to fun spots in the neighborhood. If you are fortunate enough to live near a rustic setting, explore the wilderness; for the urban bound, take a walk in the park. If we think of our need for exercise as an onerous burden that we must dutifully fulfill, then we will never enjoy doing it. But if our perspective on activity is that it is valuable time we can use for the things we've always wanted to do, we not only get the exercise we need but we'll also be happier. And most importantly, we'll rediscover the joy of using our bodies, which is a big part of this whole health and fat loss thing to begin with. Fat Loss is about more than just "reducing the risk of heart disease by 22.62904%".
Now, outside of our after-meal constitutionals, we should seek to increase our physical activity in other ways. The approach is the same: find things that you really enjoy doing but always thought that you didn't have the time for. The best activities are social ones, because they are more likely to be engaging and pleasant. Each of us is different so there are no universal prescriptions. However, three big categories that most people are attracted to are dance, sports, and sex. Dance is great physical exercise that most dancers swear by. For the competitive, there's nothing like a little sports challenge to get the blood moving. Plentiful sex with our partner is rousing, enjoyable exercise. And there are other relational benefits that come from slowing down, smelling the roses, and spending quality romantic time with your spouse. Start creating the active life that you want to live for the rest of your life, today. You have time for it, right now.
Exchange Carbohydrates for Filling Proteins
Now that we've laid the groundwork we're now in a position to mount our major
campaign against fat. The main thrust is to lower our carbohydrate intake
and replace it with an equivalent amount of protein, while keeping our fat
intake reasonably constant. The two intakes we calculated above, the Target
Carbohydrate Intake (TCI) and Target Fat Intake (TFI) will guide us during
this process. Here's the general idea. We don't want our fat intake to
increase, because we already know that too much fat (in an absolute measure)
is bad for us. We know that carbs are the primary influence on weight gain
and weight loss, so we have to restrict our intake of those, too. The only
other option is to increase our intake of protein in order to meet our
caloric requirements. The body responds by shedding fat to meet its
increased need for blood glucose. Voila!
Here's where using the numbers comes in handy to give us a proportional feel for things. Referring back to the Typical Diets chart the typical Fat Gain diet has too high a carb and fat intake. In order to change our Fat Gain profile to the Fat Loss profile, we will need to more than halve our carb intake and replace it with more than triple our current protein intake. Depending on your particular situation, the factors may be even larger. Trust me, this will feel muy loco. We are so used to carbs as a staple and protein as a rarity that it will seem like you are pigging out all the time. Well, pig out. Somewhat counterintuitively, stuffing ourselves with protein will cause us to lose fat. And if we make those sources mostly calorie sparse ones like vegetable protein, then we'll feel full and sated all the time. Minimizing hunger is a major factor in the success of a Fat Loss diet.
The approach is very much the same as before, namely, slow and tactical. First, calculate how much your current carb intake differs from your Target Carb Intake. In the example above, it would be 1650 - 800 ~ 850 calories ~ 212g. That how much our "typical example person" needs to change into protein. So, make continual replacements in your diet to do that. As a general guideline, I'd suggest a steady 200 calorie replacement every week, i.e. replace 50g of carbs for 50g of protein every week until you are under your TCI. You'll notice weight loss within the first week. Now, once your carb intake is steady, then work exchanging fat intake to protein to meet your Target Fat Intake. Most of the time this is a non-issue at this point, because high-carb and high-fat foods are usually found together; when you reduced your carb intake you were likely reducing your fat intake as well. However, in the rare case where you still have a high fat intake for some reason, lower that as well.
You've now made the conversion to the full Fat Loss profile, and you will drop pounds steadily. We are nearing the heart of the highly controversial but undeniably effective Atkins diet: low-carb high-protein diets make people lose fat. Now, as you lose weight, you'll want to decrease your protein intake as well. As usual, slow and steady wins the race. I would suggest making micro-changes to the intake to keep your fat loss rate steady. If you are losing it to quickly (nearing one pound every 5 days), then slow down your protein descent. If you are losing it too slowly (almost 10 days per pound), reduce down your protein intake by 100 calories or so. Lather, rinse, repeat. The Fat Loss you should expect is dramatic near the beginning and slower near the end. That means that as you approach your target weight it might take substantially longer to lose a single pound. At that point, I don't think anyone will care. If you've just lost 60 lbs in a year, you can probably wait a couple months for the last 5 lbs.
Trimmin' The Fat aka There Is No End
Now, here's where the magic comes in. After all is said and done, the diet
you are left with once you've reached your target weight is almost your Ideal
Weight diet! To stabilize your weight and prevent further weight loss, just
tweak your intake so that it resembles the Ideal Weight profile we calculated
for you above. This usually just requires a small change, namely, converting
a bit of fat and protein back to carbs. Congratulations! You've now
attained a wondrous thing. You are eating healthy, are the weight you've
always wanted to be, and are enjoying life more. Not too shabby, eh?
So is the diet over? No! This is it. Whatever you were eating when you hit your target weight is what you should continue doing for the rest of your life. It's the diet that will keep you at your target weight indefinitely. But if you regress to your previous Fat Gain diet, then you will put the weight back on. It's that simple. You have adopted a new diaita, not just a temporary fad diet. Enjoy it!
Now, as you move forward from this point, you'll want to make sure that you maintain your target weight. As long as you keep your intake about the same, it shouldn't be a problem. However, if you begin drifting up again the solution is similar to the above phases. Replace carbs and fats with proteins until you reach your TCI and TFI. Lower your weight, and then recorrect to your Ideal Weight profile. Of course, you now have some more flexibility than before, so I suggest tweaking your diet within the recommended ranges until you find something that works best for you.
Okay. Let's start getting down and dirty with our digestive biochemistry and
really start explaining what happens when we ingest food. For those readers
that aren't professional chemists, we begin with a crash course on
biochemistry. Since weight loss is a timely topic, we'll focus all our
efforts just on understanding our Metabolic Energy System. We have
four Metabolic Pathways, three major (Carbs, Fats, Proteins)
and one minor (Alcohol). We then describe the Metabolic Regulation
Systems, three primary (Insulin / Glucagon, Thyroidal, Ketosis), and one
secondary (Adrenal). Armed with all this information in hand, we then
dispel the Fat Myth and talk about the practical ways to lose weight.
We also describe several characteristic Metabolic Regimes,
that are basically combinations of states of the regulation systems, and
thus activation of the pathways.
Our bodies are the ultimate authoritative source of all things nutrition, so let's see if we can understand them. Onward!
Bio-Chemistry Made Easy
Our bio-chemistry (BC) consists of two different chemical universes
that coexist side by side. We'll call these the Protein Bio-Chemistry
(Protein BC) and Carbohydrate Bio-Chemistry (Carb BC) [a chemist might
be more precise and call them the Amine and Organic]. The two
different BCs are highly redundant: most generic processes that occur
in one occur in the other, which might seem like a wasteful duplication of
effort. However, it ends up making our bodies more robust overall;
the body doesn't critically rely just on one universe for its needs, it can
use both or switch between them as necessary. This is the central idea
behind metabolic energy regulation: the body adapts to conditions by drawing
more heavily on what's available and less on what's not. We'll talk about
this in more depth in a bit.
Perhaps the single most important guiding principle of all biochemistry is that complex biochemicals are constructed from simpler building blocks. Here's a chart of building blocks that will get us started:
BioChemical Building Blocks
|Simpler Building Block||Amino Acids||Simple Sugars
(A, T, C, G)
There are three major flavors of combining building blocks:
Secrets of our Metabolism Revealed!
Our Metabolic Energy System (or metabolism for short) is a
specific subset of our biochemistry devoted to energy production. Our
metabolism is arguably the most crucial biochemical system we have, as every
living cell in our body needs energy in order to function properly. Here's
what the metabolism is trying to do:
Overview of the Metabolic Energy System
|Take Energy Inputs||Do Stuff To Them||And Service our Constant Energy Needs||By Maintaining...|
Fats / Oils
Maintaining our Basal Metabolic Rate is where most of our calories
That includes Thermal Regulation (governed by thyroidal hormones),
Brain Activity (a big consumer of blood sugar and blood oxygen),
and Cellular Function, as well as other stuff like our heartbeat.
In addition, our Smooth Muscles need energy for movement.
...Good Circulation, especially of the blood.
...Constant Body Temperature, despite environment and activity.
...Constant Blood Sugar Level, despite eating and fasting.
...Hormonal Balance, through self-regulation systems.
...Ample Stores, especially of energy rich fat and muscle.
We can think of our metabolism as a big molecular factory. With respect to food, it takes raw ingredients in the form of dietary inputs, breaks them down into their building blocks, and then uses those blocks for bodily function. Our metabolism is constantly taking those blocks and reconstructing new complex molecules out of them, as we need them. (The original "manufacture on demand". :-) Something that may surprise you (it surprised me!) was that the body can even alter some fundamental blocks into others. It can change some amino acids into glucose (via gluconeogenesis), or either amino acids or glucose into some fatty acids (via fatty acid synthesis).
However, our body can't change anything into everything. What a particular organism can change into what is called a metabolic pathway. Not all creatures have all pathways (for example, plants can synthesize sugars but animals can't). This gives rise to the idea of essentiality; a nutrient is called essential if the body can't construct it from simpler components on its own. That's the reason why proteins, fats, and carbohydrates are essential nutrients: we can't make most amino acids, some fatty acids, or glucose. We _can scavenge_ glucose from some large blocks, and some acids from others, but that's deconstruction of a larger thing into a smaller one, not building it from simpler materials. Now, of all the available pathways not all are active at any given time. Which pathways the body chooses to activate at any given time is called metabolic regulation, and the messages that determine how much a pathway is active is usually done through hormones. (BTW, we're going to ignore the very important role our nervous system has in metabolic regulation, since it would complicate an already over-complex description.) We'll be focusing later on the lipolytic pathway (the breakdown of body fat into fatty acids and glycerol) and which hormones regulate that process.
Here's another chart to give you a feel for what gets converted into what:
Overview of the Digestive System's Main Energy Pathways
|Energy Input||Carbohydrates||Protein||Fats / Oils||Alcohol|
|Gets Broken Down Into||Glucose||Amino Acids||Glycerides / Fatty Acids
|Changed by liver...|
|And Stored As||Glucose||Bound
|Bound Fatty Acids||Not Stored|
|And Can Become||Blood Fat||Never releases||Glucose||Glucose Precursors||Ketones||Fatty Acids||Glycerol||Never releases||...into Acetate|
|Which Ends Up As||Blood Ketone Bodies||Blood Glucose||Blood Ketone Bodies||Blood Glucose||Blood Glucose|
Now, let's talk about the overall picture of nutrition. In general, the body uses the big three macronutrients (carbs, fats, protein) as fuel for energy, and the big three micronutrients (vitamins, minerals, water) as crucial helpers to maintain the body. More specifically, vitamins and minerals (and proteins the body manufactures all the time called enzymes) act as chemical catalysts. That means that they make the body more efficient, usually by speeding up (or slowing down) specific metabolic pathways. That's the essence of what we need nutrients for; here's a slightly more accurate picture:
|What the Body Does||What the Body Normally Needs for It||What Else It Can Use|
|Produce Energy||Carbs, Ingested Fat, Proteins||Alcohol, Body Fat, Cannibalized Body Tissue|
|Create Body Structure||Proteins, Fats, Water, Minerals|
|Maintain Cellular Processes||Amino Acids, Vitamins, Minerals, Water||Cannibalized Cells|
By just looking at the pathways we might conclude that any input could get used for any type of energy. However, that doesn't do justice to the kinetics of the situation, namely, which pathways are preferred at any given time. The body favors using carbs directly for energy because they are more efficient. Simple sugars are exactly the carbon stuff that it needs to oxidize, whereas fats need to be slightly changed and proteins need to undergo major alteration. So while all the sources can be used, the body prefers carbohydrates first, fats second, and proteins last for energy purposes. [Note on Alcohol: Alcohol falls outside this standard picture. Alcohol is interpreted as a toxin, changed by the liver into acetate, and eventually becomes blood glucose. So for our purposes alcohol can be considered a carbohydrate, though it takes a long strange trip through a non-digestive pathway to become blood sugar.]
An Important Note on Low-Carb: So, given that carbohydrates are only used for creating glucose, and that either proteins or fats can become glucose, does that mean carbohydrates are optional? In some way, yes; and in a big way, NO. Under normal circumstances we can get all our glucose requirements from proteins and fat. However, under changing circumstances we need the protein and the fat for other things more urgently, but the body still has to break it down into glucose, sometimes to its own detriment. A pregnant mother could die and have serious birth complications without enough carbohydrates in her diet. Similarly, during times of illness, high exertion, etc. our bodily needs can change on the timespan of hours, and unless we have a broad mix of available nutrients, we'll get hosed. So, approach the "low-carb" dogma with caution. Technically, it is true that "we can survive on proteins and fats alone", but that doesn't mean "we need only proteins and fats". This is the core reason why we need a good balance of all the essential nutrients to begin with: to have robust, good health under all circumstances, not just the normal ones. We can't foresee when abnormal circumstances are going to strike, so the course of prudence suggests always having a good mix of nutrients on hand at all times, even though some might be superfluous most of the time.
Workin' The Numbers
The standard measure of how much energy a food has is the calorie. Let's take a look at some numbers to give us a feel for what a calorie means:
|This Many Calories||Is About|
|3,500||One Pound of Weight from Body Fat|
|3,000 / 2,000||Average Daily Calories Consumed by Men / Women|
|2,320 / 1,790||Recommended Daily Calories for the "Average" Sedentary Man / Woman|
|1,785||Basal Metabolic Rate (BMR) of 170lb 30 year 5'9" Man, henceforth = "Average" Man|
|1,377||Basal Metabolic Rate (BMR) of 130lb 30 year 5'5" Woman = "Average" Woman|
|300-600||Moderate Daily Physical Activity (PA)|
|200-400||Sedentary Daily PA|
|262||A Small Pina Colada|
|250||20oz of Soft Drink|
|~170-320||Thermic Effect of Food (TEF)|
The overwhelming factor in our caloric expenditure is just maintaining our metabolism, which is called our Basal Metabolic Rate (BMR). Our BMR is usually 50%-75% of all our daily calories. You've got to spend money to make money, and you have to spend calories to get calories. Digesting food takes usually takes 10% of our overall intake, which is called the Thermic Effect of Food (TEF). The remainder of 15%-40% is usually Physical Activity (PA) (though what it often really goes into is weight gain). Besides the fact that this is great grist for a game of Trivial Pursuit, why do we care what our expenditure profile looks like? The reason is because that means that our weight loss projections might be as much as a factor of two off. So, a realistic estimate is on the order of one pound of body fat lost per ten  days; moreover, this is a target that we can actually achieve.
Now, some readers might be wondering what correlation the BMR has to our health. Let's take a closer look at this:
Caloric Expenditure Profile for "Average" Adult Male / Female
|% of Total Intake||Sedentary PA||Moderate PA||Active PA||Very Active PA||Athletic PA||Intense PA|
|Walking per Day||60 min||90 min||120 min||150 min||180 min||210 min|
|OR Jogging per Day||40 min||60 min||80 min||100 min||120 min||140 min|
|Assumed Calories||400 / 300||600 / 450||800 / 600||1,000 / 750||1,200 / 900||1,400 / 1,050|
|BMR||1,785 / 1,377||74% / 75%||68% / 69%||62% / 63%||58% / 59%||54% / 55%||51% / 52%|
|TEF||220-320 / 170-270||10% / 10%||10% / 10%||10% / 10%||10% / 10%||10% / 10%||10% / 10%|
|PA||See Columns||16% / 15%||22% / 21%||27% / 28%||32% / 31%||36% / 35%||39% / 38%|
|Assumed Total Intake||2,404 / 1,845||2,624 / 2,010||2,844 / 2,175||3,064 / 2,340||3,284 / 2,505||3,504 / 2,670|
The Straight Poop on Fat Loss
Now, as much as I like diddling with numbers (I was a mathematician in
college 8^), I've found calorie-based weight loss programs to be
too-detailed, confusing, and impractical to implement.
What calories are very good at is making exact measurements on projected
dietary replacements, but once you assessed and made the replacement,
the calorie information is no longer really necessary. Another thing
calories are very good for is to give a good feel for the relative
effectiveness of different approaches. For example, calories indicate to
us that regulating our diet is more efficient at weight loss than an
increase in physical activity. A small amount of food is equivalent to a
large amount of physical activity (which, if you think about it, is the whole
point of eating). Now, don't get me wrong; I'm not saying physical activity
isn't important. First, exercise is definitely a major factor
in weight loss. Second, exercise is crucial to our good health and we don't
get enough of it; in fact, the recommended amount of physical activity was
doubled to a full hour per day. Third, being fit has
benefits, in particular to our blood circulation, a key factor in our
metabolism. All that being said, ten seconds of deciding to forego
one soft drink a day saves as many calories as 30 minutes of exercise
expends. When we control our diet, we get a huge benefit from a small amount
of effort; intense exercise gives us a huge benefit for a large amount of
effort. I heartily endorse physical activity for its proven, positive effect
on our health; but with respect to weight loss, we'll get more "weight loss"
bang for our "effort" buck by carefully managing our diet instead. In any
event, even if we do choose heavy physical activity as a weight loss tool, it
still needs to be coupled with diet management for the overall plan to be
This is such an important idea I'm going to restate it, but in a different way. The key to weight change (loss or gain) is the regulation of our metabolic hormones; everything else (diet, activity, genetics, etc.) only matters insofar as it affects these hormones. Physical activity expends energy, it is true. It also causes the release of several hormones that makes us feel hungry. That causes us to eat just a bit more than we might have otherwise, balancing the increase in expended calories with an increase in intake calories, with net zero effect on our weight. There is a similar reason why starvation diets don't work in the long term. These cause our body to go into a temporary starvation regime where it reacts by carefully rationing our energy stores (including body fat) until it can gorge itself the next time it gets food. Crash diets are also really harmful to our health for other reasons. Most weight loss plans neglect to properly account for hunger, which plays a huge role, since a small change in food yields a large change in calories. For those of us with an iron will that can ignore our hunger pangs, great!... but those typically aren't the people who need to lose weight to begin with. Thus, we want to look for a weight loss approach that doesn't make us feel hungry all the time because we'll have a better chance of controlling our eating habits. This is the other compelling reason why diet is more important than physical activity on weight loss, because it can directly chemically manipulate our bodily hormones.
Snack-Time, Hunting the Food Coma Snark, and Hallelujah!
No diet essay is complete without testimonials, and this one is no
different. ;-) When I was growing up, there were three meals in my family's
house: lunch at noon, dinner at 6PM, and Snack-Time at 9PM, where you could
eat pretty much anything you wanted. So, of course, I porked out at
Snack-Time (my personal favorite concoction was Hersheys Almond bars,
smeared with Skippy Peanut Butter, dipped in powdered sugar, and then
washed down with egg-nog. Yum!) I ate sugary candy, drank sugary drinks,
all-day every day and constantly felt hungry for more. I ate sugar
all the time, and I never felt full because of it. Even when I did
feel full, I always had the urge to eat more sugar. It's basically
the dessert paradox: we can be stuffed... and yet still make room for some
sugary dessert. Perhaps you can find similar parallels in your own
life: sugar doesn't satisfy our hunger, or perhaps more accurately,
the desire to eat sugar overrides any feelings of satiety we might have.
Years later I was a computer programmer in Silicon Valley. The place was jumping, everyone was in a rush, and time was at a premium. The standard office practice was to nominate someone every day to go on a fast food run for lunch; fast food was convenient, easy, and agreeable to everyone. During that time I noticed something interesting: at 2PM every day everyone would enter into a food coma. We'd all feel brain-fogged, sleepy, and some people would even take naps; needless to say, no work got done an hour after lunch. The food coma would pass in a half-hour or so... and then everyone would feel hungry again around 4PM. At the time I thought: ah, I guess this is the price of getting older, having to take a small nap after meals. Maybe it was my body needing blood in my stomach and pulling it away from brain or something. However, after many years I finally discerned a pattern: carb dense meals give a short burst, then a food coma, followed by hunger, the major factor in the "carb meal" being the sugary soft drink. Have you ever experienced such a food coma? Or perhaps noticed that orange juice makes you feel peppy for awhile... and then feel sleepy? It's reminiscent of the "hyper then crash" effect that sugar has on children, and it is very real.
The last piece of the puzzle was when I decided to try a combination Atkins / Zone diet, where I basically pigged out on protein and fat, with no sugar and reduced carbs. (I usually don't drink, by the way.) What happened? I felt great. I could eat a huge meal and never had a food coma, not once. Most importantly, I never felt hungry; in fact, I would occasionally need to force myself to eat because I knew in my head that I needed to, even though my body wasn't telling me to. In addition, my energy level increased. I felt more spry and zesty than I had in ages. Last but not least, as you can probably guess, I lost lots of weight without any change in physical activity. I'm a believer in gradual weight loss (as if you couldn't tell that by this point!), so I tinkered with re-introducing carbs to gradually control my descent. The profile I ended up with then was the 40C:30P:30F Zone diet, which is essentially what I'm proposing above (mixed in with a bunch of other diet plans, too).
Now, like any good little boy that's found a new toy, I experimented with my newfound diet discovery. The first thing I found was that sugar stops weight loss dead in its tracks. When I was eating pure protein and fat my weight loss was about 1 pound every 5 days, representing a caloric deficit of 700 calories a day. Yet, the addition of a single 12oz can of root beer (120 cal) halted that. From a pure calorie perspective, it should have merely slowed my rate of loss to 1 pound per 7 days, but it kept my weight stable for about four weeks, enough time to have noticed a difference. So, something was going on there besides just raw calorie counts. The second thing I noticed was that I could induce food comas at will. I would interrupt my Atkins-esque diet to eat fast food... and could get a food coma after only my second fast food lunch. The third thing I noticed was that eating fat made me feel full. Avocado became my new best friend, and I found that chicken and guacamole burritos were apparently the perfect food. (Thank you, Baha Fresh! 8^)
Expanding the Canonical Calorie Model
Let's review the Canonical Calorie Model:
Caloric Intake - Caloric Expenditure = Fat Gained (or Lost) * 3,500 cal
Many dietitians promote this model as sacred canon and declare that weight loss reduces to just counting calories. The reality of the situation is, sadly, much more complex. The calorie model, while simple and appealing, is only an approximation. It fails to account for many significant factors, among them growth, mass transport, thermal variation, individual variation, the time-sensitive nature of physical processes, and hormonal effects. Before we get into each of these considerations I'd like to reiterate what I'm saying. I'm not saying the Calorie Model is useless; it's a great first estimate based soundly on scientific fact. What we need to realize is that other factors also influence weight loss, and these factors include both caloric and non-caloric considerations.
Let's consider the first assumption of the Caloric Model: "all energy nutrients we eat get used by the body for energy, either immediately or stored for later use". For adults that might be a reasonable assumption, but for children and other youths it is not. Why? Because quite a bit of protein and fat get used to create relatively permanent body structure. Isn't that also weight gain? Yes. However, the 3,500 cal figure is calculated for adipose fat storage (1 lb of body fat = 454g * 9 cal / g = 4,090 cal - 10% TEF and other minor stuff ~ 3,500 cal). For protein, the calculation would be something like (1 lb of protein stuff = 454g * 4 cal / g = 1,816 cal - who knows what ~ 1,500 or somesuch). The exact number doesn't matter; the point is that it differs by factor of 2 from the Calorie Model. Carbohydrate calories are only used as energy by the body, so the Calorie Model is dead on for carbs. But fats, and especially protein, can be used for other things by the body. So calories from carbs, fats, and proteins have different caloric multipliers associated with them. The different sources of calories have varying effects on the body. So, scientifically speaking: all calories are the same amount of energy. But practically speaking: not all calories have the same effect on body fat.
There is another subtle way that the first assumption isn't completely accurate. In a word, it's poop. Not everything that we eat gets fully digested. Under normal conditions some of our food is partially undigested; when we glut ourselves, that amount increases. That means that a calorie we took in never got used as one we expended, which breaks the calorie equation in a fundamental way. Fat in our poop under normal conditions can create a discrepancy of 60 cal a day; fecal protein as much as 40-80 cal per day, depending on protein intake. Among proteins, not all of them are equally digestible. Oh, and there's eighty-kabillion other niggling subtleties to the protein metabolism, some of which also affect our caloric equation in minor ways. There's also many disorders that can cause abnormal protein loss, in particular through the urine. These cases don't concern us normally; I bring them up only as further demonstration of the oversimplification Calorie Model, in particular with respect to protein.
Let's talk about another hairy subject: hair. Under normal conditions your body invests fats and proteins into the construction of hair, fingernails, and new skin. Healthy hair contains a robust composition of amino acids with a greasy coating: a recipe for calories. Hair grows at the rate of .4mm / day, which is a steady loss of ~ 4-7 cal / day. (Hmmm... that isn't too impressive, even to me, and I just calculated it!) The calculations for fingernails and skin is in the same ballpark [~5s of calories per day]. The litany goes on and on here. The thermic effects of some foods are net negative: it takes more energy to break them down than we get from digesting them [10s of cals]. Changes in ambient temperature can alter our caloric expenditure in real time [up to 80 cals]. Heat transport via sweat isn't accurately modeled by the basal metabolic rate [10s of cals]. Yaddah, yaddah, yaddah.
Anyway, the simple Calorie Model can be off by as much as 200 calories a day from purely caloric considerations, and seriously off if we are growing or bingeing. The numbers we are usually bandying about are 2,000 calories a day, so this represents at most a 10% error in the calculations. To be perfectly honest, that's really quite good for such a simple formula. And given that, in practical implementation, we mostly guess at the calorie values of what we eat, human error is probably a much greater source of inaccuracy than this fundamental oversimplification of the model. So let me reiterate: the Canonical Calorie Model is not exact, but it's a great first estimate from the caloric perspective. In fact, what we should be doing is incorporating the known factors into the model to make it more accurate. So, I hereby toss down the gauntlet to ye dietitians and nutritionists out there to come up with something like:
Expanded Caloric Model First Draft
|Caloric Intake||- Caloric "Loss"||- Caloric Expenditure||= Weight Change|
|Carb Cals||* Carb Digestibility Index?||BMR Range||Weight of Body Fat * 3,500|
|Fat Cals||* Fat Absorption Index?||PA Range||Weight of Body Protein? * 1,500?|
|Protein Cals||* Protein Retention Index?||TEF Range?||Somehow account for Water Weight?|
The situation with the non-caloric considerations is completely different, however; we can have direct changes in body weight that have nothing to do with calories. Consider, our total body water is on the order of half our body weight. Of this, a sizable fraction is so-called "water weight" that can be quickly gained or lost, through drinking, urination, changes in salt intake, perspiration, etc. These gains and losses have nothing to do with caloric intake or expenditure, and thus further skew the equation by tens of thousands of calories when innocently applied. Let me say that a different way. An atypical increase in caffeine intake will cause urination. One really big pee can be as much as a pound of water. So the occasional cup of tea has just messed up your calorie equation by a couple thousand calories, on the order of a whole day's worth of caloric intake. Assuming you are following the 500 Calorie Deficit rule, that's now four fictitious days of deficit that didn't change a gram of your body fat. This is the reason why dietitians today focus on body composition instead of body weight. We should be targeting a leaner body composition instead of a lower weight, because that is ultimately a better measure of long-term weight loss. An overweight person can easily yo-yo thirty pounds of water weight back and forth, with no substantial erosion of body fat. It looks like we are losing fat, but in reality we are just losing water weight.
Back to the calorie model. Genetic factors alter what metabolic pathways are available, as well as our "set-point" for weight. Again, this has nothing to do with calories, it has to do with our bodies inherent proclivity for processing food in certain ways. More specifically, it has to do with the kinetic equilibrium of our metabolic pathways, basically which pathways our bodies prefer to others. There are also two other huge factors that have been slowly discovered over the last couple decades: time-sensitivity and hormonal effects. Before we get into those, let's review the Calorie Model one last time. Caloric intake is a major factor in weight gain and weight loss, but it is only one of many. In particular, there are substantial non-caloric factors that influence the gain and loss of body fat.
Postprandial Constitutionals: OR, My Brush with Diabetes
Here's a perfect example of what I mean by time sensitivity. We've all heard
that frequent snacking contributes to tooth
decay. Why? It turns out that the chemical processes in our mouth are
time-sensitive, and the greatest damage to teeth comes within the
first twenty minutes after eating. So if we eat three meals a day, that's an
hour of prime tooth decay, but if we have three snacks in between, we've just
doubled our rate. (And, of course, food that gets lodged or sticks can cause
damage for hours just by themselves.) Thus, the activity of brushing our
teeth is most effective when done immediately after a meal,
especially a sugary snack. We
get the most "tooth cleaning" bang for our "tooth brushing" buck by doing
it at the best time, namely, right after we eat. Not all programs of
brushing our teeth three times a day are equally effective. For example,
brushing my teeth three times in a row right in the morning would be very
ineffective, whereas brushing my teeth five minutes after breakfast, lunch,
and dinner would be very effective. The maxim of the famous comedian Del
Close rings true: "It's all about timing".
Allow me to relate a personal story. In 2001 my mom was diagnosed with diabetes. At the time, I didn't know anything about it, or how seriously widespread a condition it has become. I just wanted to understand what she was going through and what I might do to help, so I went to the Diabetes.org website and started bumming around. I got to the page on the symptoms of Type II diabetes and was shocked. I had, not one, not two, but _all eleven_ of the common symptoms, including some pretty esoteric ones like "Wounds take a long time to heal". I later discovered that several of my family members also have diabetes, and thus I am at serious risk of developing it. Technically, I am classified as pre-diabetic, a recently created category to describe people just like me, someone in the process of developing diabetes. (At last count, there are 16 million of us in the US alone, and that number is growing.)
Anyway, on the website it said that the primary treatment of diabetes was activity and diet management; insulin injections were used only in Type I cases or extreme Type II cases. Quote: "a fifteen minute walk after every meal is a highly effective tool for the management of diabetes at any stage." A fifteen minute walk? I thought, what could that possibly do? However, they did recommend it, so I tried it out. And after a week every diabetic symptom that I had disappeared completely. I was just taking strolls, not even vigorous activity at all, and it had a profound impact on my well-being. Nowadays, I've scaled back to just a postprandial constitutional, just one fifteen minute walk after dinner, and it seems to be sufficient to keep the diabetic symptoms at bay. Fifteen minutes a day of activity, done tactically at the right time, has a substantial beneficial effect for me. Whereas, I've discovered, fifteen minutes of walking right before a meal doesn't do jack for my diabetic symptoms, though it's just as healthy for me as fifteen minutes of walking at any other time. By doing things at the right time we garner multiple benefits from the same effort.
If you think about it for a little bit, there is ample evidence that timing is pretty crucial, especially with respect to meals. Take medications, for instance. Every medication I've ever taken has come with a specific timing recommendation, like "Take every 4 hours". We also commonly see things like: "Do not take with meals", "Take before meals", "Take after meals", etc. A few even have very specific constraints: "Take at least one hour before any ingestion of lactose or dairy products". When you boil us down, we are basically big chemical factories. And just like any chemical reaction, timing is crucial. So, we'll want to understand what timing issues are going on in our body, focusing specifically on food digestion. That way, we can "work smarter, not harder", converting our knowledge into a plan that more effectively utilizes our effort in achieving what we want.
Breaking The Fat Myth
Wowsers! I just looked back on this page and realized that it's already
_huge_. What began as a straightforward guide to diet seems to have grown
into magnum opus on all things health-related. I appreciate your sticking it
out this far and reading things through. We've already come this far
together, so we might as well see things through to the end. At long last
we'll talk turkey about what I've been alluding to the entire page, namely,
why I think sugar and carbohydrates are the primary factors influencing
weight loss, and paradoxically why we need to keep our fat intake high to
Understanding Blood Sugar
At the heart of our blood metabolism is a keen sensitivity to the level of
glucose in our blood. The body wants to keep it in a very
range, usually between 90 to 120 mg / dl for the typical (non-diabetic)
person. It's sort of like the "body temperature" for the blood, except
whereas our body temperature can only differ by a few degrees our blood sugar
has a bit more slack. Now, when we eat food our blood glucose levels shoot
up to somewheres around 140, where they stay for a couple hours before coming
back down to the desired range. So all day, every day, our blood sugar level
is going up and down, up and down, as we eat and as we fast.
(I know it seems odd to think of the time between meals as fasting, but
that's exactly what it is. Any moment we aren't actually eating we are
fasting, even if we are getting three square meals a day. That why the meal
after we sleep is called the break-fast, i.e. the break of our
fast.) The question is: how sharply do our blood glucose levels change in
response to food? We'd like what our body would like, namely, to keep the
level as steady as possible.
It turns out that different foods take different times to become glucose in the blood. Just among carbohydrates there is a metric called the Glycemic Index (GI) which measures how fast the food becomes glucose in the blood. The fastest thing that becomes glucose is dietary sugar. The more complex a carbohydrate is (like a whole grain) the slower it becomes glucose, and the slowest carbohydrates are vegetables like legumes and pulses. So, a high GI like sugar (90-105) represents a very fast rate, and a low GI (like under 50) is a slower one. Among proteins and fats there is no comparable measure, because whether they even become glucose at all is determined by whether specific pathways are activated. Those pathways are only activated when the body can't supply the necessary glucose from just carbohydrate intake alone.
So why do we even care about the Glycemic Index? The reason is: faster is worse for us and slower is better. Whenever we eat sugar, it gets dumped into the body quickly all at once. Since that makes the blood sugar level spike, the body has no choice but to a) consume it with exercise or b) store it as fat. Assuming you don't exercise after dinner (by, say, taking a fifteen minute walk) then your body stores all that sugar as fat. Whereas, slower carbs like vegetables take a long time before they become blood glucose. Since our body is consuming blood glucose all the time, that means that the curve gets "smoothed out". The blood glucose doesn't spike, it sort of wavers gradually up and down. And most saliently, less of our intake gets converted to fat.
The final piece of the puzzle is how the body knows to store things as fat. We have a organ called the pancreas that is constantly measuring blood glucose. When our blood sugar is too high, it releases a hormone named insulin which tells liver to convert glucose in the blood into tri-glycerides. That is so important I'm going to repeat it: excess glucose in the blood gets converted to fat by the liver. Moreover, this conversion is a one-way process. Once glucose gets converted into a fatty acid, it eventually becomes a ketone body, never a glucose. If you recall, body fat is a tri-glyceride, which is a glycerol and three glycerides. The glycerol part of body fat can be recouped as glucose, but the glyceride parts cannot. Thus, whenever we have an excess of carbohydrates around three-quarters of it gets irrevocably converted to fat. Since the insulin message is stronger the higher the blood glucose is, carbohydrates with a higher GI are more likely to get converted into fat, whereas carbohydrates with a lower GI are less likely. Sugar is the carbohydrate most likely to be converted to body fat.
Now, on the flipside, when our blood glucose levels are too low, the pancreas releases a hormone called glucagon. This hormone does many things. First, it tells the adipose cells to release tri-glycerides into the bloodstream. Second, it tells the liver to start changing that fat into glucose and ketone bodies. Third, it tells the kidney to pick up some of the slack for the liver and start changing a bunch of stuff (amino acids, lactate, fatty acids, and glycerol) into glucose. The part we're most interested in is the effect on the adipose cells: lower blood sugar makes the body burn fat. Now, that doesn't mean a zero blood sugar is best! We need a minimum blood sugar in order to keep the brain and other vital organs functioning well, the same way we need a minimum fat intake.
The keen reader might be asking herself at this point: wait, if carbohydrates get converted into fat, why do we need fats in our diet at all? Here's where the imprecision of the word leads us astray. Glucose get converted into tri-glycerides (with the help of some other body chemicals), which is what body fat is made from. Dietary fat, on the other hand, contains not only tri-glycerides but also small amounts of other types of fat. Those small amounts are important to our body, not just the tri-glycerides. So, once again, just because one thing can be converted to another doesn't mean the latter is unnecessary. In this case, the imprecise application of the word "fat" in so many contexts is downright misleading. The technical term for all fats is called lipids; triglyceride (body fat) is just one type of lipid (dietary fat).
Understanding Blood Fat
The Insulin-Glucagon balance of the pancreas is a nice symmetrical system of
metabolic regulation. Blood sugar levels go up, more insulin is released,
which causes the conversion of glucose into fatty acids. Blood sugar levels
go down, more glucagon is released, which causes many things to be converted
to glucose. So the blood sugar level is kept within its narrow range by
constant dynamic feedback that is keyed directly to blood
glucose levels. As blood glucose level varies, there is some hormone
acting directly to restore it into balance.
The situation with lipids in the blood is completely different. There are many types of lipids in the blood, the most notorious being cholesterol. However, we will be interested primarily in the tri-glycerides floating in our blood, since that's what can become body fat. Hence, we will dub "tri-glycerides in the blood" as "blood fat". Tri-glyceride levels lack restorative hormones that act to restore it to a fixed range. Consequently, the blood fat levels vary considerably. The fasting level is considered good if under 100, and it can be anywhere under 100. A level over 200 is now considered an indicator of increased heart risk. The number can climb to over 1,000 under some conditions (though cholesterol seems to be the salient factor in heart risk past 200, not increased tri-glyceride levels). The level of blood fat is not regulated the same way that blood sugar levels are, and thus vary without restorative bound.
So, what forces influence our blood fat levels?
Influences on Blood Tri-Glyceride Levels
|Increases...||...In Response To||Decreases...||...In Response To|
|Intestines||Digestion of Ingested Fats||Muscles||Increase of Physical Exertion, Low Glycogen Stores|
|Liver||Insulin, Full Glycogen Stores (high blood sugar)||Adipose Cells||Insulin (high blood sugar)|
|Adipose Cells||Glucagon (low blood sugar),
Thyroid Growth Hormone (thermal / growth regulation),
Adrenal Hormones (dangerous situation)
|Liver||Glucagon, Low Glycogen Stores (low blood sugar)|
There are three key observations to make from this chart. First, our blood fat is mediated primarily by responses to our blood sugar levels, and specifically _not_ to blood fat levels. Second, that means that fat we ingest only becomes body fat when blood sugar levels are also high. Said differently, fat we ingest just gets dumped in the blood and stays there until something tells it to go somewhere else. If our blood sugar is low, glucagon tells it to go to our liver and muscles to be used for "keto"-energy. If our blood sugar level is high, insulin tells it to hop into our adipose cells. Third, low blood sugar level is the key to weight loss, because that's what tells our adipose cells to cough up their fatty goods into the bloodstream. (Or rather, of the hormones influencing lipolysis glucagon is the one most under our dietary control.) So, how do we do that?
The Essential Proposition
Here's basic proposition behind debunking the Fat Myth in a nutshell. We are
always consuming glucose, fatty acids, and amino acids from the bloodstream.
A spike in blood glucose leads to a spike in blood fat, and specifically, to
an increase in insulin that tells our adipose cells to absorb blood fat.
The main reason why blood sugar levels spike is because of ingested
carbohydrates with a high glycemic index, specifically sugar. So, the
primary influence of sugar and carbohydrates on weight gain is non-caloric:
it's timing, and hormonal.
Now suppose that we restrict our caloric intake of "fast" carbohydrates (especially sugar) and favor "slower" carbs like vegetables. Right off the bat we smooth out the spikiness of our blood sugar curve, which leads to an overall decrease in the production of insulin, which leads to less of a conversion of glucose to blood fat after meals. Over time, we gradually change the kinetics of our blood glucose, lowering the average store of glycogen in the liver, which signals it to divert its energy into the production of ketone bodies. A dearth of blood glucose tells the body to release fatty acids and start converting them to ketone bodies, and release amino acids and convert them to glucose. That's fat burning right there. So the trick is to avoid high spikes of blood sugar and lower the fractional intake of our carbohydrates relative to protein and fat. Since we don't want an unlimited fat intake, either (no greater than 35% calories from fat), that means that our only available option is to trade carbs for protein. We are maxing out our fat and protein percentages because we need to reduce our carbohydrate intake, not because there's anything good about an excess of fats or protein.
Now consider a low-fat diet, which by definition must be higher carb. Nothing about a low fat diet tells the body to start releasing body fat from adipose cells. Blood fat changes are controlled by blood sugar levels, not by blood fat levels themselves. We can't even invoke a kinetic argument here (i.e. low-fat induces the body to release fat from the adipose cells because of a reduced amount of fat in the blood), for two main reasons. First, the body is already going to convert the excess carbs into tri-glycerides anyway because it needs to reduce its maximal blood sugar. That means that a low-fat, high-carb diet leads to just as much blood fat as a high-fat diet does. Second, there's no hormone currently known that tells the adipose cells to release tri-glycerides into the blood in response to low blood fat levels. So all that ends up happening with low-fat diets is our bodies become starved for the essential trace fats it requires for proper functioning.
I hope you are convinced that low-carb, high-protein diets are more effective at weight loss than low-fat, high-carb diets, as well as being more safe. However, if you are still skeptical, I suggest that the proof <ahem> is in the pudding. Try both! If this is your first attempt at weight loss, try both approaches, each for month, and see which one gives the results it predicts. If you've already tried low-fat diets and they haven't been long-term effective, what harm could there be to try a different one? I've seen this diet approach work for seven of my friends so far, and it has worked unerringly for each one. I've also spoken to dozens of people who swear by Atkins-esque plans... and still swear by them years later. Keep in mind, I'm not trying to sell you on anything here. I'm not a diet guru, and I don't plan on becoming one. I'm just a guy that's taken a hard look at the available evidence and come up with a reasonable conclusion to explain things. I suggest that you run your own diet experiment to determine whether this will work for you, too. I'm pretty confident that it will.
That's All She Wrote
Well, I guess I'll wrap things up here. I was originally planning on writing
up a bunch of other stuff. Explaining how the different diets affect our
feeling of hunger, in particular the "pep-crash-hunger" cycle of high-carb
meals. A series of inspirational personal anecdotes. An
illuminating study that demonstrated that changes in behavior were just as
effective as drug therapy in changing obsessive-compulsive disorders. A
distillation of current food trends, and book reviews of Food Politics and
Fast Food Nation. A more comprehensive in-depth look at our metabolism
(titled: "A Big Ass Chart That Explains More Than Everything You Ever Wanted To
Know About Our Metabolic Energy System" :-) In particular, a chart of the
four metabolic regimes: eating, fasting, fat burning, and cannibalization and
the differences between them. And most of all, a projection of where food
preparation needs to head in order to meet both economic and health
priorities at the same time. I believe food preparation needs to head into
small-scale freshly-prepared food, a la places like Baha Fresh, In-n-Out, and
However, this page is already over-full with pith. Maybe someday I'll get around to finishing it off, but for today I think we've covered enough useful ground. Perhaps I could be persuaded to finish it sooner than later if you sent me some supportive e-mail... 8^)
I hope this information helps improve your health. Bon Vivant!
Kim E Lumbard
P.S. If you liked this page, please e-mail the link to your friends! I feel that this is important information that everyone needs to know about because it affects our most precious resource: our health. Thanks!
FUTURE Write-up Movement toward time and convenience Dollar moving out of the home into restaurants Products because of longer cycle time to buy foods Food preparation being done on large-scale centralized because of efficiency Need to make small-scale, local, personal food preparation "kitchens" Some centralization necessary for variety, too much is too impersonal Want to focus on freshly-prepared dishes "buying convenience and health" Pharmacueticals Americans obsessed with "the pill" We can change our biochemistry through behavior as effectively as drugs