Doctor Pierce's Notebook

Evidence for Why the Scale (and BMI) is Deceptive

Same woman, same scale weight. Jason at Everyday Paleo uses one of his clients to demonstrate that the scale is a virtually meaningless data point. Also note that her BMI would also be the same, and it is the standard used in most studies of obesity and nutrition, as well as by physicians and insurance companies.

You would also do well to note that the muscle layer replacing her fat layer is not only firmer, leaner, and more attractive, it improves insulin sensitivity rather than decreasing it, it maintains a higher metabolic rate for her even at rest, and it doesn't secrete hormones that may increase her likelihood of developing female cancers.  

Jason writes: 

"Faced with the facts above, basing your goals – or even worse, your happiness – on the number on your scale is absolutely ridiculous."

 

Clinical Experience of a Diet Designed to Reduce Aging

Clinical Experience of a Diet Designed to Reduce Aging

Nutrition is funny--it is probably the single most important factor in our health, yet it is one of the least studied or understood in medical circles.

Everyone thinks she's an expert on food--reading blogs and even premiere news outlets on nutrition are filled with misinformation and snarky, ignorant sniping against concepts that are either willfully misrepresented or simply misunderstood. (I recently read a blog post attacking Dr. Atkins that reported that his diet included fat marbled steak and an ice cream sundae every night. Had the writer even READ a sentence of Dr. Atkins' books?)

But the clinical evidence in favor of high-fat, adequate protein, low-carbohydrate nutritional plans keeps pouring in.

This study shows that the nutritional approach we favor reduces markers associated with aging and age related disease--independent of caloric intake. Which is another one of my mantras: calories are nearly meaningless.

In this study, body weight, serum leptin, insulin, fasting glucose, triglyceride, and free T3 significantly decreased as well as the triglyceride/high density lipoprotein ratios.

Dr. Oz's Report on Diet and Genes

via www.doctoroz.com

Dr. Oz recently did a show on genetics and weight loss--nutrigenomics, which was a combination of really good information and some not so good information.

There is something to the idea that your genetic make-up has a lot to do with what kind of diet you will respond to and how. While isolating the particular genes that identify which diet is best for you is somewhat new, the general hypothesis has been around for awhile in the form of both anthropological and ethnographic nutrition. Which is to say: we've often looked at our human ancestors in general, and our specific ancestors and their places of origin in order to determine what diets suit which people best.

This is the foundation for the paleolithic diet--eat only what the cave men ate, nuts, berries, leafy greens, and meat--and for the real food movement, which basically says, if it has a food label, you shouldn't eat it.

The nutrigenomic idea is slightly misleading--the report suggests you have a gene that tells us exactly what you should eat.  This is not exactly the case.  You have genes that tell us what sort of disease processes and metabolic tendencies that you've inherited.  What diet that means you should have is, at best, a hypothesis, (what I like to call a SWAG, a scientific, wild-ass guess) much of it based on faulty premises, like the idea that low-fat dieting has a positive effect on stroke and heart-attack, or the idea of a calorie and its relationship to nutrition and obesity. 

For that is the most potentially misleading part of Dr. Oz's report: the idea that the bottom-line is "calories in, calories out"--the laws of thermodynamics tell us that this is not the case. It takes more energy to process a protein "calorie" than a carbohydrate "calorie". I use calorie in quotes, because even the concept of a calorie is rather bizarre and very flawed.

Quality of calories matter more than quantity, and it seems that all calories are not created equal.

It's not just calories in, calories out.  Not by a long shot. 

Lard and Fat - Yum

Slate Magazine references the book Fat: an Appreciation of a Misunderstood Ingredient, with Recipes.   The book has won the Best Single Subject Cookbook award, as well as Cookbook of the Year, at the 2009 James Beard Awards, and is on my bedside table.  This gist of the article is that lard has gotten a bad rap. 

Lard's advantages over vegetable shortening:

1.  No trans fats to cause an immune/inflammatory response

2.  Mostly monounsaturated, and even the saturated portion will increase your HDL*

3.  Great taste and texture in cooking/baking

4.  Higher smoking point (along with coconut and palm oils), meaning less fat absorbed by whatever you're frying

Vegetable shortening's advantages over lard:

1.  Um, none that I can think of

The article outlines a method to make your own lard.  Unfortunately, unless your live near my brothers and my mom in Charlotte, NC (pork capital of the world!), it can be difficult to find pork fat in your grocery store.  I make my lard with Trader Joe's Low Sodium Bacon, following the method outlined in the article.  You can even use this TJ Lard in cooking/baking; just don't add any additional salt to your recipe.

*Remember HDL is the "good" cholesterol and you want that level to be higher

More on Animal Protein

This study explains the possible link between saturated fats and inflammatory processes which are linked to several diseases.  Note that it is not so much the fat itself but the ratio of "bad fats" to good fats. 

For the past century, changes in the Western diet have altered the consumption of omega-6 fatty acids (w6, found in meat and vegetable oils) compared with omega-3 fatty acids (w3, found in flax and fish oil). Many studies seem to indicate this shift has brought about an increased risk of inflammation (associated with autoimmunity and allergy), and now using a controlled diet study with human volunteers, researchers may have teased out a biological basis for these reported changes.

Anthropological evidence suggests that human ancestors maintained a 2:1 w6/w3 ratio for much of history, but in Western countries today the ratio has spiked to as high as 10:1. Since these omega fatty acids can be converted into inflammatory molecules, this dietary change is believed to also disrupt the proper balance of pro- and anti- inflammatory agents, resulting in increased systemic inflammation and a higher incidence of problems including asthma, allergies, diabetes, and arthritis.

Floyd Chilton and colleagues wanted to examine whether theses fatty acids might have other effects, and developed a dietary intervention strategy in which 27 healthy humans were fed a controlled diet mimicking the w6/w3 ratios of early humans over 5 weeks. They then looked at the gene levels of immune signals and cytokines (protein immune messengers), that impact autoimmunity and allergy in blood cells and found that many key signaling genes that promote inflammation were markedly reduced compared to a normal diet, including a signaling gene for a protein called PI3K, a critical early step in autoimmune and allergic inflammation responses.

Relating to the previous post, the balance of these fats is significantly altered in a positive direction when animals are freely pastured, eat a natural diet of grass, and treated humanely.    Eat grass fed beef whenever possible and make sure to eat cold water fish twice a week.  Non meat-eaters and meat eaters can also use free-range eggs, brussel sprouts, nuts, and flax seed as a natural supplement, or take three fish oil capsules a day.  Note: inflammation is also related to CAD (coronary artery disease).