‘What’ you eat is more important than ‘How Much.’

Image via Wikipedia

Finally a large-scale study has concluded what I have been telling patients for years! What you eat is more important than how much of it you eat.  A calorie is not a calorie!

If you ask many classically trained dietitians about maintaining a healthy weight they will regurgitate the same old rhetoric they always have – “as long as you don’t eat more calories than you expend you won’t gain weight,” and “there are no bad foods, just bad amounts of food.”

The above statements have never made sense to me.  I remember taking ‘advanced biology’ in high school.  (There was nothing really ‘advanced’ about it. It was just the second of two courses, the first being ‘basic’ biology.)  In this class I remember learning about physiology and how the body responded differently to different types of food.  Some foods caused the release of insulin while others caused little or no release of this hormone.  The job of this hormone? It basically tells the body to store fat.  From that information I concluded that what you ate had to make a difference in your weight.

As I progressed through my eduction in college (as a biology major) and then on to chiropractic school where I truly received advanced training, my view did not change – the quality of food that I ate had to make a difference on maintaining my weight.  It could not possibly be as simple as calorie-in/calorie-out.

Yet when you read information online or from other mainstream media outlets you will hear just the opposite. “Eat whatever you want, just be sure it’s in moderation.” Or “It doesn’t matter what kind of food you eat as long as it’s low calorie.”

A new study of just over 120,000 people finally has come up with a conclusion that makes more sense.  Hopefully the American Dietetic Association will take notice.  Individually there are some very good dietitians out there, but the American Dietetic Association is making people sicker and sicker with their stance on many aspects of health in my opinion.

The researchers analyzed data on three separate studies over a 20-year period, tracking the long-term effects of different foods and lifestyle changes on more than 120,000 men and women. Adults in the study gained an average of 3.35 pounds every four years, for a total average weight gain of almost 17 pounds.

Regular consumption of potato chips, French fries and sugared beverages were most to blame for slow and steady weight gain. However, people who ate yogurt, fruits, vegetables, nuts and whole grains either lost weight or gained the least.

Now, I will be the first person to tell you that weight is not the be-all, end-all of health markers.  It’s a good one, but there are plenty of thin people in this world who are very unhealthy.  Also, I generally do not recommend grains be a big part of anyone’s diet.  In small amounts they are ok, but they contribute to inflammation which can be problematic for many reasons.

The other foods in this study – yogurt, fruits, vegetables and nuts – are free foods! Eat them as much as you want.  I routinely encourage people to eat these foods as much as possible.

Interestingly, nuts are a high calorie food yet they performed very well in helping people lose or maintain their weight.  If it truly was about calorie-in/calorie-out then nuts should have performed poorly.  It just goes to show you it isn’t about the calories that we’re putting in, it’s about the quality of those calories.

As much as I’d like to say it’s only about the quality of our food that matters, I cannot.  The amount matters to a certain extent.  If you are regularly consuming 7,000 calories per day you will gain weight.  That type of excess cannot be combated with ‘good’ foods.  However, to get that kind of extra calorie one would have to consume huge amounts of the ‘bad’ foods like fast food, doughnuts, etc.  Those clearly are not quality foods in the first place.

Dr. Dariush Mozaffarian of the Harvard School of Public Health and Brigham and Women’s Hospital is the author of the study that appears in the New England Journal of Medicine.  He says the calorie-in/calorie-out theory is incorrect “because different foods have a different effect on the body. ‘You can’t just say a calorie is a calorie. It doesn’t address your feelings of fullness, your blood glucose levels, your blood insulin levels and the other biological responses in your body.”

I could not agree more and this has been my point to other ‘experts’ on nutrition when we debate the calorie-in/calorie-out theory.

Let me pose this scenario to you –

Two people are going to embark on an experiment.  They are going to eat identical calorie diets for the next year.  One person is going to eat 2,000 calories per day in potato chips and the other is going to eat 2,000 calories per day in chicken and vegetables.  Who will be healthier and have the most optimal weight at the end of our experiment?  Intuitively we would say the person eating the chicken and vegetables would be and I believe this is correct.

There have been many short-term studies that have concluded healthy diets only need to focus on calorie content.  The quality of the food was not important for maintaining weight.  Finally a study has looked long-term and concluded that the quality of your food is important. Make sure your choices are good choices.  If you focus on the quality of your food you will maintain your weight more effectively than counting those calories.

Activity or Exercise? Do you know the difference?

Image via Wikipedia

Exercise is the key to staying healthy.  Studies show that exercise is an important part of a healthy lifestyle because it reduces heart disease, cancer, depression, stroke and dementia to name just a few.  However, I find that most people do not know what exercise really is.  All too often they confuse it with activity.  Exercise and activity are cousins, but they are not the same thing.

In all of my new patient appointments I ask each person about their exercise habits.  Some people truly exercise, but the vast majority get no regular exercise. Still others think they exercise when in fact they are just active.  What’s the difference?

First, let me say that being active is without a doubt better than being a couch potato. However, it does not substitute for regular exercise.

So what exactly do I mean? Doesn’t being active mean I exercise? Not necessarily.

Here are the two scenarios I hear in my office the most.

The first is the busy mother of a small child.  Routinely they tell me, “I don’t need to exercise, I chase my small child around all day and pick him up and put him down.  That’s plenty of exercise.” Unfortunately that’s incorrect.  This person is active, but does not exercise and cannot possibly gain the benefits of exercise by looking after a small child.  Unless this mother is repeatedly picking up and putting down their child and squatting down over and over in a short period of time to do so and their heart rate is significantly elevated while doing so, they are not exercising.

Now, I understand that caring for a small child is tiring, but so is sitting at the library and doing research. Activities that make us tired do not always qualify as exercise.

The second scenario I hear most often in response to my question of exercise habits is actually one of two things; people will say, “I walk a few times per week,” or “I like to garden on the weekend.” Both of these again, are activities.  Very few people walk fast enough or the distances required for walking to be considered exercise.  I have one patient in particular who actually does walk far and fast enough for it to be exercise, but that’s a rarity.  Gardening will never be considered exercise.  Again, it may be tiring but two things disqualify it as exercise.  First, it does not increase the heart rate enough and second it is not done with enough regularity to be exercise.

Again, I want to stress that being active is a great start and is far superior to sitting on the couch and watching television.  But it’s just that – a start.

Exercise is something that drives heart rate, builds muscle and changes body composition. It should be done with regularity – at least 3 times per week for a minimum of 30 minutes.

I would ask you to consider this question; If you are a person who falls into one of the above scenarios and believe your lifestyle creates an environment in which you do not need to exercise because you are active consider this.

Are you happy with the results?

Are you tired and/or overweight despite chasing your small child around all day or gardening on the weekend?

If you answered no to the first question and yes to the second you should consider changing your point of view on what you consider exercise.

Remember, activity is a good thing. However, it is not exercise and cannot be used as a substitute.  I would encourage you to make time to exercise even if you are busy and active.  It will only help you in the end.

The New “Food Guide Pyramid”

Well, it’s not really a pyramid anymore.  It’s a plate.  And it’s still wrong.  But before I get into that let me focus on the

New design, same old (incorrect) message.

positives about it.

First, the design.  I like it.  It’s simple and much easier to understand than the old pyramid.  It’s also eye-catching.  It looks very modern and should attract more attention.

Secondly, fruits and veggies make up half of the new plate meaning that, essentially, half of your diet should be made up of fruits and vegetables.  I could not agree more.  When I make a meal I always include fruits and vegetables and I strive to have half of my plate at each meal filled with brightly colored fruits and/or vegetables.

That’s it.  That’s all I like about this new “MyPlate” setup from the USDA.

Here is what I don’t like.

First and foremost there is no area for healthy fats on this plate.  None!  That is a major disservice to the American public.  Every single cell in the entire body has fat in it.  Fat is necessary and essential to life.  If we don’t consume fat, we die. Period!

Additionally we know that omega-3 fats from nuts, seeds and fish are exceptionally important for maintaining cardiovascular health.  These are only briefly mentioned when you click on the protein section of the new plate.  There is also an “oils” section on the main website (www.choosemyplate.gov) that explains a little about oils and their properties.

My point is that the new “MyPlate” design is intended to be something that people can look at quickly and get a gross idea of how they should be eating.  When people glance and this plate they will infer that they shouldn’t eat any fat and that’s a major problem.  People should consume fat and they need to consume fat.

My second major problem is that grains are still too dominant in this design.  Yes, they stress whole grains, but they say that you only need to make half  (HALF!) of your grains from whole sources.  I would never encourage my patients to eat any refined grain on a regular basis, let alone half of their grains on a daily basis!

In my opinion, grains should be a very small of the diet, even if they are whole grains.  They don’t need to be eliminated from the diet, but they should never make up a full quarter of what you eat.  A diet high in grain leads to many problems such as inflammation and heart disease.  Human beings should consume a paleolithic type diet.

Unfortunately, despite the new design, this is still the same old information regurgitated based on science that is decades old.  The USDA needs to get with the times and reduce the grain recommendations and increase the healthy fat recommendations.  Until they do that I fear Americans will continue to lead the world in obesity.