Can the Internet Really Supply You With Healthy Meals?

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You’ve probably heard about one or more of the new meal delivery services on the market. Popular services include Blue Apron, Plated and Hello Fresh. If you’re not familiar with any meal delivery service providers, check out this in-depth review of the various choices currently available.

There’s no question having pre-portioned ingredients with recipes and directions delivered directly to your door is convenient. However, convenience comes with a price. Most of the meals cost between $9 and $13 per serving.

So, do these meals live up to the hype? Can the internet really supply you with healthy meals?

What is a “Healthy” Meal?

To review and compare the available options for getting healthy meals online, we’re going to use the following criteria (which are fit for the vast majority of healthy people). A healthy meal is one that:

  • Includes a lean protein, a high ratio of fruits and/or veggies, a whole grain, a serving of dairy and a healthy fat
  • Doesn’t include excess fat or added sugar
  • Is between 500 and 700 calories per serving (very active individuals and athletes may need more calories per meal)

Comparison

Blue Apron – Meal #1: Spaghetti Bolognese with Butter Lettuce Salad & Creamy Italian Dressing

Lean protein: No
Fruits and vegetables: Yes
Whole grain: No
Dairy: Yes
Healthy fat: Yes
Added sugar: No
Calories per serving: 770
Saturated fat: 11 g
Trans fat: No

Blue Apron – Meal #2: Za’atar-Spiced Chicken with Pink Lemon Pan Sauce & Pearl Couscous

Lean protein: Yes
Fruits and vegetables: Minimal
Whole grain: No
Dairy: No
Healthy fat: Yes
Added sugar: No
Calories per serving: 750
Saturated fat: 9 g
Trans fat: No

The Results
Both of the meals from Blue Apron come in over the 700 calories per serving mark, though both are less than 800 calories. If you are eating a 2,000 calorie diet, though, that’s still almost 40 percent of your calories in one meal. These meals are also relatively high in saturated fats, clocking in at 11 g and 9 g per serving, which is more than half of the recommended allowance of 16 g per day on a 2,000 calorie diet.

Blue Apron includes video tutorials with each of their recipes to demonstrate proper cooking techniques. All of the video lessons are available on YouTube. If you have trouble accessing any of the videos, you might be getting blocked by a content filter on your internet connection. Using a virtual private network can help you bypass the content filter so that you can access the videos no matter where you’re preparing to cook.

Hello Fresh – Meal #1: Wasabi Lime Salmon over Soy-Simmered Rice with Baby Bok Choy

Lean protein: Yes
Fruits and vegetables: Yes
Whole grain: Yes
Dairy: No
Healthy fat: Yes
Added sugar: No
Calories per serving: 660
Saturated fat: 4.5 g
Trans fat: unknown

Hello Fresh – Meal #2: Dukkah-Crusted Chicken with Sweet Potatoes and Sugar Snap Peas

Lean protein: Yes
Fruits and vegetables: Yes
Whole grain: No
Dairy: Yes
Healthy fat: Yes
Added sugar: No
Calories per serving: 510
Saturated fat: 4 g
Trans fat: unknown

The Results
In this review, Hello Fresh’s offerings both came in under 700 calories per serving and all of the meal options included a lean protein, a serving of vegetables and a healthy fat. Hello Fresh does not document the amount of trans fat in their recipes, so that information was not available for comparison. Also, at less than five grams per serving, both of their recipes also included a relatively low amount of saturated fat, at less than 5 grams per serving. If you want to try Hello Fresh’s recipes for yourself – they include them on their website (see Recipes at the top of the navigation screen).

Plated – Meal #1: Soy-Glazed Turkey Meatloaf with Coconut Rice and Greens

Lean protein: Yes
Fruits and vegetables: Minimal
Whole grain: No
Dairy: No
Healthy fat: Yes
Added sugar: Yes
Calories per serving: 840
Saturated fat: unknown
Trans fat: unknown

Plated – Meal #2: Cheesy Sweet Onion Panini with Truffle Fries

Lean protein: No
Fruits and vegetables: Minimal
Whole grain: No
Dairy: Yes
Healthy fat: Yes
Added sugar: No
Calories per serving: 870
Saturated fat: unknown
Trans fat: unknown

The Results
Of the three services we reviewed, Plated fared the worst. Their meals were both over 800 calories per serving, and the site doesn’t offer information regarding trans or saturated fats for their recipes. Also, there was very little focus on healthy ingredients, such as whole grains and vegetables. While the meals looked delicious, they probably can’t be called healthy.

In this limited review, Blue Apron and Hello Fresh both fared well in their offerings of healthy options. Their meals were low in calories, relative to the other options, and included many of the other markers of health, such as lean proteins and a high ratio of vegetables.

Meal delivery services claim they can deliver all the ingredients, recipes and cooking instructions you need to create healthy meals in your home. A closer look, though, indicates you might need to supplement some of these meals with other ingredients so that they can give you all the nutrients you need.

This is where you come in. Everyone has a different diet and everyone’s body processes food differently. So while healthy meals are available through the internet, you need to do a little homework to make sure these services’ meal options live up to their promises and offer the kind of food that will support your lifestyle.
About the Author: Cassie is a fitness professional and writer. She loves helping people learn about health and fitness and teaching them how to make the healthiest choices for their body’s individual needs.

Fuel Your Child for Learning More this School Year

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Kids learning potential skyrockets when they are healthy from head to toe. This school year, support your child’s growth, development and learning by following these 3 tips each day:

Bank on Dairy

From celebrity websites and diet books to popular Instagram feeds and “clean eating” blogs, its trendy to ditch dairy. Yet experts say going dairy-free has multiple downfalls – and it may be downright dangerous – especially for kids and young adults. Kids and teens have a limited time period to build bones. A dairy-free diet during these critical growing years could mean a child doesn’t reach Dairy for growth and learningtheir full height potential, they may have an increase in stress fractures during adolescence, and a greater chance of developing the brittle bone disease osteoporosis as an adult. In addition to 9 essential nutrients, including bone-building calcium and vitamin D, the combination of protein and carbohydrate in dairy will help build and fuel active muscles and minds.

Make Fruits and Veggies Fun

Introducing kids to new foods can be both fun and easy. In addition to offering a food multiple times and modeling healthy eating (eating a wide variety of foods in front of your kids), try pairing less familiar foods with ones that are more familiar. Many kids love getting in the kitchen and helping prepare food, especially when it comes to baking. Why not make muffins, bread or even a cake with vegetables in it. Carrot cake, zucchini muffins and avocado cupcakes taste great and  make a child more familiar with these vegetables. Once kids see them again, sautéed at dinner time, baked into a lasagna or  sliced on top of a sandwich, they will be more likely to eat them.

Pack better Snacks for better Learning

As a kid I played hard then lost steam quickly. Luckily my parents let us snack whenever we felt the need to eat. Frequent snacking can help keep children alert and attentive. Pack snacks that please their taste buds while fueling their bodies with nutrients they need for good health. Naturally sweet fresh or dried fruit, trail mix, yogurt, string cheese and nut butter with whole grain crackers are all excellent options that will satisfy your child’s taste buds while providing the nutrients they need for good health.

 

 

 

Spring Clean Your Diet, Satisfy Cravings

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If warmer weather and fresh air send you into tidying mode, don’t forget your pantry. Spring clean your pantry and refrigerator and you’ll make better food choices and improve your health in the long run.

Count on Color for Protecting your Body

The colorful compounds in fruits, vegetables and grains protect plants from diseases and pests. In your body they help protect your tissues including skin, bone and muscle, from harm. Think of all forms of produce and grains in a variety of colors (see below). Fresh, frozen, 100% juice, dried or roasted veggie snacks and dried fruits with no added sugar (I often turn to figs and raisins when I want something sweet).

Here’s an example of of what color can do for you:

Orange fruits and vegetables may be protective against bone loss.

Black, deep red and dark purple produce and grains (examples: black rice, purple carrots, 100% grape juice made with Concord grapes, 100% pomegranate juice) are good for artery health; they help expand arteries to accommodate greater blood flow (very important for maintaining healthy blood pressure).

Dark greens are good for skin and eyes. They can help eyes adjust to bright light and also support night vision. Some examples include spinach, kale, turnip greens, collard greens, broccoli, zucchini, Brussels sprouts and romaine lettuce.

Add Snacks that Satisfy Hunger and Taste

When you want to satisfy hunger, look for foods high in protein and fiber. If you want to satisfy hunger and taste at the same time, consider options that fulfill your cravings. Looking for salty and crunchy? Beanitos hint of lime chips are amazing with guacamole. Searching for something sweet? Yogurt parfaits, granola + milk (Purely Elizabeth’s and The Toasted Oat are 2 of my favorites). There are also a number of bars that satisfy hunger and taste at the same time. Check out the newest Luna bars including chocolate dipped coconut (you won’t miss Mounds or Almond Joy). Find a few other crave worthy options here.

Discover Missing Nutrients

Vitamin D has been the rage for years but there are other nutrients that are ‘shortfall nutrients,’ those most of us do not consume in adequate amounts. Among them are potassium and magnesium.  Potassium is important for healthy blood pressure, nerve and muscle functioning and removing waste products from cells. Branch out from bananas and consider including leafy greens, carrots and potatoes and citrus fruits such as oranges and grapefruits for potassium. Think out of the box with kale chips, roasted carrots and potatoes or slow cooker vegetables with potatoes. Magnesium is  necessary for muscle and nerve functioning, blood sugar control, bone health, blood pressure regulation, energy production and normal heart rhythm. It also helps with sleep and muscle relaxation. Get a little more magnesium with beans, nuts, seeds, dark green leafy veggies, avocados and potatoes.

In addition to focusing on the food mentioned here, place foods you want to consume at eye level and treats you want to eat rarely in the back of the cabinet or bottom of the freezer out of sight and reach. Chances are, you’ll forget they are there.

 

Gluten free blueberry cottage cheese pancakes

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Gluten free blueberry cottage cheese pancakes

Ingredients:
Makes about eighteen 4-5” pancakes
· 3/4 cup gluten free all purpose flour
· 1/2 cup almond flour (make you own, tip below)
· 1/2 tsp. baking soda
· 1/2 tsp. sea salt
· 2 Tbsp. Swerve sweetener
· 2 eggs 1 cup whipped cottage cheese (*whip your own in a blender or food   processor until smooth)
· 1/2 cup 2% milk · 2 Tbsp. pecan, sunflower, safflower or other medium-high heat oil
· 1.5 cups blueberries
· Cooking spray (I used Pompeian grapeseed oil spray)
Directions
Rinse blueberries with water and blot dry with a paper towel. Set blueberries aside on a plate. In a bowl, stir together gluten free all purpose flour, almond flour, baking soda, salt and Swerve sweetener. In a separate bowl, whisk together eggs, whipped cottage cheese, milk and oil. Add flour mixture to egg mixture and whisk or stir until just blended. Blend in blueberries.
Lightly coat a large frying pan or skillet with cooking spray then heat over low – medium heat. Pour small amounts (about 1/2 cup) of batter onto the skillet. Flip each pancake when golden brown underneath and partly cooked. Move to plates and enjoy!
Nutrition information per pancake:
Calories: 71
Fat: 2 g
Carbohydrate: 6 g
Fiber: 0.8 g
Protein: 4 g

 

Get Cultured: Probiotics can Help You Lose Weight & Stay Healthy

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From Greek to Icelandic Skyr, yogurt is everywhere. Choose the right kind, one packed with probiotics and protein, and yogurt can help you trim your waistline while supporting overall health at the same time.

In this article, I’m covering:
• How gut bacteria influence your weight and health
• Probiotic-rich foods for health & healthy weight

Your Gut Bacteria Influence Your Weight & Health

There is an entire community of over one trillion microbes (bacteria) taking up valuable real estate in your gut. Some are good, some are bad and the rest are neutral. The good guys are key players for digestive and immune functioning (remember about 70% of your immune system is located in your gut). They have many other functions as well:
bacteria, probiotics and body weight

Research studies show lean and obese people have a different makeup of bacteria in their gut. In addition, lean individuals have a greater diversity of bacteria in their gut. Diversity is important –  think of bacteria like a team of people each one has a different job and they work better together than in isolation.

If an obese person loses weight their overall makeup of bacteria more closely resemble’s a lean person’s gut. Greater weight loss = even greater the changes in gut bacteria. Also, changing bacteria seems to influence weight, though scientists know less about the influence of altering gut bacteria and changing body weight. Lean mice transplanted with bacteria from obese mice experienced a 60% increase in body fat without changing their food intake (calories in) or physical activity (calories out). The authors of this study believe the change in gut bacteria resulted in an increased absorption of some carbohydrates, increase in the production of fat and increase in fat storage. Authors from another study, this one examining human twins, also found a connection between types of bacteria in the gut and body weight, particularly visceral fat – deep layers of fat that coat the organs and are tied to higher risk of certain chronic diseases such as heart disease. The authors of this study believe, like the study in mice, obese individuals may be absorbing more calories from the food they eat.

Probiotic-Rich Foods for Health & Healthy Weight

How did they swap out bacteria in studies? Poop transplants. This isn’t exactly something you should try at home. But there’s another, easier way to keep your gut healthy. Get cultured by picking up foods that contain healthy bacteria including yogurt (with live and active cultures), kefir (drinkable yogurt, it’s so good!), miso soup, homemade sauerkraut, and tempeh (made from soy, this has a nutty taste). There might be something special about yogurt – a meta-analysis (a study that combined the results of other studies) looked at dairy intake and weight changes over time. They found greater yogurt intake was associated with lower body weight. Plus the protein in Greek yogurt seems to help people feel full so they eat less at their next meal. Also, feed the bacteria by eating plenty of fruits, vegetables and whole grains, particularly onions, greens, beans, legumes, berries and bananas, to get enough prebiotics (food) to support their growth.

 

References
Benno Y. Mitsuoka T. Development of intestinal microflora in human and animals. Bifidobacteria Microflora 1986; 5:13-25.

Quigley EMM, Quera R. Small Intestinal Bacterial Overgrowth: Roles of Antibiotics, Prebiotics, and Probiotics. Gastroenterology 2006;130:S78-S90.

O’Hara AM, Shanahan F. The gut flora as a forgotten organ. EMBO Rep 2006;7:688-93.

Ramakrishna B. The normal bacterial flora of the human intestine and its regulation. J Clin Gastroenterology 2007;41:S2-S6.

Douglas LC, Sanders ME. Probiotics and prebiotics in dietetics practice. J Am Diet Assoc 2008;108:510-521.

Million M, Maraninchi M, Henry M et al. Obesity-associated gut microbiota is enriched in Lactobacillus reuteri and depleted in Bifidobacterium animalis and Methanobrevibacter smithii. Int J Obesity 2012;36:817-825.

Hempel S, Newberry SJ, Maher AR, Wang Z et al. Probiotics for the Prevention and Treatment of Antibiotic-Associated Diarrhea. A Systematic Review and Meta-analysis. JAMA 2012;307(18):1959-1969.

An Introduction to Probiotics. National Center for Complementary and Alternative Medicine. National Institutes of Health. http://nccam.nih.gov/health/probiotics/

Marik PE. Colonic flora, probiotics, obesity and diabetes. Front Endocrinol 2012;3:87.

Bäckhed F, Ding H, Wang T, Hooper LV, Koh GY, Nagy A, Semenkovich CF, Gordon JI. The gut microbiota as an environmental factor that regulates fat storage. Proc Natl Acad Sci U S A. 2004;101:15718-23.

Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Microbial ecology: human gut microbes associated with obesity. Nature 2006;444(7122):1022-3.

Kalliomäki M, Collado MC, Salminen S, Isolauri E. Early differences in fecal microbiota composition in children may predict overweight. Am J Clin Nutr 2008;87(3):534-8.

Yang YX, He M, Hu G, Wei J, Pages P, Yang XH, Bourdu-Naturel S. Effect of a fermented milk containing Bifidobacterium lactis DN-173010 on Chinese constipated women. World J Gastroenterol 2008;14(40):6237-43.

Yaeshima T et al. Effect of yogurt containing Bifidobacterium longum BB536 on the intestinal environment, fecal characteristics and defecation frequency: a comparison with standard yogurt. Bioscience Microflora 1997;16:73-77.

Hempel S et al. Probiotics for the Prevention and Treatment of Antibiotic-Associated Diarrhea
A Systematic Review and Meta-analysis. JAMA 2012;307;1959-1969.

Semova I, Carten JD, Stombaugh J et al. Microbiota Regulate Intestinal Absorption and Metabolism of Fatty Acids in the Zebrafish. Cell Host & Microbe 2012;12:277.

Schwingshackl L, Hoffmann G, Schwedhelm C, Kalle-Uhlmann T, Missbach B, Knuppel S, Boeing H. Consumption of Dairy Products in Relation to Changes in Anthropometric Variables in Adult Populations: A Systematic Review and Meta-Analysis of Cohort Studies. PLoS One 2016; 11(6): e0157461.

Top 10 Flat Belly Foods

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Your abs are made in the gym and revealed in the kitchen. A good training program develops the muscles in your midsection and the right diet helps banish bloating so you can see your abs. Here are the 10 flat belly foods you should add to your diet for a better looking (and better feeling) mid-section):Greek yogurt for belly fat

Greek Yogurt with Live and Active Cultures

Look for Greek yogurt with “live cultures (aka good bacteria)” or the “Live & Active Cultures” seal. The cultures are good bacteria that take up valuable real estate in your gut, helping your body digest food and decreasing gas and bloating. The amount of healthy, versus harmful, bacteria influences body weight and how much weight you can lose while following a lower calorie diet. Plus, a study published in the International Journal of Obesity found people who get their calcium from yogurt, as opposed to other foods, may lose more weight in their belly. Even more evidence to support yogurt consumption comes from a study showing dieters who ate five servings of dairy, such as Greek yogurt, daily lost more weight and abdominal fat than those who ate just three servings every day. A more recent review of the research found higher dairy intake was associated with lower risk of obesity in the midsection and yogurt seems to help keep weight in check.

2 Nuts

Though nuts are relatively high in calories for a small amount of food,  people don’t gain weight when they add nuts to their previously nut-free diet. A study in over 13,000 adults revealed nut eaters, those who ate at least ¼ ounce of nuts or peanuts (technically a legume) per day had smaller waists than adults who didn’t eat nuts. Additionally, tree nuts and peanuts contain a considerable amount of monounsaturated fat. Dieters who eat more foods containing monounsaturated fats may lose more belly fat than those who eat the same number of calories per day with less monounsaturated fat.

3 Asparagus

When examining dietary patterns, weight and waist circumference in close to eighty thousand people over a 10-year period, researchers found those who ate more vegetables every day had both a lower BMI and smaller waistline compared to adults who ate few vegetables. Asparagus contains prebiotic fiber, a type of fiber that is food for the good bacteria in your gut. Plus, asparagus is a natural mild diuretic making it the perfect food before hitting the beach or wearing a more formfitting outfit.

4 Avocados

Avocados contain a good amount of monounsaturated fat, not to mention nineteen vitamins and minerals. But, their monounsaturated fat is the ticket to a smaller waistline. In one study scientists gave obese adults with type 2 diabetes diets rich in saturated fat, monounsaturated fat or  carbohydrates. Those on the high carbohydrate diet ended up with fat redistributed to their stomachs while the monounsaturated fat rich diet prevented fat redistribution to the belly area. Plus, a look at dietary intake data from close to 18,000 adults found body weight, BMI and waist size were all significantly lower in avocado consumers versus those who didn’t include avocados in their diet.

5 Popcorn

Popcorn is a whole grain and when you pop it yourself on the stovetop (or in a brown paper bag in the microwave, just add good old fashioned popcorn kernels in a brown paper bag and fold the top) and top it with a little spray butter or spices for flavor, you’ll end up with a snack that takes a long time to eat and fills you up on relatively few calories. In addition, several studies show people who eat about three servings of whole grains per day weight less and have a smaller waistline compared to those who don’t.

6 Cold Pea Salad

Peas are naturally rich in resistant starch, a type of fiber that isn’t completely broken down or absorbed during digestion. Cooking and cooling peas to make a pea salad will significantly increase the amount of resistant starch they content. Rodent studies show resistant starch helps reduce stomach fat and increase hormones that tell the brain it’s time to stop eating.

7 Eggs

Choose eggs over cereal in the morning and you’ll tame hunger pangs for hours after breakfast, decreasing the likelihood of overeating later in the day. Make a meal containing at least 25 – 30 total grams of protein (the protein is in the white of the egg so this equates to 4 – 5 egg whites though you can choose any combination of whole eggs and egg whites as long as you consume at least 4 -5 of the whites) so you can cash in on the satiety-enhancing benefits of eggs. Added bonus: following a high protein diet for a short period of time can lead to significant reductions in belly fat.

8 Green Tea

The combination of caffeine and antioxidants in green tea may lead to small to moderate reductions in body fat and waist size. However, you need to consume quite a bit of it so get creative and cook with green tea by brewing it and using it to cook rice (it’s particularly good with jasmine rice), make stews, soups or stocks. You can also poach fruit green tea or use dried green tea leaves as part of a rub for meats, tofu or fish.

9 Barley

Barley is a cereal grain with a nutty taste and consistency that is a cross between pasta and rice. In a double-blinded trial (both the men and the researchers didn’t know which food they were getting), Japanese men were given rice or a mixture of rice with pearl barley. The group receiving the pearl barley and rice mixture lost a significant amount of visceral fat, the kind that covers your organs like a thick winter blanket and increases risk of heart disease, stroke and type-2 diabetes. Compared to the rice only group, the group who ate pearl barley decreased their waist size.

10 Blueberries

Blueberries are an excellent source of dietary fiber, which will not only help keep you full but also help keep your waistline in check. Plus they are a natural source of prebiotic fiber – the kind that the good bacteria in your gut munch on.

A flat belly is one of the most recognized signs of a fit body. Blast away abdominal fat with high-intensity cardio and build the underlying muscle by regularly switching up your training program. Also, incorporate a 30-minute abs classes to your routine. At least one study found you can spot reduce if you exercise the same muscle group for at least 30 minutes at a time. Keep in mind abs are made in the gym but revealed in the kitchen. Add the top 10 flat belly foods to your diet while cutting down on sugar alcohols (sorbitol, maltitol, and mannitol are the worst for causing gas and bloating), fizzy drinks and chewing gum (all of these can increase bloating at least temporarily) and you may fall in love with skinny jeans.

 

References
Clifton PM, Bastiaans K, Keogh JB. High protein diets decrease total and abdominal fat and improve CVD risk profile in overweight and obese men and women with elevated triacylglycerol. Nutr Metab Cardiovasc Dis 2009;19(8):548-54.

O’Neil CE1, Keast DR, Nicklas TA, Fulgoni VL 3rd. Nut consumption is associated with decreased health risk factors for cardiovascular disease and metabolic syndrome in U.S. adults: NHANES 1999-2004. J Am Coll Nutr 2011;30(6):502-10.

Kahn HS, Tatham LM, Rodriguez C, et al. Stable behaviors associated with adults’ 10-year change in the body mass index and likelihood of gain at waist. Am J Public Health 1997;87:747-54.

Ridaura VK, Faith JJ, Rey FE, Cheng J, Duncan AE et al. Gut microbiota from twins discordant for obesity modulate metabolism in mice. Science 2013;341:6150.

Turnbaugh PJ, Ley RE, Mahowald MA, Magrini V et al. An obesity-associated gut microbiome with increased capacity for energy harvest. Nature 2006;444:1027-1031.

Vidrine K, Ye J, Martin RJ, McCutcheon KL et al. Resistant starch from high amylose maize (HAM-RS2) and dietary butyrate reduce abdominal fat by a different apparent mechanism. Obesity (Silver Spring) 2014;22(2):344-8.

Bisanz JE, Reid G. Unraveling how probiotic yogurt works. Sci Transl Med 2011;3:106.

Dhurandhar NV, Geurts L, Atkinson RL et al. Harnessing the beneficial properties of adipogenic microbes for improving human health. Obesity Reviews 2013;19:721-735.

Delzenne NM, Neyrinck AM, Bäckhed F, Cani PD. Targeting gut microbiota in obesity: effects of prebiotics and probiotics. Nat Rev Endocrinol 2011;7(11):639-46.

Furet JP, Kong LC, Tap J et al. Differential adaptation of human gut microbiota to bariatric surgery-induced weight loss: links with metabolic and low-grade inflammation markers. Diabetes 2010;59:3049-3057.

Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Microbial ecology: human gut microbes associated with obesity. Nature 2006;444: 1022–1023.

Santacruz A, Marcos A, Warnberg J et al. Interplay Between Weight Loss and Gut Microbiota Composition in Overweight Adolescents. Obesity 2009;17:1906–1915.

Harland JI, Garton LE. Whole-grain intake as a marker of healthy body weight and adiposity. Public Health Nutr 2008;11(6):554-63.

Yadav BS, Sharma A, Yadav RB. Studies on effect of multiple heating/cooling cycles on the resistant starch formation in cereals, legumes and tubers. Int J Food Sci Nutr 2009;60 Suppl 4:258-72.

Keenan MJ, Zhou J, McCutcheon KL et al. Effects of resistant starch, a non-digestible fermentable fiber, on reducing body fat. Obesity (Silver Spring) 2006;14(9):1523-34.

Nagao T, Komine Y, Soga S et al. Ingestion of a tea rich in catechins leads to a reduction in body fat and malondialdehyde-modified LDL in men. Am J Clin Nutr 2005;81(1):122-9.

Paniagua JA, Gallego de la Sacristana A, Romero I et al. Monounsaturated fat-rich diet prevents central body fat distribution and decreases postprandial adiponectin expression induced by a carbohydrate-rich diet in insulin-resistant subjects. Diabetes Care 2007;30(7):1717-23.

Fulgoni VL 3rd, Dreher M, Davenport AJ. Avocado consumption is associated with better diet quality and nutrient intake, and lower metabolic syndrome risk in US adults: results from the National Health and Nutrition Examination Survey (NHANES) 2001-2008. Nutr J 2013;12:1.

Shimizu C, Kihara M, Aoe S et al. Effect of high beta-glucan barley on serum cholesterol concentrations and visceral fat area in Japanese men–a randomized, double-blinded, placebo-controlled trial. Plant Foods Hum Nutr 2008;63(1):21-5.

Du H, van der A DL, Boshuizen HC et al. Dietary fiber and subsequent changes in body weight and waist circumference in European men and women. Am J Clin Nutr 2010;91(2):329-36.

Peters EM, Anderson R, Nieman DC, et al. Vitamin C supplementation attenuates the increases in circulating cortisol, adrenaline and anti-inflammatory polypeptides following ultramarathon running. Int J Sports Med 2001;22(7):537-43.

 

The Ketogenic Diet Craze: Fat-Filled Lies, Part 1

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ketogenic diPicture this: a thick, juicy, tender eventeak grilled to perfection with melted butter glazed on top, gently dripping down the sides. Lying next to the steak there’s a side of dark green asparagus sautéed in coconut oil and dusted with a sprinkle of sea salt. Could a diet loaded with fat help you lose diet-resistant body fat that’s been taunting the seams of your dress pants and poking through buttons on your shirt? Will eating fat turn you into an all-star athlete? This is part 1 of a 2 part series on the ketogenic diet.

Here is what I will cover in this blog post:

  • What is the ketogenic diet?
  • Adverse health effects.

Here is what I will cover in tomorrow’s blog on this topic:

  • The issue with ketogenic research studies.
  • Is the ketogenic diet superior for losing fat?
  • How will the ketogenic diet affect muscle?
  • How will the ketogenic diet impact athletic performance?

What is the Ketogenic Diet?

For nearly a century, epileptic patients have used ketogenic diets to control seizures when common medications provide no relief. Scientists aren’t sure why following a ketogenic diet decreases the incidence and severity of seizures but it works.

The ketogenic diet contains – 80-90% of calories from fat, 15% from protein and 5% from carbohydrate (1, 2). Food choices may include heavy cream, bacon, eggs, non-starchy vegetables, mayonnaise and sausage while fruits, starchy vegetables, breads, pasta, cereal and other carbohydrate-rich foods are not allowed.

During the first several days on a ketogenic diet, your body’s limited supply of carbohydrate stored in liver and muscle tissue decreases dramatically. As a result, you will feel like you have mono – exhausted, with headaches and easy exercise will feel like you’re climbing Mount Everest (3). Once your stored carbohydrate has dwindled, ketones, formed from the breakdown of dietary fat, become the primary source of energy for brain and body. Ketogenic means “ketone forming.” It takes at least seven days to reach nutritional ketosis and several weeks to fully adapt to the diet (12). If you aren’t in nutritional ketosis (as measured by blood, urine or breath ketones; ketone levels > 0.5 mmol/L), then you aren’t following a ketogenic diet, you are on a low carbohydrate diet.

Adverse Health Effects from the Ketogenic Diet

Much of the research on adverse effects comes from studies in epileptic children since they have been on the diet for long periods of time. These studies show soon after starting a ketogenic diet, blood cholesterol levels and artery stiffness increase (4, 5). High total and LDL cholesterol are risk factors for cardiovascular disease (diseases of the heart and blood vessels). When arteries are stiff, they cannot expand as well in response to changes in blood pressure. Think of this like a garden hose when you turn up the water pressure, your hose either expands or the water bursts out of the space between the faucet and the hose. When arteries cannot open widely to accommodate increases in blood flow, blood pressure increases leading to microscopic tears on artery walls, development of scar tissue and the perfect surface for plaque buildup (6). Blood cholesterol levels returned to normal in patients who went off the diet and in those who stayed on it, they returned to normal after 6 to 12 months. Artery stiffness returned to normal after 24 months on a ketogenic diet.5 Studies in obese patients suggest ketogenic diets improve blood sugar and blood cholesterol levels over time, either due to the diet, weight loss from the diet, a combination of the two or carbohydrate restriction (7, 8). Lose weight, regardless of what you eat and blood cholesterol, blood pressure, inflammation, blood sugar and many other disease risk factors will improve.

Ketogenic diets are typically low in calcium, vitamin D, potassium, magnesium, folic acid and fiber. There are several potential consequences associated with consistently low intake of each of these micronutrients including softening of the bones, decreased bone density, muscle damage, muscle weakness or spasms, and abnormal heart rhythm. However, with careful planning, a fiber supplement, multivitamin and under the guidance of a physician who may prescribe potassium and sodium supplements (blood sodium could drop to dangerously low levels while on this diet), nutrient needs can be met. Also, to prevent constipation when on a ketogenic diet, a fiber supplement may be necessary along with more water / fluid intake then you are used to.

Here are some other potentially bad side effects from following a high fat diet:

  • Harm to your Brain. Studies in mice show a high fat diet, even when followed for as little as two months leads to chronic inflammation, sedentary immune cells in the brain – these cells typically act like janitors picking up trash and infectious compounds but when they become sedentary they stop doing their job, leading to cognitive impairment (9). Does this happen in humans and resolve over time? We don’t know.
  • Mad Bacteria in Your Gut. A diet with no probiotics (healthy bacteria) and low in prebiotics (certain types of fiber that the healthy bacteria much on for food keeping them happy) will likely change the composition of bacteria in your gut so you have more harmful and less beneficial bacteria.
  • Leaky Gut. High saturated fat meals increase bacterial toxins (endotoxins) in the intestines and intestinal permeability. In other words: leaky gut (10, 11). If you are on this diet, consider opting for foods lower in saturated fat and higher in unsaturated fats (liquid oils, avocado, nuts, seeds, olives).
  • Free radicals in overdrive? If you can’t eat a number of colorful foods including blueberries, beets, corn, oranges, and more, chances are you won’t get a wide array of antioxidant compounds to quench free radicals (compounds that are important for good health but can wreck your body when they aren’t tamed by antioxidants) as well as other plant-based compounds that keep your arteries, muscles and other parts of your body healthy. Will your body adapt? We don’t know at this time.

Are the side effects and potential negative side effects worth it if you can lose weight on this diet? Stay tuned for tomorrow’s post on how the ketogenic diet impacts body fat and athletic performance.

References

1 Freeman JM, Freeman JB, Kelly MT. The ketogenic diet: a treatment for epilepsy. 3rd ed. New York, NY: Demos Health; 2000.

2 Paoli A, Bianco A, Damiani E, Bosco G. Ketogenic Diet in Neuromuscular and Neurodegenerative Diseases. BioMed Research International 2014, Article ID 474296, 10 pages, 2014.

3 White AM, Johnston CS, Swan PD et al. Blood ketones are directly related to fatigue and perceived effort during exercise in overweight adults adhering to low-carbohydrate diets for weight loss: a pilot study. J Am Diet Assoc 2007;107(10):1792-6.

4 Tanakis M, Liuba P, Odermarsky M, Lundgren J, Hallböök T. Effects of ketogenic diet on vascular function. Eur J Paediatr Neurol 2014;18(4):489-94.

5 Coppola G, Natale F, Torino A et al. The impact of the ketogenic diet on arterial morphology and endothelial function in children and young adults with epilepsy: a case-control study. Seizure 2014;23(4):260-5.

6 Cecelja M, Chowienczyk P. Role of arterial stiffness in cardiovascular disease. JRSM Cardiovascular Disease 2012;1(4):1-10.

7 Dashti HM, Mathew TC, Hussein T, Asfar SK, Behbahani A, Khoursheed MA, Al-Sayer HM, Bo-Abbas YY, Al-Zaid NS. Long-term effects of a ketogenic diet in obese patients. Exp Clin Cardiol 2004; 9(3): 200–205.

8 Volek JS, Feinman RD. Carbohydrate restriction improves the features of Metabolic Syndrome. Metabolic Syndrome may be defined by the response to carbohydrate restriction. Nutr Metab (Lond) 2005;2:31.

9 Hao S, Dey A, Yu X, Stranahan AM. Dietary obesity reversibly induces synaptic stripping by microglia and impairs hippocampal plasticity. Brain Behav Immun 2016 Jan;51:230-9.

10 Mani V, Hollis JH, Gabler NK. Dietary oil composition differentially modulates intestinal endotoxin transport and postprandial endotoxemia. Nutr Metab (Lond) 2013; 10: 6.

11 Lam YY, Ha CW, Campbell CR, Mitchell AJ, Dinudom A, Oscarsson J, Cook DI, Hunt NH, Caterson ID, Holmes AJ, Storlien LH. Increased gut permeability and microbiota change associate with mesenteric fat inflammation and metabolic dysfunction in diet-induced obese mice. PLoS One 2012;7(3):e34233.

12 Paoli, A, Grimaldi K, D’Agostino D, Cenci L, Moro T, Bianco A, Palma A. Ketogenic diet does not affect strength performance in elite artistic gymnasts. J Int Soc Sports Nutr 2012;9:34.

Full Fat or Low Fat Dairy?

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If you are totally against low-fat dairy, it’s time to take a closer look at the research. After listening to this dairy debate and watching the finger pointing, I started searching through the literature for an answer to this question “does dairy fat increase LDL cholesterol and risk for cardiovascular disease?” Then I came to my senses. No one eats dairy fat. Unless you’re a food scientist, you aren’t separating the fat from milk or full-fat yogurt and eating it or adding it as an ingredient to your recipes. However, we do eat cheese and yogurt and drink milk. The array of compounds in each of these foods influences how they affect your cholesterol and risk for heart disease. So, I revised the question to: “how does full fat cheese, yogurt and milk impact cholesterol and risk for heart disease?”

Here’s what I’ll cover in this article:

  • Why people are up in arms about saturated fat – saying it is either good or bad;
  • How does full fat cheese, yogurt and milk impact cholesterol;
  • What should you do with this information?

Dairy Fat isn’t the Only Factor

The research on dairy generally follows the research on saturated fat: the replacement strategy matters. For instance, it isn’t a good idea to take cheese out of your diet and replace it with a highly refined carbohydrate (not a good move for blood fats). Butter isn’t better than liquid oil. Butter raises LDL cholesterol. Some research suggests dairy fat might raise the large, less artery clogging LDL cholesterol compared to small dense LDL. However, “less artery clogging” does not mean “not artery clogging” and this area of the science needs more work before we can draw firm conclusions. Also, there are a few differences based on the type of food (milk, cheese, yogurt, butter); aged cheese reigns.

dairy and cheddar cheese

-> Aged cheese does not raise LDL as much as butter (accounting for total fat in each). In fact, several studies show aged cheese appears to have a “relatively minor” impact on LDL cholesterol or no impact at all. This could be due to the calcium content, which leads to the excretion of some fat or, fermentation may have an effect. Aged cheese stands out in the research.

-> Yogurt appears to have less of a cholesterol raising effect than expected. However this research is inconsistent possibly due to differences in the type of bacteria in the yogurt (aka probiotics). I recommend choosing yogurt with “live and active cultures.”

– > Milk – when consuming the same amount of fat from whole milk or butter, both raise LDL to the same extent. Milk contributes substantially less total fat per amount consumed compared to full fat yogurt and butter. Cross-sectional studies suggest milk consumption doesn’t raise coronary artery disease risk, however, this may reflect lower total fat intake from milk compared to butter.

-> Cottage cheese –  this incredible food is oftentimes forgotten yet an excellent addition to your diet. I couldn’t find any studies on cottage cheese, however, the highest fat cottage cheese I could find  (4% milk fat) contained 5 g total fat per serving so we can expect the impact cottage cheese may have a lower impact compared to whole milk.

What Should You Do with this Information?

If your LDL is high, choose skim, 1% or low fat milk. Opt for a good quality yogurt with naturally occurring probiotics. As far as cheese goes – I’d take out all of the other offending foods and work on other aspects of heart health before ditching the cheese (unless your LDL is very high) and cottage cheese. However, always follow the dietary advice of your registered dietitian since there are many variables that should be taken into consideration.

What about the trans fats in dairy? They are good for you right? No. In large amounts, the trans fats in dairy have the same impact as those found in partially hydrogenated oil (not good for cholesterol, cardiovascular disease risk etc.). However, we don’t eat dairy trans fats in significant quantities (they make up very tiny amounts of dairy fat and beef fat).

Take Home Points

In general, dairy foods help lower blood pressure plus there is emerging evidence about the positive role dairy foods may play in metabolic syndrome. What about dairy fat? Consider the whole food and your diet overall so you can make the right choices based on your personal risk factors for cardiovascular disease. Also, keep in mind there are many factors that influence cardiovascular disease pathology, some of which are unrelated to cholesterol.

References

Tholstrup T, Hoy CE, Andersen LN, Christensen RD, Sandstrom B. Does fat in milk, butter and cheese affect blood lipids and cholesterol differently? J Am Coll Nutr 2004;23:169–76.

Hjerpsted J, Leedo E, Tholstrup T. Cheese intake in large amounts lowers LDL-cholesterol concentrations compared with butter intake of equal fat content. Am J Clin Nutr 2011;94:1479–84.

Biong AS, Muller H, Seljeflot I, Veierod MB, Pedersen JI. A comparison of the effects of cheese and butter on serum lipids, haemostatic variables and homocysteine. Br J Nutr 2004;92:791–7.

Nestel P. Effects of Dairy Fats within Different Foods on Plasma Lipids. J Am Coll Clin Nutr 2008, 27(6): 735S–740S.

Thorning TK et al. Diets with high-fat cheese, high-fat meat, or carbohydrate on cardiovascular risk markers in overweight postmenopausal women: a randomized crossover trial. Am J Clin Nutr 2015.

Labonté MÈ et al. Dairy product consumption has no impact on biomarkers of inflammation among men and women with low-grade systemic inflammation. J Nutr 2014;144(11):1760-7.

Sjogren P et al. Milk-derived fatty acids are associated with a more favorable LDL particle size distribution in healthy men. J Nutr 2004;134(7):1729-35.

Hodson L, Skeaff CM, Chisholm WA. The effect of replacing dietary saturated fat with polyunsaturated or monounsaturated fat on plasma lipids in free-living young adults. Eur J Clin Nutr 2001; 55(10):908-15

Soerensen KV et al. Effect of dairy calcium from cheese and milk on fecal fat excretion, blood lipids, and appetite in young men. Am J Clin Nutr 2014;99(5):984-91.

Grebe A, Latz E. Cholesterol crystals and inflammation. Curr Rheumatol Rep 2013;15(3):313.

 

 

Sourdough – Safe for Gluten Sensitivity?

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There’s something special about sourdough bread. Made through a slow process that begins with simple ingredients, warm water and flour, yeast and bacteria feast on the flour’s carbohydrate, producing carbon dioxide gas and bubbles that expand the dough. Each batch may tastes a little different depending on the flour and water used as well as the environment the starter is made in. My favorite sourdough bread, the kind that is made over the course of several days, has an alluring pungent, slightly sour taste. This long fermentation process leads to more complex flavors while also creating bread that is easier for those with gluten sensitivity to digest. I shared the science behind sourdough in this segment on Fox TV:

What is Gluten?

Gluten’s stretchy fibers give dough it’s rubberband-like elasticity allowing it to stretch when pizza dough is tossed in the air like a frisbee. Gluten-rich dough traps air and water during the baking process so bread rises with delicate ease, producing light and fluffy baked goods. Without wheat (and therefore gluten, which is produced when wheat flour is mixed with water), gluten free items require a blend of flours, starches and additives yet they still can’t replicate the texture of gluten-containing baked goods.

In people with celiac disease, an autoimmune digestive disease, repeated exposure to gluten damages villi, fingerlike projections in the small intestine that help us absorb nutrients from food. Over time, a decrease in nutrient absorption can lead to anemia, osteoporosis, miscarriages and other complications. The University of Chicago Celiac Disease Center website lists over 300 symptoms associated with celiac disease though anemia is the most common symptom in adults. The only available treatment is a strict gluten free diet – which helps reverse intestinal damage over time. Gluten sensitivity is not an autoimmune disease but instead a vague medical condition without a uniform definition or diagnostic test at this time. People with gluten sensitivity report various symptoms triggered by the ingestion of gluten-containing foods including abdominal pain, bloating, and constipation or diarrhea. Though gluten sensitivity is real, someone who thinks they have sensitivity may actually be reacting to something other than gluten (another protein or the starches – see below under Is it the Gluten?)

Sourdough bread

The Science behind Sourdough

Standard yeast leads to a fast fermentation process. This ramps up production speed and it is also foolproof so companies can produce batches of bread at warp speed. Sourdough bread is made slowly, over time, letting the yeast work it’s magic to deliver an array of flavors as well as bread that is easier to digest. In one study, sourdough bread made with selected sourdough lactobacilli and long-time fermentation resulted in bread with gluten levels of 12 parts per million (ppm), which qualifies for gluten-free (anything below to 20 ppm is gluten free). A long fermentation process allows bacteria and yeast adequate time to feed on proteins and starches breaking them down into more digestible parts. Yet sourdough also boasts a lower glycemic index than many other types of bread (including white bread) and therefore it doesn’t lead to a quick spike in blood sugar levels.

In 2011, a small study conducted in Italy tried giving volunteers with celiac disease a small amount of specially prepared sourdough bread. The bread was fermented until the gluten was broken down to more easily digestible parts. The subjects in the study reacted well to the sourdough, with no changes in intestinal villi and no detectable antibodies typically found when a celiac disease patient eats a gluten containing food. According to the study authors, the bread “was not toxic to patients with celiac disease.”

In another study, conducted over 60 days, baked goods made from hydrolyzed wheat flour, manufactured with sourdough lactobacilli and fungal proteases, was not toxic to patients with celiac disease. Though these studies are groundbreaking, it is far too soon for celiac disease patients to try this at home. For sourdough bread to be an option for those with celiac disease, a uniform production process would need to be established to ensure the end product is gluten-free.

For those with Gluten Sensitivity, Is it Really the Gluten?

Some people may experience bloating and flatulence in response to FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols). FODMAPs are a type of carbohydrates that are not well absorbed in the small intestine and are present in bread along with a number of other foods (other grains, some vegetables and fruits). In some people the problem may be FODMAPs, not gluten. The long fermentation process reduces FODMAPs.

How to Make Sourdough at Home

Sourdough starter begins with flour and water that sits for several days while being fed intermittently with both flour and water allowing bacteria (lactobacilli) and yeast to grow and multiply creating live cultures. These microorganisms are what makes the dough ferment similar to the way milk ferments to become yogurt. Check out these recipes to make your own sourdough bread: Healthy Aperture, the Perfect Loaf.

If you run into problems making sourdough check out this page for troubleshooting.

 

 

Are Low Carbohydrate Diets Best for Weight Loss?

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If you haven’t been bombarded with advertising for low carbohydrate foods, diets, plans and crazed anti-carbohydrate friends and coworkers in the past few years, you must be living on a remote island somewhere (taking any visitors?). The anti-carbohydrate, pro-fat crowd (including keto, Paleo, and Whole 30 – aka Paleo reinvented) devotees might be onto something. But that “something” isn’t a miraculous cure for obesity. Should you trade your low fat, higher carbohydrate diet for full fat foods and “bread” made from cauliflower and mozzarella cheese? It’s time to look past the media headlines to the latest research on low fat vs. low carbohydrate diets.

In this article I’ll cover:

  • the latest research on lower carbohydrate diets;
  • what this research means for you; and
  • a sidenote on the insulin hypothesis.

Should you switch to low carbohydrate vs. high carbohydrate foods?

The Latest Research on Low Carbohydrate Diets

In an attempt to determine which diet is best for weight loss, one of the latest studies collected and analyzed studies on low fat and low carbohydrate diets. A systematic review and meta-analysis, which combines the results of several studies, compared intervention studies > 1 year in length where participants were placed on low fat diets, low carbohydrate diets, other high fat dietary interventions or they continued eating whatever they wanted (their typical diet). Low fat diets ranged from  < 10% of calories from fat to < 30% of calories from fat. The diet interventions used ranged from providing instructions at the start of the study and expecting participants to follow the diet plan to regular counseling sessions with dietitians, food diaries and cooking lessons to actual feeding studies where participants were given most of their overall food intake (with the last approach the most well-controlled). Some studies coached participants to cut calories while others, including those put on low-carbohydrate Atkins-style diets, were told to eat until they were full without worrying about calories.

They analyzed results from 13 trials that examined weight maintenance as well as studies that didn’t include weight loss as a primary goal. In these studies low-fat and high-fat diets lead to a similar amount of weight loss. Low-fat diets were superior only when compared to the subjects’ normal diet – in other words actually going on a diet led to greater weight loss than not dieting (no surprise there). The tiebreaker came from an analysis of 35 weight loss trials, 29 of which were conducted using adults who were overweight, obese, or had type II diabetes. Overall, there was no difference between low-fat and high-fat diet interventions. Low-fat diets led to greater weight loss compared to groups who didn’t diet. However, higher fat diets were the clear winner (according to the headlines), leading to significantly greater weight loss after a year than low fat diets. Before tossing out your steel cut oatmeal, whole-grain bread and fresh Summer fruit, let’s take a closer look at this data. It was pulled from a comparison between low-fat diets and high-fat diets that varied by more than 5% of calories. So did low carbohydrate, higher fat diets really win or was it because subjects cut calories? Is it easier to cut calories on low carbohydrate, high fat diets? Participants on low carbohydrate diets lost about 2.2 pounds more weight after one year versus those on a low-fat diet. A 2.2-pound difference in weight loss after one year on a diet isn’t very impressive, especially considering many of the subjects were overweight or obese to begin with.

The End of Higher Carbohydrate, Low-Fat Diets?

Based on these results the authors suggest low-fat diets shouldn’t be the go-to recommendation for weight loss. However, the results of this study are mainly applicable to overweight, obese and type II diabetics – the primary populations examined in these studies. We can’t take the authors conclusion that low carbohydrate, higher fat diets are better if you are looking to lose a few pounds for a beach ready body. What works for an obese adult or type II diabetic will not necessarily work for an active adult who wants to get a 6-pack. Secondly, previous research shows low carbohydrate diets tend to produce greater weight loss, initially, than low fat diets (some of this is water weight since carbohydrates store 3-4 times their weight in water in the form of glycogen in muscles and the liver and your glycogen stores will start dropping when you drastically lower your carbohydrate intake) yet after a year, weight loss is equivalent between both diets. Other research shows weight loss over the first six months on a diet is the main predictor of both weight loss success and sticking to a diet over the long-term. Greater weight loss initially = better adherence = better success over time.

Long-term Success

What’s more disappointing than the paltry 2.2-pound difference between the low-fat and high-fat diets after one year is the total average weight loss in the studies designed for weight loss – a mere 8.25 lbs. after 1 year. Instead of declaring low carbohydrate, higher fat diets a clear winner over low fat, higher carbohydrate diets (especially considering the 2.2 pound difference), we should be asking why it’s tough to stay on a diet, any diet? Why aren’t study participants losing more weight? I don’t have the answer to these questions and leading weight loss researchers don’t seem to have a complete picture right now either.

If you want to lose weight, choose a lower calorie diet primarily based on high quality foods or create your own plan that fits into your lifestyle and is one you can stick with it. There are many diets that could, potentially, work for you. If you want to try a low carbohydrate diet for a while, by all means go for it (especially if you need to see that number on the scale move pretty quickly)! If cutting carbs sounds like being in detention, then skip that approach! I’m giving you permission to alter your plan as often as you need to based on changes in your lifestyle (some research papers actually suggest doing this and I am a huge fan of this approach), motivation, and results.

Conceptually, low carbohydrate diets are very easy. You don’t have to worry about portion sizes, log calories, count points or determine if you have to eat less at dinner to make up for a lunchtime splurge. Decision-making is boiled down to: it contains carbs and therefore off my diet or it is low in carbs and the carbs it does contain are high in fiber so I can eat it. Just don’t buy into the hype that low fat, higher carbohydrate diets are the only way to lose weight or that these diets are better, over the long term, than other dietary approaches that also cut calories.

References

Tobias DK, Chen M, Manson JE, Ludwig DS, Willett W, Hu FB. Effect of low-fat diet interventions versus other diet interventions on long-term weight change in adults: a systematic review and meta-analysis. Lancet Epub before print. 29 October 2015.

Greenberg I, Stampfer MJ, Schwarzfuchs D, Shai I; DIRECT Group. Adherence and success in long-term weight loss diets: the dietary intervention randomized controlled trial (DIRECT). J Am Coll Nutr 2009;28(2):159-68.

Franz MJ, VanWormer JJ, Crain AL, Boucher JL, Histon T, Caplan W, Bowman JD, Pronk NP. Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc 2007;107(10):1755-67.

Hall KD. Predicting metabolic adaptation, body weight change, and energy intake in humans. Am J Physiol Endocrinol Metab 2010;298(3):E449-66.

Hall KD, Sacks G, Chandramohan D, Chow CC, Wang YC, Gortmaker SL, Swinburn BA. Quantification of the effect of energy imbalance on bodyweight. Lancet 2011; 378(9793).

Rosqvist F, Iggman D, Kullberg J, Cedernaes J, Johansson HE, Larsson A, Johansson L6, Ahlström H, Arner P, Dahlman I, Risérus U. Overfeeding polyunsaturated and saturated fat causes distinct effects on liver and visceral fat accumulation in humans. Diabetes 2014;63(7):2356-68.