How Dieting Wrecked your Self Esteem and Made you Overweight

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This article is for all serial dieters. If you’ve been dieting on and off for years yet never achieved or maintained your “goal” weight, you’ve been handcuffed to the multi-billion dollar diet industry. I’m here to tell you why you need to break free and how to do it.

Why You Need to Break Free From Dieting

If you are a perpetual dieter, in search of the latest magic weight loss diet or pill, you may be doing more harm than good.

Dieting Slows Your Metabolism
Losing weight leads to a drop in the amount of calories you burn each day so you need to cut your calories even more after you lose the weight to maintain your new weight. This happens even if you preserve muscle (each pound of muscle burns about four more calories per day then a pound of fat) (9). This is termed metabolic adaptation and the reasons for it aren’t entirely clear though the decrease in metabolism is correlated with how many calories you cut and changes in the hormone leptin. Leptin is a hormone secreted by fat cells; it helps regulate body weight and energy balance (7, 8).

The more you cut calories the more your metabolism will drop.

Rapid and massive weight loss seems to lead to the greatest drop in metabolic rate.

Though this happens, it doesn’t mean you shouldn’t lose weight if needed for health reasons. However, the “Oprah” cycle of repetitive low calorie dieting followed by weight regain needs to stop.

Diets Over Promise and Under Deliver
Diets promise you’ll get ripped in no time. Research tells us you won’t lose all of the weight you expect to lose (1). And that’s ok. However, unrealistic expectations are a problem because they make you want to ditch the diet or worse, binge eat because you are pissed off that you’ve been lied to.

Reign in your expectations with these validated weight loss calculators:

Pennington Biomedical Research Center Weight Loss Calculator

USDA SuperTracker

Your Life Won’t Magically Change
Dieting tells you your entire life will get better once you lose 10 lbs. Sure, you might need to hem a few pairs of pants and your self esteem may improve a bit. However, you won’t turn into a GQ or Sports Illustrated swimsuit edition cover model. Your boss will treat you the same, your relationships won’t magically improve and everything else in your life might appear to be static if you are waiting for fireworks.

There are many times I run into people who want to lose weight and as I start asking questions and digging I realize they are attempting to control their weight and hyper control their food intake because there is something in their life that is out of control. They are transferring the focus on their body, food and exercise to calm their brain down and decrease anxiety about parts of their life that are raveling out of control.

Don’t use dieting as an excuse to avoid major life issues.

Dieting Tells You “You’re Not Okay”
Many popular diets, pills and programs marketed through airbrushed ads tell you one thing “there is something is wrong with you and this book, program or pill can help you fix it.” They are preying on your vulnerable self-esteem. Taking the bait is like jumping into a dark and depressing pit over and over, attempting to crawl out, losing your grip and getting kicked right back down. Every time you gain a little weight back or judge yourself based on the bathroom scale you’ll feel dejected.

“Where there is perfectionism there is always shame (guilt, regret, sadness),” Brene Brown.

Consistently feeding your mind with a diet of “I’m not good enough” is no way to live. Treat yourself with some respect.

“I’m not good enough” is also a mental roadblock to achieving your goals. One day you’ll have a tough day, come home and say “F this. I’m fat, I might as well eat this whole package of Milky Ways.” Next thing you know you feel like a failure and fall into the ultimate Feedback Loop from Hell. “Why can’t I stick with a diet? I suck.” Once stuck in this mindset, it’s hard to recognize there could be something wrong with the diet itself and the promises (lies) you’ve been told if you just follow it.

I’m here to say you are okay.

Letting Go of the Diet Crutch

If you’ve been dieting on and off for years, recognize that you will have some anxiety in letting go. That’s okay. There are steps you can take to combat anxiety over time and still achieve good health.

What if You Want to / Need to Lose Weight?
If you need lose weight for health reasons, yet you’ve dieted over and over in the past, without reaching your goal, it is time to do something different. Here are steps you can take to a healthier weight and life without dieting:

• Get Support – research shows people who have support are more likely to take weight off and less likely to gain it back.

• Keep in mind moderate weight loss can make a tremendous difference in health. Even small amounts of weight loss can lower blood fats (triglycerides), cholesterol, blood sugar, risk for diabetes and other chronic diseases.

• Start with exercise while focusing on the immediate benefits of exercise – improved mood, improved memory, greater self esteem.

• Be proud of small “wins.” If you haven’t exercised since recess in elementary school, it isn’t necessary to jump right into high intensity interval training three days per week. Start small and be proud of your changes along the way. Even 5 to 10 minutes of exercise each day plus one diet change will help build healthy long-term habits.

• Realize that nobody is looking at you in your bathing suit on the beach and judging your body. We are the harshest critics of ourselves. Someday you will look back and regret not wearing that bathing suit and enjoying the water.

• Go on a diet from the media. Constantly viewing “ideal” body images reduces body satisfaction. In other words, the more you look at popular magazines with airbrushed pictures the worse you will feel about yourself (2, 3, 4). This is true for both men and women.

• Find a physical trait you love and focus on it daily. You will feel better about your body when you focus on the parts of your body you like the best. Conversely, focusing on the parts of your body you do not like will increase body dissatisfaction (5).

• Check out the Happiness Trap – an empowering self-help book based on behavioral psychology.

Follow This Approach
There are two approaches to not dieting and both go hand-in-hand. The first one is Intuitive Eating. Intuitive eating breaks the dieting cycle and teaches you how to feed your body based on hunger and satiety cues. There are number of intuitive eating counselors who can help you with this.

The second approach is Body Kindness. This book is about creating a happier and healthier life. The focus is on spiraling up, the idea that your mindset and mood influences your choices and vice versa to help you stay more positive, optimistic and open to bring the best you to the world — and it has nothing to do with what you weigh. Author Rebecca Scritchfield, RDN, a former chronic dieter who broke free from the cyle of dieting and emotional overeating, believes dieting creates a downward spiral because it enhances your negative emotions. Body Kindness is based on three pillars: Love Connect Care. Make choices from a place of love, connect to your body to find out what you really need, and fully commit to your self-care plans.

I use diets, when warranted, and prescribed the right way for those who are not perpetual dieters. I do not recommend them for people who have gone on and off them for years and have a poor body image. I will never forget the time I counseled a woman in her 30s who had been on and off Weight Watchers since she was a pre-teen. She said, “it works for me.” And she was surprised at my response “no, it hasn’t worked for you because if it did you wouldn’t be sitting in front of me today.” She said she was ashamed about how she looked. My response, “let’s work on that. It’s time to let go, break free, give up emotional overeating and body shame.” That’s no way to live.

References

1 Dhurandhar EJ et al. Predicting adult weight change in the real world: a systematic review and meta-analysis accounting for compensatory changes in energy intake or expenditure. Int J Obes (Lond) 2015;39(8):1181-7.

2 Morry MM, Staska SL. Magazine exposure: Internalization, self-objectification, eating attitudes, and body satisfaction in male and female university students. Can J Behav 2001; 33: 269–279

3 Grabe S, Ward LM, Hyde JS. The role of the media in body image concerns among women: a meta-analysis of experimental and correlational studies.
Psychol Bull 2008;134(3):460-76.

4 Agliata D, Tantleff-Dunn S (2004) The impact of media exposure on males’ body image. J Soc Clin Psychol 23: 7–22

5 Smeets E, Jansen A, Roefs A. Bias for the (un)attractive self: on the role of attention in causing body (dis)satisfaction. Health Psychol 2011;30(3):360-7.

6 Lowe MR et al. Multiple types of dieting prospectively predict weight gain during the freshman year of college. Appetite 2006;47(1):83-90.

7 Zhou Y and Rui L. Leptin signaling and leptin resistance. Front Med 7: 207-222, 2013.

8 Knuth ND, Johannsen DL, Tamboli RA, Marks-Shulman PA, Huizenga R, Chen KY, Abumrad NN, Ravussin E, and Hall KD. Metabolic adaptation following massive weight loss is related to the degree of energy imbalance and changes in circulating leptin. Obesity (Silver Spring) 22: 2563-2569, 2014.

9 Johannsen DL, Knuth ND, Huizenga R, Rood JC, Ravussin E, and Hall KD. Metabolic slowing with massive weight loss despite preservation of fat-free mass. J Clin Endocrinol Metab 2012; 97: 2489-2496.

Is TMAO from Fish, Meat and Eggs Harmful?

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In another confusing nutrition story that should be titled “is there anything left for us to eat?” recent research threw a curveball. Fish, a staple of the Mediterranean diet, as well as meat and eggs may be doing more harm than good thanks to a compound called trimethylamine-N-oxide (TMAO). TMAO is found in fish and produced in the body after eating meat and eggs. TMAO is linked to greater risk for heart attack, stroke and death; yet the research isn’t crystal clear. Is it time to give up fish meat and eggs or ignore the recent media headlines?

This post will cover:

  • TMAO: More than a Gut Reaction—What gives us higher TMAO levels?
  • TMAO and health?
  • The bottom line

TMAO: More than a Gut Reaction

Blood levels of TMAO are ~ 50 times higher after eating fish compared to eggs or beef. The human body absorbs intact TMAO like the kind found in fish, easily. However, the human body’s production of TMAO, after eating foods containing the essential nutrient choline (found in eggs and meat) and the compound l-carnitine (found in meat and pork and in much smaller quantities in chicken breast and dairy products), depends on the makeup of bacteria in your gut, kidney functioning and genetics.

In one study, regular meat eaters produced more TMAO than a vegetarian did after eating steak (which contains ~ 180 mg of l-carnitine). After wiping out their gut bacteria with antibiotics, the carnivores didn’t produce any TMAO after consuming 250 mg l-carnitine. The makeup of gut bacteria in the habitual meat eaters was presumably responsible for greater TMAO production compared to the vegetarian, yet this was a small study and we don’t know anything else about the participants’ diet. Was it the meat that altered gut bacteria or something else in their diet? After all, a steady diet of red meat may mean double cheeseburgers on white bread with regular servings of French fries and soda on the side. This isn’t exactly the diet you want for promoting good bacteria in your gut.

Another study found blood levels of TMAO were greater in those with a less diverse makeup of microbes and greater amounts of a less healthy type of bacteria (firmicutes), compared to one that is healthy (bacteroidetes). A diet higher in saturated fat will promote this environment.

While bacteria seem to influence TMAO production from l-carnitine, l-carnitine also influences the makeup of gut bacteria. A study in mice found those with their gut bacteria wiped out thanks to antibiotics produced a different makeup of bacteria in the gut after consuming l-carnitine while also doubling the risk of plaque buildup in their arteries.

Higher TMAO levels come from:

  • Eating fish
  • Less diverse array of gut bacteria and increased levels of bad versus good bacteria
  • Consuming l-carnitine (mouse study)

TMAO and Health

A few human studies found higher blood levels of TMAO were associated with greater risk for heart disease. However, all research isn’t pointing in the same direction. One study in over 300 patients found blood TMAO levels were not associated with heart attack or heart disease over the course of eight years, following the initial test for TMAO. However, TMAO levels were higher in those with diabetes, patients with metabolic syndrome and those with declining kidney functioning. Another study examined over 800 people between the age of 33 and 55 and found blood TMAO levels were not associated with clogged arteries, insulin resistance (this comes before type 2 diabetes) and inflammatory markers or negative changes in blood lipids suggesting TMAO levels might not contribute significantly to the progression of clogged arteries. However, this study shows TMAO levels were significantly lower than in previous research, showing an association between TMAO and heart disease.

TMAO is considered a risk factor for cardiovascular disease. In those with type 2 diabetes, higher TMAO levels are associated with greater risk for death, heart attack, heart failure and unstable angina (chest pain). Also, higher levels of circulating TMAO are associated with higher risk of death in those with chronic kidney disease and greater risk of certain cancers. Yet, there are several confounding factors. Fish is the primary culprit for higher acute circulating TMAO levels, yet fish-based diets are associated with reduced risk for heart disease. Also, levels of TMAO are dependent upon disease state and the makeup of gut bacteria. Therefore, at this time it isn’t entirely clear which came first – does TMAO cause disease or does TMAO increase due to disease?

The Bottom Line

The story on TMAO isn’t crystal clear, so there’s no reason to avoid fish, meat and eggs in an effort to decrease TMAO levels. All three of these foods are good sources of several nutrients important for health. Though processed red meats are linked to higher risk of colorectal and stomach cancers, when cooked appropriately (lower, moist heat for example) red meat can fit into a healthy diet and deliver important nutrients including iron, zinc and vitamin B12. Eggs are an economical source of protein and contain many nutrients and compounds that contribute to health including two antioxidants important for eyesight.

Though there is no reason to completely avoid these foods, you can alter your diet to help diversify gut bacteria and also increase the amount of good versus bad bacteria. Probiotic rich foods such as yogurt and kefir with live and active cultures, miso soup, tempeh and other fermented foods contain good bacteria. Fiber-rich plant foods (fruits, vegetables, legumes) are important food sources for bacteria to thrive in your body.

Disclosure: this post was sponsored by USFRA. All views are my own and backed by research.

References
Koeth RA, Wang Z, Levison BS et al. Intestinal microbiota metabolism of l-carnitine, a nutrient in red meat, promotes atherosclerosis. Nat Med 2013 Apr 7.

Cho CE, Caudill MA. Trimethylamine-N-Oxide: Friend, Foe, or Simply Caught in the Cross-Fire? Trends Endocrinol Metab 2016 Nov 4. [Epub ahead of print]

Cho CE, Taesuwan S, Malsheva OV, Bender E, Tulchinsky NF, Yan J, Sutter JL, Caudill MA. Trimethylamine-N-oxide (TMAO) response to animal source foods varies among healthy young men and is influenced by their gut microbiota composition: A randomized controlled trial. Mol Nutr Food Res 2016 Jul 5.

Carnitine. Health Professional Fact Sheet, NIH. https://ods.od.nih.gov/factsheets/Carnitine-HealthProfessional/

Mueller DM, Allenspach M, Othman A, Saely CH, Muendlein A, Vonbank A, Drexel H, von Eckardstein A. Plasma levels of trimethylamine-N-oxide are confounded by impaired kidney function and poor metabolic control.Atherosclerosis 2015;243(2):638-44.

Meyer KA, Benton TZ, Bennett BJ, Jacobs DR Jr., Lloyd-Jones DM, Gross MD, Carr JJ, Gordon-Larsen P, Zeisel SH. Microbiota-Dependent Metabolite Trimethylamine N-Oxide and Coronary Artery Calcium in the Coronary Artery Risk Development in Young Adults Study (CARDIA). J Am Heart Assoc. 2016 Oct 21;5(10). pii: e003970.

The Truth about Detox Diets

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Detox Diets and Cleanses

Detox diets promise to clean up the mess left behind from daily life so you feel better, more energetic and lose excess body fat. Consider them the Merry Maids for your body. They come with an army of equipment and compounds to attack years of buildup from environmental toxins, pesticides, allergens, waste, and inflammatory substances. This “sewage sludge” is stuck to your gut, interfering with digestion, leaving you bloated, tired, fat and with joints and muscles that feel like they are on fire.

In theory this sounds great. But there’s one glaring issue. The human body doesn’t need to “detox” because it comes equipped with organs designed to remove waste products. Plus, many detox diets are simply very low calorie plans with added laxatives and diuretics (because instant, yet temporary, weight loss might fool you into believing the outrageous claims on detox and cleansing products). Instead of wasting your money, take the top 3 good points about many of these diets and incorporate them into your overall nutrition plan:

Drink More Water

There are a few studies showing that individuals who are obese can lose weight by drinking 2 glasses of water before each meal. Plus, many people don’t get enough water or total fluids each day anyway and dehydration can make you feel sluggish and grouchy. So, grab it from the tap or if it’s more convenient, fill up your stainless steal water bottles and carry them with you at all times.

Eat More Fruits and Vegetables

The average American is falling short on fruit and vegetable intake. According to the National Cancer Institute, people with diets rich in plant foods, such as fruits and vegetables, have a lower risk of getting some types of cancer as well as diabetes, heart disease and high blood pressure. Produce generally has fewer calories than many other foods making it a great addition to a weight loss diet.

Get Friendly with Bacteria

Many detox plans include unfiltered apple cider vinegar – the kind that has a cloudy appearance – is full of probiotics. Probiotics are friendly (beneficial) bacteria – the kind that live in your gut and have a number of important functions in your body. Improving your gut bacteria may support immune functioning, improve the health of your intestinal tract, increase your body’s absorption of certain nutrients and alleviate constipation. Apple cider vinegar is acidic so I don’t recommend drinking it straight. Instead, dilute it in a big glass of water or another beverage. Other great sources of probiotics include kefir, yogurt (check the container for “live and active cultures”), miso soup, tempeh, sauerkraut, kimchi.

Add 2 glasses of water before each meal, load up on vegetables and fruits and make an effort to consume probiotic-rich food daily and you will reap the rewards of better nutrition without wasting money on detox diets and cleanses.

References:
Parvez J et al. J Appl Microbio 2006;100(6):1171-1185.
Parretti HM et al. Obesity 2015, 23(8):1785-1791.
Dennis EA et al. Obesity 2010;18(2):300-307.

 

Which Fat is Best for Heart Health?

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Butter

If you are more confused than ever about dietary fats, you’re not alone. Can a high fat diet help you lose body fat? Which fat is best for heart health – butter, coconut oil or vegetable oil?

What is Cholesterol & Why is it Essential?
Cholesterol is an essential component of all cell membranes and a precursor to hormones, vitamin D and bile acids (needed for the digestion of fat). It is so important that your body regulates cholesterol balance to ensure your cells receive a continuous supply of cholesterol.

How does High LDL Contribute to Cardiovascular Disease?

Though cholesterol is critical for life, low density lipoprotein cholesterol, LDL cholesterol, is considered a risk factor for heart disease because excess LDL can lead to an increase in plaque buildup in your arteries. Think of this process like a garden hose with gunk stuck in it. The gunk interferes with water flowing through the hose. If too much debris gets in there, no water will flow through.  Likewise, plaque in your arteries will decrease the amount of blood that moves through your arteries at one time and a complete blockage could lead to a heart attack or stroke.  Now, this is a simplistic view, especially considering LDL isn’t just one particle but instead, several that contain different amounts of cholesterol. Some research suggests that smaller, more dense LDL particles are more artery clogging. However, in addition to particle size, total number of LDL particles and oxidation of LDL contribute to the disease process.

As LDL particles travel through the bloodstream, excess LDL particles can stick to artery walls (particularly walls that are damaged due to smoking, high blood pressure and other insults). Trapped LDL becomes oxidized and sets off an inflammatory cascade resulting in the development of plaque (gunk) stuck to arteries – atherosclerosis.

Coronary Artery Disease

How Can I Lower my LDL Cholesterol?

Cholesterol in food has little effect on your blood cholesterol.

Years ago we were told to stay away from shrimp, eggs and other high cholesterol foods. Yet this advice wasn’t based on sound science – cholesterol in food has little effect on your blood cholesterol levels. So there is no need to take these nutrient-rich foods out of your diet. Shrimp is loaded with protein, and is a good source of iron plus it contains just 80 calories per serving. Eggs are also packed with nutrition – the whites are an excellent source of protein and the yellow color you see in the yolk is from antioxidants – plant compounds that protect plants from disease and protect your body from the damaging effects of free radicals, compounds that are essential but can cause damage as well.

Coconut Oil, Butter and Other Solid Fats are Not the Best Options

Man-made trans fats (partially hydrogenated oils) are the worst kind of fat you can eat. However, they should, finally, be making their way out of our food supply over the next few years. High levels of *saturated fat, the kind that is solid at room temperature like butter, increases HDL (the “good” cholesterol but not a target of therapy – doctors don’t focus on HDL levels because increasing HDL does not lower heart disease risk) and LDL cholesterol in the blood. In controlled diet experiments where saturated fat is replaced with polyunsaturated fat rich vegetable oils, risk of heart disease is reduced. Replacing saturated fat with monounsaturated fat, the kind found in olive oil, also lowers LDL but not to the extent that polyunsaturated fat does.

Coconut oil is popular and calorie for calorie it might be better for weight management than other fats. However, coconut oil raises our total, good and bad cholesterol levels. And therefore, it is not the best option for heart health.

Excess Carbohydrate Intake can Increase LDL

Overconsumption of carbohydrate-rich foods can also increase VLDL cholesterol (very low density lipoprotein). Foods with added sugars, in particular, are potent stimulators of VLDL production when the energy (calories) aren’t needed right away for energy or increasing glycogen stores (stored carbohydrate in your liver and muscle).

Best Fats for Your Heart

Nuts, seeds, avocados, olives and liquid oils are your bets for heart health. Oils with more polyunsaturated fat have a greater impact on LDL cholesterol than those rich in monounsaturated fat. Make sure you are choosing the right oil for the right cooking application. Many oils can’t stand high heat and they break down, damaging the structure (and function) of the oil.

Fatty Acids in Oils

Conclusion

Many factors contribute to high blood cholesterol levels, including genetics, overweight/obesity, inactivity, smoking, diabetes and age, making cholesterol management a multifactorial issue. Saturated fat increases LDL cholesterol but, as I’ll say over and over, we are all different and, people vary in their response to dietary saturated fat due to intrinsic differences in fat metabolism as well as other factors including obesity, insulin resistance and high triglycerides.

Replace fats that raise cholesterol with liquid oils, nuts, seeds, avocados, and olives. Consider your overall diet as well. Eat a plant-based diet including vegetables (non-starchy veggies as well as beans, lentils and peas), fruits, nuts, seeds and whole grains (oats, barley etc.). Consume fatty fish ( salmon, mackerel, herring, halibut, sardines etc.) at least two times per week. Limit your intake of foods with added sugars and refined starches as well as your alcohol consumption. 

* There are differences in specific saturated fatty acids and their effects on blood cholesterol. Therefore, some foods high in saturated fat do not raise LDL cholesterol. Also, oils have a different array of vitamins (primarily vitamin E) and plant-based compounds that may be beneficial for heart health.

Fatty acids composition of oils taken from the USDA Nutrient Database.