Tuesday, July 27, 2010

Body for Life: What Went Wrong, Part 3

I didn’t know anything diet or metabolism or how prehistoric humans ate when I first read BFL. But if I’d only read the book with a more critical eye, I might have questioned its assertions.

Little Meals throughout the Day?
For example, Phillips claims it’s better to eat small, frequent meals throughout the day, or "graze." He has some iffy reasons for doing so.

On p. 44 of Body for Life, Phillips states,

It’s revealing to take a look at the animal kingdom and notice the relationship between creatures’ eating patterns and their body “types.” At one end of the spectrum are animals that load up on large amounts of food at one “meal,” then go for days, weeks or even months without eating at all. Bears are a prime example of this type of infrequent feeder....At the other end of the eating-pattern spectrum are the frequent feeders: animals that eat almost constantly but in far lesser amounts. Horses, buffalo, elk--I call these grazers. Relatively speaking, they have very low body fat and lots of lean muscle. It seems pretty clear that we should graze, not binge, don’t you think?

Phillips is confusing association with causation: he’s saying that frequency of eating affects body fat level. But by using the same reasoning, we could say that the binging bears are omnivores and the grazing horses, buffalo and elk are vegetarians, therefore we should be vegetarians to be lean and muscular. In fact, large cats like lions and cheetahs are lean, muscular animals that gorge themselves after kills. Maybe the fact that bears hybernate has something to do with their binge eating and fat storage?

Phillips again recalls the practices of our ancient ancestors:

If you look at how humans evolved, you’ll see our long-lost relatives were ‘frequent feeders’, not bingers.

He doesn’t cite a source for this (or anything else) in BFL. In contrast, Dr. Loren Cordain, who has had a long career studying our stone-age ancestors, says in The Paleo Diet Newsletter,

The most consistent daily eating pattern that is beginning to emerge from the ethnographic literature in hunter-gatherers is that of a large single meal which was consumed in the late afternoon or evening. A midday meal or lunch was rarely or never consumed and a small breakfast (consisting of the remainders of the previous evening meal) was sometimes eaten.*

This makes more sense: prehistoric humans didn’t have a constant supply of snacks, did they? Phillips says himself on p. 45 of BFL,

[Our ancestors] did not have a consistently abundant supply of food. They were hunters/gatherers and, more recently, farmers, who sometimes had plenty to eat but regularly endured periods of time when there was little or nothing to eat.

I don't know whether it's best to eat frequently or not. I just eat when I'm hungry and stop when I'm full (usually). However, I believe the real reason for frequent meals has nothing to do with our cave-man ancestors, and everything to do with blood sugar levels.

As you probably know, falling blood sugar can make you feel hungry. What causes it to fall? Even in normal people, a high-carbohydrate meal makes blood sugar rise and then fall quickly. Check out this graph showing normal blood sugars:


The blue line shows average blood sugar of the group after eating a high-carb breakfast at 7:30--you can see the spike even in normal people. In people with a metabolic problem, blood sugar can "easily exceed 180" on a high-carb breakfast of "healthy whole grain" oatmeal--an "authorized" food on BFL. At that level (the top edge of the graph), your blood sugar has a long way to fall. When it does, you get hungry, even if you're normal and healthy, and it's time to...eat another meal.

Of course, a BFL meal consists of both lean protein and carbohydrate, which could affect blood sugar levels for the better. But if you are hungry every few hours, that suggests to me that the protein isn't having much effect on your blood sugar level.

Does the small size of the meals make it necessary to eat often? If so, why not save yourself some trouble and just eat three normal size meals a day? I think it's because your blood sugar will go up even further with a double serving of carb at one sitting. And notice that the grazers Phillips lists are all carb-eaters.

Before and after photos are great, and I think it's reasonable to be a little suspicious of an unhealthy looking person giving health advice. (Phillips looks very fit and healthy, BTW.) But it's worth knowing how they got to those after photos. Clearly BFL works in some cases--it worked for me for a few years. However, I believe I could have saved myself a lot of workouts, a whole lot of cooking, and some health problems both niggling and significant (which would have been caused by any high-carb diet, not just BFL) if I had examined the program more closely.

*Copied from the Heart Scan Blog, November 23, 2009, http://heartscanblog.blogspot.com/2009/11/paleo-approach-to-meal-frequency.html

Monday, July 26, 2010

Body for Life: What Went Wrong, Part 2

What is a High-Carb and Low-Fat Diet?
So if eating a high-carb diet is bad, how does it follow that the solution to balance protein and carbohydrates? Phillips seems to understand that a high carb, low-fat diet hasn’t been good for Americans since they took heed of the Surgeon General's warning about fats (BFL p. 47):

In place of fat, more and more carbs were added [to foods]. And the myth that “fat free” means “all you can eat” spread like wildfire. But yet, over the past 10 years [since 1988], we’ve continued to see a dramatic rise in the incidence of obesity....I’ve worked with a lot of people over the years who were consuming a low-fat, high-carb diet and exercising, but they were getting even fatter!

Why not just adopt a low-carb or a paleo diet, then? Phillips writes of our ancient ancestors’ health and vigor before the advent of farming and attributes their good health to their diet. But according to what I’ve read about our hunter-gatherer ancestors, they didn’t eat much carbohydrate--they ate mostly meat and plants. (Plants are, of course, carbohydrate, but leafy plants in particular contain a lot of fiber, which is indigestible carbohydrate.) Archaeologist Brian Fagan wrote in his book Cro-Magnon that humans who lived in Europe during the 100,000-year Ice Age ate mostly meat (including fat and organ meat) and that if current hunter-gatherers in Canada are an indication, ate about one cup of plant material per year. Humans ate more plant material before and after the Ice Age, of course, but it seems unlikely that six servings a day of fruit, grains and starchy vegetables probably were on the menu, especially during winter.

Granted, the terms “low-fat” and “high-carb” are relative. Compared to the standard American diet in which people consume 250 to 350 grams of carbohydrate a day* BFL is a lower-carb diet. But compared to a diet like Atkins or Protein Power or a paleo diet, BFL IS a high-carb, low-fat diet.

*Heartburn Cured by Norm Robillard, p. 94.

Sunday, July 25, 2010

Body for Life: What Went Wrong, Part 1

Some readers may know that I was a Body for Life enthusiast for six years. At age 33, I had no workout program, was a little on the fleshy side, and yet I was constantly hungry. A friend showed me a book called Body for Life (BFL) by Bill Phillips, and I was so impressed by the before and after photos that I tried the program. The plan consisted of eating six servings each of carbohydrates and proteins and two servings of green vegetables per day, plus six short but hard workouts per week. (A serving is the size of your fist.) I did, indeed, go down two dress sizes quickly and build muscle while eating more on BFL.

Four years later, I had recovered from a sprained neck and back from a car wreck and resumed BFL in earnest. But it stopped working, and by late 2009, I had put on 20 pounds of fat despite following the diet as well as I had before and being diligent about workouts.

Why did the same program produce different results at different times? This is the question I’ll explore in this post.

Why I think BFL worked, and then stopped working for me
I believe BFL worked for me initially because I was eating sufficient protein and lifting weights. The insulin released due to carb intake was used in building muscle. (Some weightlifters inject insulin to bulk up; I never did nor does BFL even mention the practice.) I believe that BFL stopped working for me because I was no longer building much muscle (I was lifting the maximum that my joints, not my muscles, would take) and because I was releasing more and more insulin, which increases appetite and sends more nutrients to the fat cells.

How metabolism changes
A person’s metabolism can change with time. The perfect example is diabetes II, formerly known as adult onset diabetes. Over time, the pancreas can lose its ability to produce enough insulin to handle excess blood sugar. Carbohydrate intake increases blood sugar, and insulin is released to send it to certain cells instead of leaving it in the bloodstream, where it can cause damage. High carb intake leads to lots of insulin, which can lead to the cells becoming insulin resistant, so the pancreas has to produce more and more insulin. When the pancreas cannot produce enough insulin, blood sugar levels remain too high, a condition called diabetes II. And the “lots of insulin” part causes some people to gain fat, which is why diabetics are often overweight. (People with diabetes I cannot produce insulin at all; therefore, they cannot gain fat without insulin injections.) You cannot get diabetes without certain genes; there are diabetics on both sides of my family.

Phillips himself says much the same thing about metabolism on p. 48:

Insulin is what I call a “nutrient-transport hormone.” It shuttles amino acids and glucose (blood sugar), among other things, into cells. But, when you eat too many carbs over a long period of time, your body becomes “insulin resistant,” and you can develop adult-onset diabetes, which can lead to obesity, heart disease, and a whole lot of other health problems, including unstable energy levels and fatigue. Eating a high-carb diet can also stimulate the appetite and cause unfavorable and unpredictable mood swings (especially in the midafternoon). Moreover, whenever insulin levels are elevated, your body will not burn fat....The solution is to balance carbohydrate and protein intake.

Stimulated appetite, not burning fat, and according to some coworkers, unpredictable mood swings (or "being unhelpful") was exactly what happened to me. So how does it follow that the solution is to balance carbohydrate and protein? I'll address that in my next post.

Sunday, July 18, 2010

My Dog: Fluffy or a Fattie?

Does Molly's fur coat make her look fat?

My dog, Molly, has been to the vet a few times in the past couple of months for an infection and teeth cleaning. The vet recommended that Molly lose some weight and asked how much Molly was eating. "One and a half cups a day of ... dog food and some cabbage," I said. And yes, that's using a measuring cup, I explained, not a slurpee cup. Yes, Molly gets exercise--she runs on the treadmill every day. Nonetheless, the vet suggested giving Molly less food.

Is this a good idea? Let's consider some observations, facts and assumptions.

First, is Molly fat? Someone at the dog park nicknamed her "Marshmallow," and her hips look quite a bit wider than her chest when she sits down. Yet there aren't rolls of fat on her. When I pinch her fat around her middle, it's only 3/8" thick. Her hind quarters are too firm to pinch. Her midriff is thick and her hips are wide--but maybe that just means she isn't built like a greyhound. She also has a long, fluffy double coat, which makes her look bigger than she is.

What about weight? She's put on ten pounds since I adopted her in 2007. Molly was pregnant and stray when she was picked up and taken to the animal shelter. The first time I saw her, she had a thin, poor, oily coat, and she was docile and full of woeful charm. In other words, she looked like a stray dog at 45 pounds.

At 55 pounds, she's happy, playful, and energetic. (To be fair, improved diet, exercise and a loving home surely made some of the difference here.) Every day when I come home, she demands some affection for a few minutes and then jumps on the treadmill. I crank it up to 10 miles an hour for a few minutes while she barks at birds and squirrels outside the window. Molly can also run up steep hills like a mountain goat, keep up with any dog at the park, and she'll take on all comers--even pit bulls--if she's attacked. She can run under a bench and out the other side at a full gallop. So even if Molly is fat, she's fit and and athletic.

But so far, it doesn't look to me like Molly is fat. Nevertheless, I tried something that Dr. Williams Davis blogged about recently: checking blood sugar levels to avoid eating things that spike your blood sugar, which will put on weight. Molly's fasting blood sugar yesterday was 49--yes, forty-nine. It seemed low, so I checked my own blood sugar: it was 79. An hour after dinner, her blood sugar was 33. So Molly's dog food (Taste of the Wild, bison flavor) can't make her fat--just full. Two hours after her dinner, my mother's meter showed Molly's blood sugar was back to 49. (I used my own meter for Molly's first two tests.) Despite the low BG readings, Molly doesn't have any signs of hypoglycemia. I think those "normal" BG readings of 75 to 120 for dogs are due to a diet of typical corn-based (read: high-carb, high sugar) dog foods.

Another fact: Molly had a mild heart murmur when I first adopted her. A scan showed two congenital heart defects. Yet the murmur disappeared a few years ago. If a dog with a defective heart is overweight, does she run up mountainsides, chase dogs at the park, and jump on the treadmill at will?

Molly doesn't need to go on a diet: she's not fat, and typical calorie-restricted diets don't work anyway. She's a bit like Joe Nameth: she's fit, she's stocky, and she wears a thick fur coat.

Tuesday, July 13, 2010

Ripping Away the Veil, or Think and Grow Thin

Have you ever had the wrong idea about something, then saw the truth and wondered how you could have been so blind? Most of the common sense people have about weight gain is an illusion.

My mother has been overweight most of her life. She's been sedentary since middle age (she started getting arthritis around age 40), but pictures of her in her 20s and 30s from before my time show her on horseback when she and my father went hunting together. She also took care of my brothers and sisters with few modern conveniences. In other words, she was overweight but pretty active.

My parents and I always ate dinner together, almost always steak or chicken, potatoes, gravy, bread, corn and green beans. My mom never seemed to overeat. She wasn't a drinker, either.

I was an average thin kid (I didn't like my mom's cooking) and a little on the fleshy side as an adult until age 34 when I started Body for Life. After three years on this program, which includes lots of protein, carbs and hard workouts, I started gaining back the weight I'd lost. At age 41, I weighed 140 pounds--over 20 pounds more than I weighed at age 18.

What made me think that gaining weight was caused simply by overeating and lack of exercise? I had forty-one years' observations to the contrary. My mom was active (in her younger days, at least) and a moderate eater. I was eating a low-fat diet, doing a lot of workouts and gaining weight and didn't know why. It was only when I started thinking about how and when my weight gain started and I began to read other points of view and put them to the test that I began to tear away the veil.

But sometimes even seeing isn't believing. When I visited my best friend in May, I had dropped 20 pounds since the last time she saw me, and I told her how I did it: a very low-carb diet. Yet she still had a hard time believing I was eating a fatty diet and losing weight--even though she cooked the bacon herself.

This is my challenge to you: set aside common knowledge for a moment and consider what you've seen with your own eyes or felt in your own body. If it doesn't square with what you've been told, then what you've been told needs to be modified. Confusing and uncomfortable? Yes, but it's the first step to getting to the truth.

If you're confused about what causes weight gain (and how to lose weight), others have made progress on this front. Recently, others have written some terrific blog entries on this subject. Read them, and see if they make sense to you.

However, I’ve seen a lot of people who have found that aerobic exercise is not the weight loss holy grail it’s often claimed to be. These individuals generally do well to know that when they fail to get the results they’re seeking, they are not the problem – the approach is.

I like watching the reactions of people who see me for the first time since last winter. That is, if they even recognize me.
Read the rest of Sami's mini-autobiography, with before and after pictures, here: The How and Why of Weight Loss by Sami Paju

In this first part I'll focus more on the conventional wisdom and its shortcomings in explaining why people become overweight.

One thing missing from the conventional hypothesis (Change in weight = Calories IN - Calories OUT) is the arrow of causality. Even if we'd believe this formula to be correct, it doesn't tell us anything about what causes people to eat too much and expend too little of their energy.

Now it’s time to put it all together and discuss what you can do to lose weight, gain better body composition, better health, and feel more energetic.

In a nutshell, this is what the [government] committee concluded:

  • We’re fat because we consume too many calories and don’t move around enough, period, end of story, so would everyone please shut up about macronutrient balances and just go on a low-calorie diet for Pete’s sake, and then maybe go jogging.
  • We consume too many calories because we eat too much fat … uh, and sugar too.
  • We eat too much fat (uh, and sugar too) because there are too many fast-food establishments and not enough grocery stores and produce markets.
Read the rest of this funny take on USDA dietary guidelines here: 2010 Dietary Guidelines: Fat Made us Fat by Tom "Fat Head" Naughton

Keeping blood sugar to 100 mg/dl or less after eating teaches you how to avoid provocation of insulin. A shrinking tummy will follow.

Read the rest of this unusual weight-loss approach here: To Lose Weight, Prick your Finger by Dr. William Davis

Thursday, July 8, 2010

Exercise without Joint Pain

I've never understood why runners keep running until they wear out their knees. Or why dancers will dance until they have blisters on their feet.

Maybe it's good that I get too tired to run that far or dance that long. In spite of this blessing in disguise, I started getting knee pain from weightlifting. Since I didn't get knee pain during weightlifting sessions, it took me awhile to figure out what was causing it. Once I realized it was squats, I stopped doing them and felt better. However, my weightlifting routines became limited to what my joints, not my muscles, would bear, particularly for my lower body.

On the recommendation of a few bloggers I read (Dr. Michael Eades and Tom Naughton--see blog roll), I tried Slow Burn by Fred Hahn and Drs. Michael and Mary Dan Eades. The Drs. Eades explain in the beginning of the book why strength training is good for you (improved metabolism, stronger bones, more flexibility, less back pain and better athletic performance, among other things). From my own experience, I know that it improves athletic performance: once I started weightlifting several years ago, I was able to dance the way I wanted to, and an isometric neck exercise really helped my neck pain. However, I didn't see any difference in flexibility, and I still had occasional shoulder pain. As for stronger bones, as a small, white, thin-boned female, I hope they're right.

The workout itself involves slow, grueling movements with heavy weights or the weight of your own body. Think pushups that last 20 seconds each--and no propping yourself up on your arms. The sets are brief, though: just 90 seconds, it only feels longer. The goal is muscle failure: to do the exercise until you can no longer move the weight. As smart weightlifters say, muscle building happens fast or not at all. It's only been in the past few workouts that I've discovered the correct weights for this--and started feeling like I worked out.

So far, this has worked well for my upper body, but I'd probably have to go to a gym to use machines and larger weights to get the most benefit for my lower body. For example, the squats described in the book are difficult, but even going all the way down, I don't have muscle failure. (I do lindy, and I don't know of anything better to strengthen your quadriceps.) I don't even bother with the heel raises, since I could do them all day. The recommended crunches don't work for me (I'm short-waisted) so I do Navy Seal flutter kicks with my head off the floor instead. If a 118-pound woman can't get lower-body muscle failure with home equipment, I imagine that big, strong women and most men would have to use a gym to make this work.

The Slow Burn system requires a few pieces of equipment: a yoga mat, a towel, weights, a metronome and a timer. I downloaded a free timer from cnet.com and found a free online metronome at metronomeonline.com.

Did I mention this is a quick workout? It really does last only about 30 minutes per week. (Originally, I wrote that this is a once-a-week workout, but Fred Hahn has informed me that it's better to do it twice a week, or once a week if you are a very athletic person. See comments.)

Saturday, July 3, 2010

My Mom's Heel has Healed

Time may heal all wounds, but zinc may help them faster.

Three years ago, my diabetic mother developed a sore on her heel. According to my father, who has been dressing the wound during those years, it was the size of a silver dollar (1.5" diameter) and all the way to the bone--about 3/4." Their doctors refused to treat it and sent them to the hospital instead. Over the years, doctors, nurses, aides and my father have been dressing it, treating it with medicinal honey, and cutting away crusty skin around it in a painful, weekly doctor's office procedure. In three years, the size of the wound went down to the size of a quarter (1") and 1/16" deep. It still required the aforementioned care.

Having had such good results with zinc healing my nose from septoplasy (I'd had nosebleeds for ten years after the surgery), I gave my mom a bottle of 100mg zinc tablets two weeks ago. She's been taking one every day. The results, according to my parents:

The wound is now the size of a nickel (.83" inches) and superficial with a hard coating on it. There's no dead skin to be trimmed. In other words, it's practically healed.

The wound healed quite a bit over the three years, though. Did the zinc tablets speed up the healing? I plotted wound volume over time. Of course, this is an approximation without exact measurements, relying on my father's memory, and with only a few data points over a long time. Nevertheless, I did it. Initial volume was about 1.35 cubic inches (my father said the wound had a slight taper on the inside, but was approximately cylinder shaped; volume two weeks ago was .05 cubic inches; and final volume was zero (with no depth, there's no volume).

Again, given the lack of data, this is iffy, but the sharp downward turn at the end of the graph indicating faster healing is encouraging.

I'd like to thank the people at Gnome, the free software desktop project. Without their Gnumeric spreadsheet software, I wouldn't have been able to create and post the graph at the top. What was Microsoft thinking when it developed Excel 2007, the Mickey Mouse version?

ETA: Last night when I visited my parents, I noticed that a three-year-old sore on my mom's ear was almost healed. (She fell asleep with a small speaker on her ear and it burned her.) I've seen this sore over the course of three years, and it didn't heal even a little bit. It's now nearly gone.

ETA, 9/10/10: My mom still has a nurse come by to tend her heel wound. (Without the nurse, she cannot have someone give her a shower, which she can't do by herself.) She told me last night that she'd stopped taking the zinc because one doctor or another told her to. "Why?" I asked. "Well, I don't know." As Michael Eades is fond of saying, Jesus wept.

Thursday, July 1, 2010

Getting Rid of Acne after 30 Years

I've had acne for almost 30 years. It started with a few pimples when I was 12 and escalated into cysts when I was 20. A coworker actually said to me, "God, what happened to your face?" "Oh," I wish I'd replied, "I bet you say that to all the girls." What's the French word for repartee you think of as you're walking out of the party, down the steps?

My sister had acne too. She was good-looking until she'd been on meth for about a year, and afterwards lived on coffee, Pepsi and burritos. She blamed her acne on--wait for it--green beans and washcloths.

I should have taken a clue from her diet. My poison isn't Pepsi, but Coke. When I stopped drinking Coke in 2007 to help my stomach, my skin cleared up. It was less dry and flaky, too. So except for falling off the wagon and going through caffeine withdrawal again in 2007, all has been well.

Then I started drinking Coke Zero a few weeks ago. "Since it doesn't have sugar," I thought, "it'll be fine." A crop of pimples proved me wrong. So, goodbye Coke--again. It's back to water, diet rootbeer, diet Dr. Pepper and tea--they don't seem to affect my skin.

My socially inept coworker aside, I've usually gotten compliments on my skin, since I've constantly been doing something to keep the acne in check. In a nutshell, here's my skin care program. It might not work for you, but I don't think there's anything in it that would be harmful for most people.

  • 100mg zinc per day
  • Burt's Bees Orange Essence Facial Cleaner
  • Queen Helene Mint Julep Mask applied at night to pimples
  • Neutrogena Anti-Wrinkle Anti-Blemish cream for rare breakouts
  • No Coke
  • No wheat
  • Low-carb, high-fat diet
I also have some good genes. My mom has wonderful skin and looks quite a bit younger than she is. We both have a lot of fat on our faces, too, which makes us look younger.

Here's a rundown of everything I've tried and the results I got:

Prescription and OTC acne medicines:
Benzoyl peroxide: no effect.
Cleocin T: mildly effective.
Antibiotics: effective.
Retin-A: very effective. Really dried out my skin, though.
Accutane: effective while I took it, but made my pores large.
Salicylic acid: effective.

Skin care products:
Queen Helene Mint Julep Mask: dries and shrinks existing pimples.
GNC Hair, Skin & Nail Vitamins: helps prevent acne.
Special soaps for acne: no effect.
Cold cream: too heavy for my skin, especially in summer.

Dietary measures:
Green beans: well, whatever you have to tell yourself.
Wheat: reducing wheat really helped my skin when I first took this measure in the late 90s. It wasn't 100% effective, but helpful enough that I kept it up through the years.
Low-carb, high-fat diet: this has been great for my skin, but doesn't prevent all breakouts.
Coke: Coke was it.