Monthly Archives: April 2012

Candy in disguise, Op. 73

Posted on April 30, 2012 | 8 comments

on the chopping block:To recharge between hunting, gathering, and avoiding predation, our Paleolithic predecessors snacked on gluten-free energy bars comprised of a variety of fruits nuts, and vegetable oils all stuck together with Mother Nature’s sweet sticky honey and dates.  <end sarcasm>

For the record, I’m not a card-carrying member of the Paleo community; just looking out for a respectable nutrition movement.

“NoGii No Gluten Paleo Bars” should not be confused with anything healthy.

INGREDIENTS: Dates, Honey, Organic Cashews, Almonds, Apple Juice Sweetened Cranberries (Cranberries, Apple Juice Concentrate, Sunflower Oil), Sesame Seeds, Dried Unsweetened Tart Cherries, Sunflower Seeds, Unsulphured Dried Apples, Freeze-dried Strawberries, Strawberry Juice Concentrate, Organic Sunflower Oil. ALLERGENS: Contains Tree Nuts (Almonds and Cashews).

Full disclosure:

Case closed.

On a more positive note, NoGii No Gluten Paleo Bars have no added sugars.  Indeed, those were saved for their “NoGii Kids Bar.” 

INGREDIENTS: Soy Protein Crisps (Soy Protein Isolate, Tapioca Starch), Marshmallow Creme (Sugar, Brown Rice Syrup, Crystalline Fructose, Invert Sugar, Water, Egg Albumen, Agar, Gum Arabic, Natural Flavor), Brown Rice Syrup, Organic Brown Rice Crisps (Organic Brown Rice, Organic Brown Rice Syrup, Sea Salt), Rice Syrup Solids, Maize Dextrin (Dietary Fiber), Organic Canola Oil, Organic Agave Syrup, Whey Protein Isolate, Organic Palm Oil, Vanilla Yogurt Drizzle (Sugar, Fractionated Palm Kernel Oil, Whey Powder, Nonfat Dry Milk Powder, Cultured Whey, Soy Lecithin [emulsifier], Vanilla), Vegetable Glycerine, Natural Flavors, Sea Salt, Soy Lecithin, Mixed Tocopherols (Natural Vitamin E), Purified Stevia Extract, Lo Han Extract.

NoGii proudly advertises “NO HIGH FRUCTOSE CORN SYRUP” and “ALL NATURAL,” but this is despicable, ESPECIALLY because these are targeted at children.

Divide and conquer

  1. Agave syrup has MORE fructose than high fructose corn syrup (it’s like higher fructose corn syrup).  Why brag about “no high fructose corn syrup” if you’re only going to include a higher fructose substitute?
  2. Crystalline fructose.  (yes, that would be 100% fructose).
  3. Invert sugar is chemically virtually identical to high fructose corn syrup.  This is deceitful… it wouldn’t be so bad if they didn’t advertise (in all capital letters) “NO HIGH FRUCTOSE CORN SYRUP” directly on the website.
  4. Lastly, there’s nothing “Brown Rice” about “Brown Rice Syrup.”  It’s just plain syrup.  It may not have fructose, but it’s still just a blend of simple sugars.

NoGii is pulling no punches, so neither am I: they are trying to trick parents into feeding their kids something that they may not have had they known what was really in it.

NoGii.  Worst company of the week.  No, of the month, because they are targeting children.

A superior alternative:

Quest Low Carb Gluten Free Protein Bars

calories proper

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Posted in Advanced nutrition, empty calories, Fructose, Grains, Protein, Sugar, Uncategorized

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The easy diet diet, Op. 72

Posted on April 26, 2012 | 4 comments

Regular followers of this blog (all 3 of you) know I think positively about carbohydrate-restricted diets.  In randomized controlled intervention studies, low-carb diets are a little better most of the time compared to low calorie and low fat diets (note the italics).  They are healthier and there is probably no end to the benefits of chronically lower insulin levels.  The only relevant disadvantage is that [I thought] such a diet requires too big of a change for most peoples lifestyle…  however, this might not be the case.  In light of some recent [relatively unscientific] findings, that change might not be so big after all.

In one study, Feinman and colleagues (Feinman et al., 2006 Nutrition Journal) surveyed a group of low carb dieters from the “Active Low-Carber Forum” about their diets.  There was no formal subject recruitment or randomization; it was just a bunch of people who were following various low carb diets.  The only requirement was that they were actually following a low carb diet for weight loss.  For starters, there were a LOT of people who lost a LOT of weight: 62% of ~86,000 participants lost at least 30 pounds and kept it off for over a year (I know I know, it’s possible that people who lose a lot of weight are selectively more likely to participate on this particular forum [this study is confounded out the wazoo but still had a few pearls]).

What I found most interesting was what these people said were their biggest dietary changes.  The top 2 were, not surprisingly, avoiding sugar and starch.  Number 3 was drinking more water.  So to sum up the top 3 changes: basic healthy dieting 101; not drastic lifestyle alterations.

Number 4 was the biggie: most people increased their green vegetable intake by over half… not bacon, hot dogs, and red meat… leafy greens.  This is great (just think of all those micronutrients).  They weren’t counting calories or replacing everything in their refrigerator; they were avoiding sugar and eating more leafy greens.

leafy greens: winner

sounds easy, right?  Of course eating more protein and fat also occurred, but it wasn’t a universal requirement: only 5% reported increasing beef, butter, and bacon… instead, people just ate a little more of whatever was most convenient for their lifestyle.

This study changed my view.  These people lost over 30 pounds on low carb and kept it off for over a year without making any huge changes.

Another more recent study (Kirk et al., 2012 Journal of Pediatrics) was a diet intervention study in obese children.  They compared a low carb diet (LC), low glycemic index diet (RGL), and a portion controlled diet (PC).

It’s hard to put kids on a low carb diet.  Indeed, adherence to the low carb diet was horrific, less than 30% at 3 months and down to 20% at 6 months (figure below on the right).  But comparing this to the figure on the left is astonishing.  Despite adherence of only around 25%, low carb dieters had the biggest reduction in body fat.  It’s not until adherence was nil that the kids starting gaining weight back.

weight loss vs. adherence

What does this say about low carb?  it’s the easiest diet in the world, even if you can barely follow it!  25% adherence to a low carb diet resulted in greater fat loss than 80% adherence to the other diets.

You might just be better off half-assing a low carb diet than strictly adhering to any another one-

calories proper

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Posted in Advanced nutrition, Dietary fat, Energy balance, Protein, Sugar

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Taxes, saturated fat, and HDL, Op. 71

Posted on April 21, 2012 | 4 comments

Since red meat won’t kill you (it will make you stronger), why is taxing saturated fat still up for discussion?  The Danish proposal will add a $1.32 per pound to foods with >2.3% saturated fat; the cost of butter will increase by 30% more and olive oil by 7.1%.  I know, right?  WTF?

Again, I don’t think taxation is the solution, but for the sake of comparison: Arizona’s proposed “fat fee” would cost an extra $50 annually for childless obese patients; Rhode Island’s $0.01/oz of soda; or France’s 3.5% tax on all sugar-sweetened beverages.

Nutritionally speaking, saturated fat should be off the political chopping block; any intervention designed to reduce its consumption will do more harm than good.  In brief, here’s one example of what might happen if it worked, i.e., if dietary saturated fat consumption was reduced:

The effect of replacing dietary saturated fat with polyunsaturated or monounsaturated fat on plasma lipids in free-living young adults (Hodson et al., 2001 EJCN)

Subjects were given a high saturated fat diet and then switched to either a high polyunsaturated fat diet (trial I) or high monounsaturated fat diet (trial II).  In both cases, as seen in the table below, HDL decreased.

 




 

Alternatively, here’s what might happen if dietary saturated fat consumption was increased (in brief):

Separate effects of reduced carbohydrate intake and weight loss on atherogenic dyslipidemia (Krauss et al., 2006 AJCN)

The bottom two groups in the chart above ate similar diets except monounsaturated fats were replaced by saturated fats in the last group.

As seen in the table below, saturated fat significantly increased HDL.

 

 

So did weight loss, but I’d choose a steak over a stairmaster any day…  (daydream thought bubble: “indeed, ‘adherence’ and ‘compliance’ would be things of the past”)

 

If you believe HDL is important, taxing saturated fat might be a bad idea.  unless you have stock in statins.

 

calories proper

 

 

 

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Posted in Advanced nutrition, Dietary fat, Energy balance, Exercise, Sugar, Uncategorized

Non-sequiter nutrition

Posted on April 16, 2012 | 3 comments

(or another over-caffeinated soapbox rant)

Taxing junk food?  If I thought the government had a clue what constituted “junk,” maybe I’d view this more favorably.  But my gut says no.

 

 

“Bad food? Tax it, and Subsidize Vegetables”  Mr. Bittman, we subsidize the hell out of corn; what good has that done?   I don’t think controlling diet via junk food taxes is the right way to healthify America, but if I had to choose I’d say shift subsidies away from corn and soybean, and toward things like organic spinach and grass fed beef.   This would impact a lot of foods containing ingredients that are [IMO] barely suitable for human consumption like high fructose corn syrup and trans fats (and corn & soybean oils).

 

 

Denmark and Romania taxing saturated fat?  Really?  we already went through this when we traded saturated fat-rich butter for diabesogenic trans fat-rich margarine-  (“saturated fat”).  A tax on saturated fat is non-specific; it hits many healthy foods and not enough junk food.  And it is, by definition, a tax NOT on the deceptively unsaturated trans fats.  Alternatively, subsidizing corn and soybeans is just making soda and junk food cheaper.

 

 

do NOT eat at KFC in Hungary, Peru, or Poland.  or anywhere.  that’s microwave popcorn levels of trans fat.

Better nutrition education and evidence-based recommendations are far better solutions, IMHO, but we aren’t a country of philosopher’s.  I’ve touched a bench on which the sign “wet paint” was taped, and I probably also touched a red hot stove despite my mother’s warning against it.  oh well.

 

 

calories proper

 

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Posted in Advanced nutrition, Dietary fat, empty calories, Fructose, Sugar, Trans fat

Paleo schmaleo, Op. 69

Posted on April 12, 2012 | 2 comments

Brief refresher:

Paleo: lean meat, fish, fruits, vegetables, potatoes, eggs, and nuts; NO grains or dairy

Paleo carbs: fruits, veggies, nuts, and beans… NO starches, cereals, whole grains, added sugars, etc.

Paleo is GFCF-friendly

Atkins is similar to Paleo but allows fewer carbs

Mediterranean diet (from last week): whole grains, low-fat dairy, vegetables, fruits, fish, oils, and margarines (the Paleo diet improved insulin sensitivity WAY more than the Mediterranean diet in patients with CHD).

Diabetic diet (this week; see below): vegetables, root vegetables, dietary fibre, whole-grain bread and other whole-grain cereal products, fruits and berries, and decreased intake of total fat with more unsaturated fat.

Paleo vs. the “diabetic diet” in type II diabetics (Jonsson et al., 2009 Cardiovascular Diabetology).  Lindeberg designed this particular Paleo diet with a much lower carb content (32% vs. 40%) than in the previous study with CHD patients.  A cynic, who might think that some of Paleo’s benefits are due to its low carb content, might think that since traditional Paleo and the comparison “diabetic diet” have a similar carb content (42% and 40%, respectively), Lindeberg intentionally modified Paleo for this study to make sure carbs were significantly lower than in the “diabetic diet” (stacking the deck in Paleo’s favor, according to the cynic).  I can’t find any reason to disagree with the cynic, but it didn’t work out so well for Lindeberg et al.

As detailed in a series of posts about crossover studies (part I and part II), this one was botched due to: 1) what appears to be improper randomization (baseline glucose values were 7.1 and 8.6 mM); and 2) a washout period that was too short to allow one of the primary endpoint variables (HbA1C) to return to baseline.  As such, data presentation was convoluted, which said cynic might think was intentional.  But if we take it at face value, Paleo still fails.  For example, according to this figure (which is NOT crossover data), although Paleo has a lower final HbA1C, the HbA1C reduction is much greater on the diabetic diet.Paleo: 0

Diabetic diet: 1

AND weight loss was similar despite Paleo dieters consuming significantly less food (1581 vs. 1878 kcal/d):So yes, in accord with the Jonsson study (above), Paleo may have been more satiating (i.e., spontaneously lower food intake), but no, this didn’t translate to greater weight loss.  Someone needs to measure energy expenditure in Paleo dieters because it looks like this pattern of food intake either lowers basal metabolic rate or simply makes people tired (though this conclusion would be vehemently denied by Paleo loyalists).  The reduced leptin levels (Jonsson study) may have caused lower energy expenditure, but this would not entirely align with my lower-leptin-equals-higher-leptin-sensitivity hypothesis and thus cannot POSSIBLY be true :/   Alternatively, perhaps the Paleo diet really does lower energy expenditure; this would’ve been irrelevant and possibly even beneficial in Paleolithic times because: 1) they would’ve conserved more energy for “hunting” (hunter-gathers) or fleeing; and 2) weight loss was much less a concern compared to starving or being predated.

The Paleo diet is interesting in that it eludes low-carb status by selectively excluding grains, and I’m pleased that high quality studies (randomized crossover) are at least being attempted, but data thus far suggest we haven’t found anything magical about Paleo (yet)… just need better studies, especially those controlling for total carb content.

Paleo:

+1 for excluding grains, but not much else

 

calories proper

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Posted in Advanced nutrition, Dietary fat, empty calories, Energy balance, Grains, Leptin, Uncategorized

Paleo vs. carbs (per se), Op. 68

Posted on April 6, 2012 | Leave a comment

The Paleo diet:

A)     the next big thing

B)      Atkins-lite

C)      Fail

D)     None of the above

While proponents of the Paleo diet take a page out of nutritionism‘s book and argue it’s about food choices, not macronutrients, my reductionism mandates inclusion of a comparative breakdown by protein, fat, and carbs.  In a recent publication, Lindeberg (a Paleo pioneer) compared Paleo to the Mediterranean diet in a cohort of CHD patients (Lindeberg et al., 2007 Diabetologia).  To make a long story short, Paleo came out on top in a variety of endpoint measures after 12 weeks.

Divide and conquer

The Paleo diet consisted of lean meat, fish, fruits, vegetables, potatoes, eggs, and nuts; grains and dairy were off-limits (Paleo is GFCF-friendly).  Paleo carbs include fruits, veggies, nuts, and beans… no starches, cereals, whole grains, added sugars, etc… FYI Atkins is very similar to Paleo but includes a lower absolute amount of Paleo carbs.  The Mediterranean dieters ate whole grains, low-fat dairy, vegetables, fruits, fish, oils, and margarines.  Both diets exclude processed junk food and both are relatively healthy diets.  

As such, both groups lost weight; slightly more on Paleo but this was probably due to reduced caloric intake (not uncommon for Paleo dieters; see below and also Osterdahl et al., 2008 EJCN):But the benefits of Paleo were much more robust WRT insulin sensitivity, which was markedly improved on Paleo but not Mediterranean.

Paleo: 1

Mediterranean: 0

With a 4% weight loss, why didn’t glucose tolerance improve in the Mediterranean dieters?  … weight loss is almost always accompanied by improved glycemic control…   The biggest difference in “foods” consumed by the two groups was cereals: 18 grams per day on Paleo vs. 268 on the Mediterranean diet… over 14 times more!  As I’ve discussed at length with gravitas, a high intake of cereals (aka grains aka fibre [in the figure below]) does not bode well for insulin sensitivity, inflammation, and outright all-cause mortality:

As such, Paleo does well to exclude grains.  Furthermore, Paleo is higher in protein and fat and lower in carbs- all good things.  A more interesting analysis showed that waist circumference (visceral fat) was associated with grain intake even when controlled for carbohydrates.  In other words, the detrimental impact of whole grains goes beyond their intrinsic carbohydrate content. (whole grains … insulin resistance … visceral fat)

Back to those calorie data for a moment, given that they were probably just as important as cereal exclusion in determining the results.  Why did Paleo dieters spontaneously eat so much less?  In a follow-up publication, Jonsson and colleagues assessed leptin and satiety in both groups (2010 Nutrition & Metabolism) and showed that despite eating less and losing more weight (things that should increase hunger and decrease satiety), Paleo actually did the opposite (hint: something to do with whole grains, perhaps?).

While the Paleo meals were smaller (5th and 6th rows) and contained fewer calories (3rd and 4th rows), they were just as satiating as Mediterranean diet meals (7th through 9th rows), leading the authors to conclude Paleo is more satiating calorie-for-calorie and pound-for-pound.  And if that isn’t enough, Paleo dieters also experienced a significantly greater reduction in leptin! (probably caused by their reduced food intake and body weight loss)  While the general consensus is that such a change in leptin should enhance hunger, as discussed previously I think lower leptin in this context reflects enhanced leptin sensitivity, which also helps to explain the improved insulin sensitivity.  Last but not least, WRT the Mediterranean diet I suspect reduced calories explains the weight loss, but the abundance of whole grains explains the blunted glycemic improvements.  (hint: whole grains … leptin resistance … insulin resistance) … (whole grain exclusion … leptin sensitivity … insulin sensitivity)

Paleo, the next big thing?  I’m holding out for a one-on-one with low-carb proper to exclude the role of Paleo’s lower carb content.  The whole grains issue requires no further confirmation IMO (e.g., Burr et al., 1989 Lancet, Jenkins et al., 2008 JAMA, etc.).

The Paleo diet:

A)     the next big thing

B)      Atkins-lite

C)      Fail

D)     None of the above

might be considered “Atkins-lite,” probably not “the next big thing,” definitely not “fail.”

+1 for excluding grains

 

calories proper

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