Category Archives: Sugar

Non-sequiter nutrition II, a sugar-thought experiment

The average western diet contains about 50 grams of fructose from a variety of sources ranging from beneficial fibrous fruits to the more insidious sugar-sweetened beverages, soda and juice.  50 grams of fructose.   2 1/2 cans of Coca-Cola.

50 grams x 4 kcal/g = 200 kcal

200 kcal / 2,000 kcal = 10%

10% of your calories are provided by fructose

Even the very high end of fructose intake rarely exceeds ~85 grams, which is still < 20%.  My point?   This is nowhere near the 60% used in mouse diet studies.  Disclaimer: I think fructose causes leptin resistance because of data from such studies.  60% fructose is the fructose that causes leptin resistance and increased susceptibility to obesity.  What does this say about “normal” levels of fructose intake?  Toxic doses cause leptin resistance and obesity susceptibility in mice, well, because they’re toxic, and fructose toxicity just so happens to manifest like that (in mice).   60% is toxic.  15 cans of Coca-Cola per day (depending on who’s counting); but is it relevant?

39 grams of sugar, roughly half of which is fructose

In mouse studies, toxic doses are used for practical reasons- it’s cheap.  The animals can be rendered leptin resistant, glucose intolerant, and susceptible to obesity within a few months of feeding this expensive purified synthetic diet.  This probably (probably) takes over 100 times longer in humans simply because it’s nearly impossible for humans to ingest mouse-toxic-levels of fructose.

1. If the dose was based on body weight (like a drug; e.g., mg/kg or mpk):

60% fructose x 12 kcal/d = 7.2 kcal.  Divided by 4 kcal/g = 1.8 grams per day.

1.8 grams for a 40 g mouse = 45 g/kg.  For a 70 kg (154 lb) human = 3,150 grams of fructose or roughly 12,600 kcal.  I.e., 150 cans of soda or about a week’s worth of calories.  In other words, you’d have to eat a hypercaloric fructose-only diet for months.

2. If the dose was based on calories:

60% fructose x 2,000 kcal/d = 300 grams = 15 cans of soda or doughnuts per day.   News flash: that’s gross, but it won’t kill you.

fructose: still not as dangerous as playing in traffic

How about just lowering your lifetime sugar exposure.  39 grams of sugar is worse than 0.01 grams of stevia or sucralose.  Anyone remember “water?”  Even if you believe “a calorie is a calorie,” exclusively, it’s still really hard to burn off 39 grams of sugar.  Try running 2 miles.  Skinny kids might do this automatically after drinking a can of soda or eating a doughnut.  Not most adults.

Don’t play in traffic either.

calories proper

Decepticon Promicor (soluble corn fiber), Op. 81

I heard a comedian say he wished exercise was like high school; once you get your diploma, that’s it.  You never need to do high school again.  Unfortunately, the same isn’t true with artificial nutrition.  the mad food scientists are at it again.

Enter: Soluble corn fiber (SCF), mass produced by Megatron Promitor

Over a decade ago, Atkins released low carb bars.  Well, they weren’t actually low carb per se, they were low sugar.  This was accomplished by replacing sugar with glycerol (a sugar alcohol) and polydextrose (a pseudo-fiber).  While their bars are made from cheap ingredients and low quality protein, sugar alcohols and pseudo-fibers are certainly better than sugar.

Later, sugar alcohols took off in popularity, appearing in Met-Rx Protein Plus, Detour Lean Muscle, Dymatize Elite Gourmet, etc., etc.  Glycerol was prominent in Labrada and Pure Protein bars.  Supreme Protein bars use glycerol and maltitol, and a LOT of ‘em.  Quest took a stand against glycerol and uses the lower calorie and more stomach-friendly erythritol (if it ends in “-ol,” its probably an alcohol).

More recently, the field took a considerable philosophical leap forward and starting using real fiber, good fiber.  Inulin appeared in some Atkins bars, VPX Zero Impact, and the original Quest bars.  Quest has since switched to another good fiber, isomalto-oligosaccharides.  Unfortunately no one is using GOS, yet, but they will … mark my words (that’s a prediction, or stock tip… not a threat).

But now the field has taken a turn and we have another artificial ingredient, a pseudo-fiber, with which to deal.  “Soluble corn fiber (SCF)” first appeared in Splenda Fiber packets and then in Promax LS bars.

If you’re like me, you’re asking yourself: what is this stuff?  Is it real fiber?  Is it like the super fibers inulin and GOS?  Hello Pubmed

Divide and conquer

Stewart (2010) compared SCF to 3 other fibers and maltodextrin, 12 g/d x 2 weeks =

Pullulan, a rather potent fiber, is not well-tolerated.  Resistant starch (an insoluble fiber), soluble fiber dextrin, and SCF were all OK.  The gut microbiota seemed to have no preference, as short chain fatty acid production was similar in all groups (perhaps 12 grams is subthreshold?).  Similarly, health biomarkers, hunger levels, and body weight were unaffected.

Boler (2010) compared a commercially available SCF preparation to polydextrose, 21 grams per day for 21 days in 21 healthy men (cute.)

NFC, no fiber control; PDX, polydextrose; SCF, soluble corn fiber

In this study, however, SCF didn’t do so well.  It caused gas and reflux.  Perhaps this wasn’t observed in Stewart’s study because of the lower dose (12 vs. 21 grams).  Furthermore, polydextrose reduced while SCF increased short chain fatty acid production, both of which resulting in a higher acetate:butyrate ratio.  So unlike 12 grams of any of Stewart’s fibers (including SCF), the gut microbiota seems to respond to 21 grams of SCF.  And they pooped more (both fiber groups).

Data are expressed as log cfu/g feces.

Interestingly, SCF was remarkably bifidogenic.  Much more so than PDX, MOS (see Yen et al., 2011), and inulin (see Menne et al., 2000), but WAY less than GOS (see Silk et al. 2009).

the holy grail

This same group reported a more detailed analysis of the gut microbiota which unfortunately did NOT exactly confirm their earlier finding (Hooda et al., 2012):

Data presentation is different in the two publications, and if both are true, then SCF selectively increases a few specific strains of bifidobacteria but reduces many others (enough to increase the total amount but decrease the variety).  The functional implications of this are unclear (to me).

In the meantime, SCF appears to be at most an OK pseudo-fiber substitute.  Megatron Promitor is not likely to test it against the super fibers (e.g., inulin, GOS, etc.) any time soon, so we won’t know if it’s an advance or simply a side-step.  Such is life.

 

calories proper

 

XL soda ban, Op. 80

People have been warned about the dangers of excess sugar consumption, but compared to the anti-smoking campaign, the recent proposal to ban XL soda’s is like bringing a cup of water to a forest fire.

In an ideal world, a proper health initiative designed to provide people (kids too) with good nutrition information would work. The new proposal takes a different route: it bans the sale of soda’s larger than 16 ounces (but you can still buy 2-12 ouncers).  I see two possible outcomes: 1) someone who would’ve bought one 24 ouncer of soda might settle for 16 ounces; 2) the one in a million customer who wanted 24 ounces will walk away with two 12 ounce sodas instead.  Win-win, right?  In the first case, the toxic sugar burden is lessened by a third.  In the second, a potentially valuable lesson on “serving size” will be on display.   Serving size 2.0, in 3-D, spelling-it-out for all to see.

It might actually work.  From a nutritional perspective, 90 grams of highly bioavailable sugar (HFCS) is a biological disaster.  Pound for pound, there aren’t many worse things you can consume… it’s the anti-thesis of “moderation.”  Regardless of your stance on the calorie debate, no one can argue that 90 grams of sugar all-at-once is more detrimental than it’s caloric content would imply.  Even for skinny people (metabolic obesity?).  It’s worse than dietary fat, and  might be THEE cause of leptin resistance.

This isn’t a TPMC original, but this graph of soda, diabetes, and obesity is just about as compelling as epidemiology can be:

 

douse those sugar cubes with artificial flavors, colors, and preservatives, and we’re good to go

If the ban goes into effect and actually impacts sales, will there be a backlash? more food company lobbying?  increased government subsidies (reduced HFCS consumption -> more taxpayer dollars used to cover the losses)?  Who knows.  If it teaches people a lesson about serving size or empty calories it might be worth it.

calories proper

Gluten vs. gut bacteria, Op. 78

Whether it is being used to treat Celiac disease, autism, or Paleo-deficiency,  a gluten-free diet (GFD) is probably the most inconvenient diet.  There’s no health risk imposed by recreational gluten avoidance; actually, it might even be healthier.

For example, cereal fibre (aka whole grains) provides the majority of gluten in the Western diet.  I have not been shy about my stance on cereal fibre in the past.  In the seminal DART study (Burr et al., 1989 Lancet), people who were instructed to eat more cereal fibre had a higher mortality rate.  There are definitely many nuances and specifics, etc., yada yada yada, but this finding should be your mind’s pantheon for all-things-gluten.

gravitas

One example of how my brain organizes information:   gluten-free diets include GFCF (duh), Paleo, and Atkins.  The low FODMAPs diet is indirectly gluten-free because cereals and grains are excluded.  N.B. these are all healthy diets… I repeat: GFCF, Paleo, Atkins, and low FODMAPs are all healthy diets.  But don’t take my word for it, Miley Cyrus and Kim Kardashian are also gluten-free (so it MUST be true; there’s no hiding from the Glutenista!).  No grain, no pain!

A downside?  One possible side effect of gluten avoidance is potentially detrimental alterations in gut bacteria.  For example, de Palma and colleagues (2009) showed that a strict GFD significantly reduced bifidobacteria (one of the good guys) in healthy adults.  A GFD is the only clinically effective treatment for Celiac disease, but my gut tells me (no pun intended) that the beneficial effects are not due to reduced bifidobacteria… I’m waiting for a study where a GFD is supplemented with bifidobacteria and inulin/GOS to test this.

On the bright side, the anti-bifido effect of gluten avoidance is not universal.  De Cagno and colleagues (2009) showed that children with Celiac disease have less bifidobacteria in their gut and this is reversed by a GFD (phew!).

gluten - hiding in plain sight... everywhere

Crackpot theory of the week:  could inulin/GOS increase gluten tolerance?  He and colleagues (2008) gave lactose-intolerant patients supplemental bifidobacteria in the form of capsules (1.8×10^9  cfu B. longum) and yogurt (3×10^10 cfu B. animalis) which significantly improved their lactose tolerance (it nearly cured them).  In this study, yogurt provided the prebiotics necessary to ensure survival of the supplemental bifidobacteria.  I imagine inulin or GOS
would’ve had a more profound effect.

Celiac disease, lactose-intolerance, IBS, and veganism are all associated with reduced bifidobacteria and could theoretically benefit from inulin/GOS supplementation.  You could try a diet high in onions, garlic, and breast milk, but cost, availability, and potential for halitosis favor the supplemental route  (finally found a source of high quality GOS).   And it sure as hell beats eating shit.

calories proper

Gluten-free food pyramid

taking the fun out of FODMAPs

bring a gun to a knife fight, part II: why “oligosaccharides” are the odd-man out.

The “O” in FODMAPs refers to “oligosaccharides” and includes a very important group of gut-friendly nutrients: prebiotics.  While some specific oligosaccharides are problematic, others are highly beneficial.

The good guys: isomalto-oligosaccharides (MOS), inulin and FOS, and galactooligosaccharides (GOS).  These nutrients stimulate the growth of healthy gut bacteria (bifidobacteria), alleviate gastrointestinal distress, and promote overall well-being.  These are all oligosaccharides, which are unfortunately excluded from the low FODMAPs diet.

support for the above claims:

MOS: Yen et al., (2011)

FOS: Costabile et al., (2012)

GOS: Walton et al., (2012)

Yen showed that at doses of 11 – 22 grams of MOS increased both bifidobacteria and lactobacilli, and improved gut symptoms in a dose-dependent manner.  Similar symptomatic improvements were seen by Chen et al. (2001) with 10 grams MOS per day.  MOS are rarely found in the diet but are present in physiologically relevant doses in Quest Protein Bars.

Inulin is a more complex version of FOS and the form found in the diet (garlic, onions, endive, etc.).  In 1995, Gibson and colleagues showed that both inulin and FOS were roughly equivalent in efficacy: 15 grams of either one increased bifidobacteria and lactobacilli.  Later, Menne et al. (2000) showed that as little as 8 grams of inulin per day increased both bifidobacteria and lactobacilli (moreso than 22 grams of MOS) with a greater effect on the former.  And Kleeson (1997) showed that up to 40 grams was even more effective and was relatively well-tolerated (confirming my suspicion that not all oligosaccharides are created equal…).  Both NOW Foods and Jarrow make high quality inulin/FOS supplements.

Overall, GOS is the most promising.  Depeint and colleagues (2008) showed that 3-7 grams of GOS per day for a week caused a huge and selective increase in bifidobacteria in healthy adults.  Silk (2009) showed even greater benefits in IBS patients.  IBS patients usually exhibit some degree of dysbiosis; indeed, while it isn’t a perfect comparison, Depeint’s healthy subjects had 10 times more bifidobacteria at baseline compared to Silk’s IBS patients.  Unfortunately, however, GOS is yet to go mainstream.  It can be found in Bimuno, which isn’t cost-limiting  until you factor in shipping charges (only sold from the U.K.).  GOS are also present in a variety of infant formulas, which, given their relative scarcity, is a pretty good indicator.

Why is this article sub-titled “bring a gun to a knife fight”?  Because supplementing the bifidobacteria or lactobacilli directly have little impact on the gut microflora.  Even at doses in the billions, almost none of them even survive (see Larsen et al., [2006]; and Tuohy et al., [2006]).  But when combined with some of these oligosaccharides, their effect is markedly improved (Bartosch et al., [2005]).  Probiotics are far more expensive than these prebiotic oligosaccharides, so unless someone had severe GI symptoms, inulin/FOS is the way to go.  On the other hand, if you have IBS, are experiencing gastrointestinal distress, or have recently undergone a course of antibiotics, then a combination of a blend of bifidobacteria combined with inulin/FOS is probably the best treatment.

Be good to your gut.

“Death sits in the bowels; a bad digestion is the root of all evil” – Hippocrates, circa 400 BC

 

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calories proper

 

 

the opposite of food, Op. 76

Processed non-junk food

or

as close to “non-junk” as processed food can be

Notice the inverse relationship between fat content and the number of ingredients in these three commercially available sour cream products.  This is processed food.

Regular:
Cultured pasteurized grade A cream and milk, enzymes.

Low-Fat:
Cultured Milk, Cream, Nonfat Dry Milk, Whey, Modified Corn Starch, Sodium Phosphate, Guar Gum, Carrageenan, Calcium Sulfate, Locust Bean Gum, Gelatin, Vitamin A Palmitate.

Fat Free:
Cultured Low-fat Milk, Modified Corn Starch, Whey Protein Concentrate, Propylene Glycol Monoester, Artificial Color, Gelatin, Sodium Phosphate, Agar Gum, Xanthan Gum, Sodium Citrate, Locust Bean Gum, Vitamin A Palmitate.

 

 

Fat-Free Half & Half

not cream

In general, “Half & Half” refers to a 50:50 blend of whole milk and cream.  People think it’s better than cream because it has less fat.  Whole milk is about 3% fat by weight, while cream is about 30%.  Mix ‘em together and you end up with Half & Half, which is somewhere in between (12-14%).  Fat has a profound effect on flavor and texture… so how exactly does “Fat-Free Half & Half” taste and feel just like regular Half & Half?!?  Muah ha ha ha haaaa!

divide and conquer

From what I can gather, the fat is replaced with corn syrup and pharmaceutical grade thickeners, emulsifiers, etc., scientifically engineered to mimic the precise flavor and texture of Half & Half.  There are even artificial colors added to make it look like cream.  There are artificial colors added to make it look like cream?  AYFKM?  For some reason, I find this oddly offensive.  It is to these artificial colors which I object.  I want this concoction (that is advertised as better than cream) to look like whatever “corn syrup, carrageenan, sodium citrate, dipotassium phosphate, mono and diglycerides, and vitamin A palmitate” looks like.  And it should release a pale green mist upon contact with coffee.

The sugar in Fat-Free Half & Half comes from corn syrup, while that in real dairy is lactose.  Glucose is sweeter than lactose, and there’s 2-3x more sugar in Fat-Free Half & Half.  Does this mean people use less of it?  I doubt it, because the additional sweetness is probably necessary to compensate for the lack of fat.

And what about all the other additives in Fat-Free Half & Half?  This is reminiscent of the introduction of trans fats into our diet by way of replacing butter and lard with margarine and shortening…

Carrageenan is partially responsible for improving the mouthfeel and texture of Fat-Free Half & Half.

carrageenan. Looks scary, right?

At high doses, it’s an inflammatory gut irritant.  Given coffee’s not-so-gut-friendly reputation, do you really want to push it with carrageenan?

On another note, carrageenan is used to design some of the most beautifully artistic desserts.

In this context, I’m reminded of the phrase: “the dose makes the poison.”  In other words, those dishes are a dietary rarity, reserved for the most special of occasions.  At that level of exposure, it could be a blend of carrageenan, trans fat, sucrose, and Red #40, you could eat 5 of them at a time, and you’d never experience any malevolent effects.  But what about a few tablespoons in your coffee every morning for 30 years???  (alternatively, perhaps I’m underestimating carrageenan exposure a bit) (other, more sordid uses of carrageenan)

Avoid processed foods, especially when they’re no more convenient or healthy their conventional counterparts.

 

calories proper

 

P.S.  Perhaps I was a little too hard on Fat-Free Half & Half.  It’s not as bad as microwave popcorn, or this classic:

One 43 gram Twinkie contains 5 grams of fat, 25 grams of sugars, 1 gram of protein, no fibre, 150 kcal, and over 35 ingredients:

  • Enriched Wheat Flour – enriched with ferrous sulphate, B vitamins (niacin, thiamine mononitrate, ribofavin and folic acid).
  • Sugar
  • Corn syrup
  • Water
  • High fructose corn syrup
  • Vegetable shortening – containing one or more of partially hydrogenated soybean, cottonseed or canola oil, and beef fat.  [trans fat]
  • Dextrose
  • Whole eggs
  • Modified corn starch
  • Cellulose gum
  • Whey
  • Leavenings (sodium acid pyrophosphate, baking soda, monocalcium phosphate)
  • Salt
  • Cornstarch
  • Corn flour
  • Corn syrup solids
  • Mono and diglycerides
  • Soy lecithin
  • Polysorbate 60
  • Dextrin
  • Calcium caseinate
  • Sodium stearol lactylate
  • Wheat gluten
  • Calcium sulphate
  • Natural and artificial flavours
  • Caramel colour
  • Sorbic acid (to retain freshness)
  • Colour added (yellow 5, red 40)

 

 

a novel gut health diet paradox, Op. 75

The low FODMAPs diet

FODMAPS  – Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols.  Basically, FODMAPs are a bunch of sugars that are poorly digested in some people and cause a fantastic variety of health problems ranging from bloating and abdominal pain all the way to chronic fatigue and anxiety.  AND a low FODMAPs diet seems to provide some relief (Ong et al., 2010; Staudacher et al., 2011).

Just like it’s weird name, it’s difficult to simplify the rules of the low FODMAPs diet, so here it is graphically:

FODMAPs vs. GFCF

Grains are excluded from GFCF due to gluten and from FODMAPs due to oligosaccharides.  Dairy is excluded from GFCF due to casein and from FODMAPs due to lactose (not sure where FODMAPs stands on fermented dairy like kefir or FAGE).  Thus, both GFCF and FODMAPs exclude grains and dairy.  However, GFCF doesn’t restrict fructose, which is excluded in FODMAPs (monosaccharide).  And last but not least, GFCF but not FODMAPs allows polyols, but as I’ll explain later, I don’t think polyols belong on this list (perhaps “FODMAPs” was just more pleasant-sounding than “FODMAs”).

“polyols”

FODMAPs vs. low carb

A low carb diet is low in both FODMAPs and gluten.  But perhaps similar to polyols, some leniency should also be applied to casein, as standard low carb diets don’t restrict casein but still improve a variety gastrointestinal symptoms (and quality of life in IBS patients; Austin et al., 2009).  Alternatively, a dairy-free low carb diet would cover all your bases.

or you could bring a gun to a knife fight, part I.

Alterations in gut bacteria are frequently associated with gastrointestinal problems, and two classes of nutritional supplements aimed at modifying the gut flora seem to help.  “Probiotics” contain the buggers themselves, while “prebiotics” contain their fuel.

divide and conquer

Bifidobacteria

With regard to the former, “bifidobacteria” seem to be the major player.  Bifidobacteria are the highest in the gut of breast fed babies and lowest in elderly folk.  They are lacking in IBS sufferers (Kerckhoffs et al., 2009; Parkes et al., 2012), and supplementation with bifidobacteria-containing probiotics improve a variety gastrointestinal symptoms (B. infantis 35624 [Whorwell et al., 2006]; B. animalis DN-173 010 [Guyonnet et al., 2007]; B. bifidum MIMBb75 [Guglielmetti et al., 2011])

B. infantis 35624 is found in Align.

B. animalis DN-173 010 is found in Dannon’s Activia yogurt.  But as with most yogurt products, it comes unnecessary added sugars.

Personally, I’d recommend a blend like that found in Jarrow Bifidus Balance (which comes preloaded with its own stock of prebiotics, to be discussed later).

Back to the paradox (or a shameless teaser for next week’s episode): the low FODMAPs, GFCF, and low carb diets all have beneficial effects on gut health but reduce bifidobacteria.  Bifidobacteria supplements and bifidogenic prebiotics are also good for the gut.

a far more enigmatic paradox than the French one, IMO, to be continued…

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calories proper

 

 

Candy in disguise, Op. 73

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

The easy diet diet, Op. 72

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

Taxes, saturated fat, and HDL, Op. 71

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