Have we got the science on why we’re getting fatter wrong?

By Lennert Veerman

An article published recently in the BMJ argues that we have been pursuing the wrong hypothesis on the causes of obesity. Along with substandard science, this wrongheadedness has apparently exacerbated the obesity crisis.

Author Gary Taubes asserts that obesity is probably not caused by a positive energy balance (more energy is consumed than spent). A promising rival hypothesis has been forgotten without having been properly investigated.

According to that hypothesis, obesity is a hormonal, regulatory disorder. Energy imbalance is only a consequence of that underlying hormonal factor. The problem is not that we’re eating too much, it’s what we’re eating. And the probable culprit is carbohydrates. But this is yet to be definitively proven.

Enter the Nutrition Science Initiative (NuSI), a US-based not-for-profit organisation co-founded by Taubes that will fund the rigorous experiments needed to “find out, once and for all, what we need to eat to be healthy”.

NuSI will also “re-introduce a culture of rigorous experimental science to the field of nutrition.” A condition for meaningful progress in this field is apparently “a refusal to accept substandard science as sufficient to establish reliable knowledge, let alone for public health guidelines.”

So, out with the research done to date, and away with current guidelines, right?

 

Who speaks and for whom?

Actually, not so fast. Let’s first examine who wants us to forget everything we know and postpone all action on obesity. Taubes is a journalist and author, not a scientist. And his organisation, NuSI, is financed by the “Giving Library”, which “offers philanthropists an innovative way to enhance their strategic charitable giving”. It also gives would-be donors a “forum for anonymous communication”.

The NuSI board of advisors “all share a passion and belief: to date nutrition science has been inadequate in drawing conclusions and making sound recommendations.” The board of directors are people with backgrounds in consultancies, corporate health care and private investment management.

Anonymous donors, claims of a scientific establishment suppressing ideas, claims that the science isn’t settled and no action should be taken, that more research by “independent, sceptical researchers” is needed, the involvement of big corporate actors in a field where research findings can have consequences for a multibillion-dollar industry – where have we seen all that before?

It smacks of denialism. But Taubes states that NuSI doesn’t accept support from the food industry, there are no food industry representatives on any NuSI board and taking aim at carbohydrates probably doesn’t make you friends in large sections of that industry. Perhaps this is just the way you raise funds for research in contemporary America.

But is it true that all the research in the field to date has uncritically accepted energy imbalance as the cause of obesity? And that no-one has yet looked at hormones as a cause of obesity? The short answer is no. While Taubes presents his ideas as revolutionary, they are actually fit quite comfortably in a long tradition of low-carb dieting. And it’s not true that such diets have never been scientifically tested.

To support his argument, Taubes cites a study that compared the Atkins diet to other diets, and found it achieved greater weight loss. That could mean carbohydrates are causing weight gain, but it could also result from the fact that carbs are the biggest part of our diets and restricting their consumption leads to overall reductions in caloric intake.

Whatever the case, it’s customary to do the research first and claim that you have found the cause of obesity (if indeed you have) second, rather than the other way around as Taubes seems to be doing. But again, this may be the way to raise funds for research in America.

 

Missing the bigger picture

Someone reading Taubes’ article might be forgiven for believing that the current thinking about solutions stops at the individual level and is all about diets and exercise. Not once does Taubes mention the “obesogenic environment”, which many obesity researchers consider to be the cause of the obesity epidemic.

Where many researchers focus on our changing living environment, Taubes puts the focus squarely on hormonal factors. But these probably haven’t changed while obesity rates soared. And he asks if we can all please wait for the results of this revolutionary research before taking any action.

That’s not helpful. We have a problem now, and contrary to Taubes’ claims, we do know something about its causes.

If Taubes believes increased consumption of carbohydrates is the cause of the obesity epidemic, he might have pointed to a trial that shows that replacing sugar-containing drinks with non-caloric drinks reduces weight gain and fat accumulation in children. Also, why not support calls for limits on advertising and availability of sugar-sweetened beverages, and for increased taxation to reduce consumption?

Taubes exaggerates the uncertainties in current nutrition science. There’s support for a causal role of carbohydrate-rich diets in the obesity epidemic but, as he notes, such diets also tend to be rich in calories. He is yet to conclusively prove it’s the carbs specifically that are to blame.

So rather than wait years for the results of NuSI-funded research, we should change our food supply to discourage excess sugar intake. A tax on sugar-sweetened beverages would be a good start, as would restrictions on advertising to children.

Lennert Veerman receives funding from NHMRC and ARC.

The Conversation

 

This article was originally published at The Conversation.
Read the original article.

De-Stressing Your Liver

The liver is hugely important in maintaining your health. It performs the vital functions of blood sugar regulation, the breakdown of toxins in the body, the production of bile which emulsifies and absorbs fat in the small intestine, and regulating cholesterol and other hormones important in weight maintenance. If your liver is overwhelmed by toxins (and let’s face it, who doesn’t overload their body even just a little bit at this time of year), or if it lacks essential nutrients, it will not function efficiently. What’s more, if the liver does not produce enough bile, fat may be stored in the liver, instead of processed.

A few weeks of poor eating and not enough exercise can harm the liver, causing liver inflammation and an increase in the amount of fat found in the liver, reducing the liver’s effectiveness.

Tell-tale signs of liver stress

  • Skin problems, rashes, acne, premature ageing
  • Dark circles under your eyes
  • Weight problems such as uncontrolled weight gain and binge eating
  • Fatigue and sleepiness
  • Digestive problems – frequent constipation, chronic heartburn, indigestion, bad breath
  • Irritability, depression, mood swings, poor memory, feelings of helplessness

The list could be used to describe the symptoms of a number of other conditions of course, but if you do suffer from a couple of these, (or even if you don’t) it is worthwhile considering giving the liver a bit of TLC by consciously including foods in your diet which will give your liver a lift, and by maintaining a consistently active lifestyle. You don’t need to go into full detox mode, but if you do want to go the whole hog, don’t jump into a detox programme cold turkey. You need to ease into it, gradually reducing toxins over a period of a week, or else you are likely to have a very severe reaction.

Liver Cleansing Foods

  • Lemon. Start the day with the juice of half a lemon in warm water. This will help with the digestive process before food gets anywhere near your liver.
  • Dandelion. Leaves can be eaten fresh in salads and dandelion root or leaf can be consumed as tea. Dandelion teabags are available in most supermarkets. I add milk, but it’s your preference. Whilst it looks a little like coffee, don’t treat it as a coffee substitute as you may be disappointed. Value it for it’s own sake! Also be aware that dandelion does have a diuretic effect, so make sure you drink plenty of water as well.
  • Filtered Water. Important not only for the liver. In the summer months, particularly if you are exercising, you need plenty of it. There seems to be very little actual evidence supporting the standard 8 glasses, or 2 litres of water a day theory, so how much is enough? You should drink enough water so that you are passing clear (or almost clear) urine.  Be aware that eating beetroot, and over supplementation of B group vitamins can change the colour dramatically!
  • Taurine containing foods such as animal protein and invertebrate seafood (basically anything from the sea which doesn’t have a backbone). Vegetarians and people with multiple allergies and chemical sensitivities should consider supplementing their diet with 200 to 500mg of taurine daily.
  • Globe artichoke
  • Carrots
  • Beetroot
  • Alfalfa
  • Barley Root
  • Raw Vegetables (especially leafy greens)
  • Raw Fruits (but stick to no more than 3 serves of fruit per day due to the high fructose levels in fruit)
  • Oats
  • Olives and olive oil
  • Beans
  • Garlic and onion – which contain phytochemicals that break down fatty deposits in the body
  • Onion
  • Tomatoes
  • Nuts
  • Cayenne
  • Tumeric – very high in beta carotene which helps protect against the damage caused by free radicals. Also helps the liver to metabolise fats
  • Flaxseed and Flaxseed oil (flaxseeds need to be crushed prior to eating otherwise they are likely to pass through the intestine undigested.
  • Psyllium 3-4 gms prior to meals

Foods to Minimise or avoid

  • Fast foods
  • Processed foods
  • Artificial food additives, colours and preservatives
  • Synthetic sweeteners
  • Sugars, especially fructose and high fructose corn syrups such as those found in soft drinks.

Remember, if it comes in a pack, put it back!

Protein Curbs Food Lust

A new study from the University of Sydney has found that including enough protein in our diets, rather than simply cutting calories, is the key to curbing appetites and preventing excessive consumption of fats and carbohydrates. “Aaahh”, I hear you all saying. “High protein diets do work”.

 

That depends really on what you call a high protein diet. The study looked at 10% of calories coming from protein, vs 15% and 25%. The findings DO NOT support those who advocate excessive amounts of protein in the diet. (Some eating plans strive for over 40% of calories coming from protein).

 

The researchers from Sydney Uni have shown that people on a 10 percent protein diet will eat more snacks between meals and consume significantly more calories in total compared with people on a 15 percent protein diet. The results show that dietary protein plays an important role in appetite and total food consumption in humans. “Humans have a particularly strong appetite for protein, and when the proportion of protein in the diet is low this appetite can drive excess energy intake,” said lead author Dr Alison Gosby. The ‘protein-leverage’ hypothesis, proposes that animals have a fixed protein target, which they will defend at the expense of other nutrients.

 

In their new study Dr Alison Gosby and Professor Steve Simpson wanted to test the ‘protein-leverage’ effect in humans. The researchers created three menus that represented low (10 percent), intermediate (15 percent) and high (25 percent) protein, based on data from the World Health Organization recommending people eat 15 percent protein diets. With the exception of protein, the three diets were identical in all other factors such as appearance, palatability, variety and availability. The researchers then took a group of 22 lean people and fed each subject each of the three menus during three separate four-day periods, monitoring energy intake over each four-day period and hunger ratings on day four. They found subjects who ate a 10 percent protein diet consumed 12 percent more energy over four days than those eating a 15 percent protein diet. Moreover, 70 percent of the increased energy intake on the lower protein diet was attributed to snacking.

 

When the protein content was further increased to 25 percent, however, the researchers observed no change in behavior relative to the 15 percent protein diet. On the fourth day of the trial, however, there was a greater increase in the hunger score between 1–2 hours after the 10 per cent protein breakfast versus the 25 percent protein breakfast.

 

Dr Gosby commented: “This result confirms the ‘protein-leverage’ effect in humans and importantly, shows counting calories is not enough to manage appetite and body weight. In the western world, where food is abundant, if you reduce your calorie intake but fail to reach your protein target you will find it hard to resist hunger pangs.”

 

Take a close look at this statement from Dr Gosby. She is not saying you can eat the same amount of calories, but as long as you eat protein you will lose weight, she is saying you need to reduce your calories, and taking in enough protein will help you do that. Weight loss is still about taking in less energy than you expend.

 

Dr Gosby points out  their  “results indicate low protein diets will cause humans to overeat. Tragically in the modern westernised environment there are many factors encouraging us to eat foods that are high in sugars and fat, including reduced cost and increased availability of these foods. Underpinning all this is our ancestral environment in which fat and simple sugars were highly prized, leaving us with a predilection for these foods.”

 

Does this mean that you should load up on protein?

Whilst protein has it’s place in your diet, too much protein can have detrimental effects on your health. Diets in which protein makes up a large amount of your daily caloric intake, so-called ketogenic diets, cause a build up of toxic ketones in your body.  Your kidneys are pushed into overdrive in order to flush the ketones from your body, and you can lose significant amounts of water, putting you at risk of dehydration. This of course is exacerbated if you exercise heavily, particularly in the summer months.

 

As well as fluid loss, high protein diets can cause calcium to be leached from your bones. Ketongenic diets can cause blood acidity. The correct pH balance of your blood is imperative if your blood is to deliver vital nutrients around your body. Your body recognises the pH imbalance in your blood and does something about it. The acidity needs to be counteracted by a buffer to return the blood to it’s correct pH. One such buffer is calcium, which is found in your bones and teeth. Basically, your body considers that your blood needs the calcium (to counteract acidity) more than your bones and teeth do, and you can become calcium deficient and suffer form oesteoporosis if you maintain a hight protein diet for a prolonged period.

Not only that, dehydration from a ketogenic diet can give you bad breath!!

 

What does a 15% protein day look like?

Don’t stress too much about hitting the magic 15% mark. Being too technical can turn you off even trying. You should simply be aiming to have protein at every meal. For meat, chicken and fish, a good rule of thumb is to have a portion about the size of the palm of your hand at meal times. Be sure to trim off all visible fat (except from fish as these are good fats). Skin needs to be trimmed from poultry BEFORE cooking. Try eggs for breakfast rather than sweet (and often salty) cereal. Try nuts and seeds instead of dipping into the biscuit tin. Limit fruit to no more than 2 pieces a day, and ditch the fruit juice for water.

 

If you are eating a sandwich at lunchtime, two slabs of bread and a skinny bit of ham in the middle doesn’t really cut it. Try a tuna sandwich with avocado instead of butter. Add a boiled egg to your lunchbox. A good amount of protein at lunchtime will go a long way to stopping that mid-afternoon forage to the snack dispenser!

 

Add your tips for including more protein in the diet below.

Reference: Protein key to curbing overeating and preventing obesity

By Carla Avolio. Oct 2011

 

Can Stress Make You Fat?

 

Stress. It makes you depressed. It makes you tired. It makes you snap at the people you love. Stress can make you drink the whole bottle of wine when you only meant to have a glass. Stress can also make you fat.

Scientists at the Universityof Liverpoolfound that women exposed to a range of mentally and physically stressful tasks ate 20 per cent more of the free chocolate they were offered, compared to when they didn’t have to do the tasks.  However, the stress-fat connection isn’t just down to those uncontrollable urges to eat a packet of Tim Tams. It appears that the effects of stress can alter the way our bodies deal with food

Research at the Universityof Californiain San Franciscofound that out of 160 women between 30 and 46 years old, those with the biggest waist measurements reported the highest levels of stress. Meanwhile, Dr Pamela Peeke, one of a team of researchers at the National Institutes of Health in America, has discovered that hormones secreted during times of stress are instrumental in causing more fat to be stored, particularly around the abdomen.

It works like this.

  • A hormone called CRH (corticotrophin-releasing hormone) rises in response to stress, triggering amongst other things, a release of cortisol and adrenalin (the ‘stress’ hormones), to help prepare the body for action.
  • Cortisol stimulates the release of glucose to provide fuel for fight or flight while adrenalin primes the nervous system for action.
  • Once the crisis is over, adrenalin disperses, but cortisol — and the glucose it has drawn into the blood — lingers, causing a surge of insulin.
  • This stimulates the appetite to encourage the body to restore its fuel stores, to be ready to cope with the next confrontation.
  • Of course, these days, our confrontations tend not to be with hairy mammals and other things we need to run away from, so we rarely expend any energy in our stressful encounters. We do still end up refuelling however, because we’re hard-wired to do so. This excess body fat is stored ‘viscerally’,  or deep within the abdomen, where it raises our risk of heart disease and diabetes.

So what to do about it? One of the most obvious ways to solve the problem is to reduce or eliminate stress by changing your lifestyle and learning coping strategies. A sensible approach — but frankly, easier said than done. So how about ‘reinstating’ the fight or flight response, by following stressful events and experiences with some physical activity, like we were born to do?

Not only will this dissipate those stress hormones, it will also release beta-endorphins, making you feel calm and contented. And  you will be a super athlete in no time with all that exercise each time you stress out about something! More importantly, regular workouts will enable you to become more stress-resilient in the future. The fitter you are, the lower the rise in cortisol under stressful conditions.

Reference http://www.realbuzz.com/articles/can-stress-make-you-fat/

Waist Measurements

Why measure your waist?

Measuring your waist is a simple check to see how much body fat you have, and where it is placed around the body. The location of body fat can be an important indicator of your risk of developing certain chronic diseases. Whatever your height or build, an increased waistline is a sign you may be at greater risk of ongoing health problems such as type 2 diabetes, heart disease, stroke, high blood pressure and some cancers.

 

How to measure your waistline

  • Measure directly against your skin
  • Breathe out normally
  • The tape should be snug, without compressing the skin
  • Measure your waist half way between the lowest point of your lowest rib and the highest point of your hip bone. If you palpate at the side of your tummy you will feel these bony landmarks.

What does it mean?

No matter what your height, the following waist measurements suggest you could be at an increased risk of developing a chronic disease.

 

Increased Risk
Women: more than 80cm
Men: more than 94 cm

Greatly Increased Risk
Women: more than 88cm
Men: more than 102 cm

 

These waist measurements are recommended for Caucasian men and Caucasian and Asian women. Not enough research has been done on other groups for a definitive measurement to be established.

References: Australian Better Health Initiative. Fact Sheet: How do you measure up?

Sugar Free Food Labelling

sugar

If you’re looking at reducing the amount of sugar in your diet, you need to be aware of what the labelling means. Here’s a quick summary.

In Australia, the Code of Practice on Nutrient Claims in Food (CoPoNC) sets out the provisions for “low”, “free”, and  “no sugar” claims as:

Sugar Free, No Sugar, Zero Sugar

Foods must contain less than 0.2grams of sugars per 100 grams of edible portion of the food Liquids must contain less than 0.1grams for 100 grams of edible portion

The policy of the Australian Competition and Consumer Commission however has a zero tolerance policy in relation to the term “free”. So technically, foods which are labelled “sugar free” and include the small tolerance level of sugar allowed for under the CoPoNC, are in breach of fair trading laws.

No Added Sugar

Foods must not have sugar or sugar containing ingredients added to them. This means that sugars  including dextrose, fructose, sucrose, lactose, starch hydrolysate, glucose syrups, maltodextrin and similar products, icing sugar, invert sugar, fruit sugar syrup, honey, malt, malt extract or maltose products, or products derived at a sugar refinery including brown sugar and molasses is NOT added to the food during processing.

“No added sugar” foods can still contain high amounts of natural sugars. Normally, “no added sugar” foods have a low Glycemic Index, which means they don’t cause a rapid spike in blood sugar.

Low in Sugar

Foods must contain no more than 5g total sugars per 100grams of edible portion. Liquids must contain no more than 2.5grams per 100 grams of edible portion.

Sweet Poison Challenge

sugar

60 Minutes ran a piece last Sunday night about the “controversial new research” surrounding sugar. Basically, it indicated that sugar is the route of all dietary evil and quitting sugar would fix most of your health problems. Have a look at the footage or read the transcript here.

The research the report referred to is that done by Dr Robert Lustig  a Pediatric Endocrinologist. It is hardly “new” however as his lecture “Sugar: The Bitter Truth” was posted on YouTube in July 2009 – nearly three years ago. Not a big deal, I know, but little things like that do tend to get me thinking about what else might be being sensationalised by 60 minutes this time!

The report gives the impression that sugar is bad, and pretty much everything else is okay, as far as healthy eating goes, which is so patently NOT TRUE it makes my blood boil.

Too much of ANYTHING is not good for you. As Jennie Brand-Miller (the glycemic index pioneer) puts it, demonising sugar and concentrating too heavily on its evils gives the message that it’s okay to eat whatever else you like as long as it doesn’t have sugar in it. We run the risk of ignoring the health effects of overdosing on other macronutrients such as fats (especially trans fats) and protein.  She suggests a moderate intake of sugar of up to 10 teaspoons per day is fine. That 10 teaspoons per day includes all sources of dietary sugar – ie the pure white stuff you add to your coffee, as well as the hidden stuff in processed foods, fruit juice etc.

Also interesting was the brain scan which indicated sugar has the same addictive qualities as some drugs, which would kind of explain why we keep eating the stuff when we know it isn’t good for us.

Lustig’s lecture“Sugar: The Bitter Truth”  is well worth listening to, but make sure you have a sugar hit, or at least a cup of coffee handy, as it runs for 90 minutes. It can be found here . He is certainly entertaining, and certainly leaves some of my old uni lecturers for dead, but his use of emotive and headline grabbing language such as referring to sugar as “toxic” and “poison” shouldn’t get in the way of critically evaluating what he says.

David Gillespie is another anti-sugar campaigner.  He  was prompted to sing the praises of a sugar free diet by his own weight loss as a result of cutting sugar out of his diet. See an extensive interview with David Gillespie here   and the Nutrition Australia position statement in response to Gillespie’s book Sweet Poison here.

 

So, what’s the bottom line?

  • Yes, too much sugar is bad for you.
  • Yes, massive intakes of soft drink will cause you to gain weight
  • Yes, fruit juice does contain heaps of sugar and should be regarded as a treat, not an everyday healthy food
  • Yes, fruit should be limited to 2-3 serves per day, depending on your overall energy requirements
  • Yes, sugar can be addictive
  • No, sugar is not the only reason we get fat.

 

The Challenge

Will cutting sugar out of your diet make you feel better? Start cutting down on sugar over the next week or so, and put your hand up below if you’re willing to go sugar free for 4 weeks, starting on Monday 25th June. I am.