At Risk at Any Weight

Today we have a special guest blog entry...

By James LaValle, RPh, ND, CCN

Just because you are not obese, doesn't mean you're off the hook when it comes to increased risk for heart disease and diabetes -- known as cardiometabolic disease. If you're just a little pudgy around the middle, you may pat your belly and chuckle about those few extra beers you had last night, but it is no laughing matter.

Two studies recently looked at the cardiometabolic health of three categories of white adults: normal weight, overweight, and obese. Researchers measured blood pressure, triglycerides, fasting plasma glucose, C-reactive protein (CRP), high-density lipoprotein (HDL), and assessed whether the study subjects were insulin resistant.

What they found was eye opening -- 23.5% of "normal weight" adults were metabolically abnormal -- and surprisingly, the research done by Wildman's group found that approximately 30% of the "obese" group was actually metabolically pretty healthy.1 In the "overweight" group, it was split about 50-50 between those who were metabolically healthy and those who were at increased risk according to these measures.

So to summarize, the study found the risk for heart disease and diabetes in the three groups to be: normal body weight, 25% risk; overweight, 50% risk; obese, 70% risk.

Another study by Stefan et al. found that 25% of obese people did not have early signs of heart disease as determined by their blood vessel thickness and an oral glucose tolerance test used to measure insulin sensitivity.2 Nor were these people categorized at high risk according to their lipid profiles and blood pressure readings.

Both of these studies assessed whether central adiposity (belly fat) raised the risk of heart disease the most, as has been seen in other studies. According to the American Heart Association, if a man's waistline is greater than 39 inches and a woman's waistline is greater than 34 inches, it's time to take action.

Interestingly, the Stefan study found that in already obese patients, the most "at risk" fat was not belly fat, but liver fat. However, in normal and overweight people, belly fat did increase risk the most. (This may be because it is very unusual to see liver fat accumulating in normal weight people.) The Wildman study also found that normal weight or slightly overweight patients are more at risk for heart disease if they have belly fat.

The blogs are now flying about this research. I have seen statements like, "These studies once again prove that just because you are obese doesn't mean you are unhealthy." And indeed these studies show that if you are obese, you have a 25 to 30% chance of being in the group that hasn't yet developed heart disease or diabetes. But the overwhelming number of studies consistently shows that the vast majority of obese people do have heart disease and/or diabetes.

Even in the Wildman and Stefan studies, only 25 to 30% were escaping risk so far. The other 70% were at risk. In the normal weight category, 75% were metabolically healthy and 25% were at risk. I would take those odds any day.

I know some obese individuals will want to hang on to that 25% chance they may not be unhealthy just because they are severely overweight -- but there are other health problems that can develop too. Certainly if you fall into the obese category, you should at least be thoroughly evaluated to find out.

What are the take home messages from this research? You can be at cardiometabolic risk even if you are at a normal body weight, especially if you have increased waist size. This is not news to me and most health practitioners, but it is a big wake up call for many people.

Increased belly fat/waist size puts you at increased risk for heart disease and diabetes -- and the more overweight you become, the greater your risks. So, no matter who you are, you should take steps to prevent insulin resistance and control your weight to have the greatest chance of avoiding these two devastating diseases.

We also need to further study the 25% of the obese population to see what is keeping them from developing insulin resistance. For instance, the Wildman study found that increased physical activity reduced risk. Other studies have found that increased antioxidant intake from foods like green tea and turmeric may prevent damage to insulin receptors from the oxidative stress that can cause insulin resistance.

Perhaps these individuals have better sources of, or utilization of, the mineral chromium which helps regulate blood sugar. Or, they might have increased vitamin C intake from fruits, vegetables, and supplements which reduces the risk of insulin resistance and diabetes.3-4

Determining which factors can best lower risk of heart disease and diabetes, even in people who have not been able to lose weight, would be of tremendous value.

References

1. Stefan N, et al. Arch Intern Med. 2008;168:1609-1616.
2. Wildman RP, et al. Arch Intern Med. 2008;168:1617-1624.
3. http://www.nutritionandmetabolism.com/content/5/1/17.
4. Arch Intern Med. 2008;168:1485-1499.

This article appears courtesy of Early to Rise's Total Health Breakthroughs, offering alternative solutions for mind, body and soul. For a complimentary subscription,
visit http://www.totalhealthbreakthroughs.com

Low-Carb Wins After All?

So this headline caught my attention the other day on the internet:

Study: Low-carb diet best for weight, cholesterol

"The Atkins diet may have proved itself after all: A low-carb diet and a Mediterranean-style regimen helped people lose more weight than a traditional low-fat diet in one of the longest and largest studies to compare the dueling weight-loss techniques."

Any of you who read my stuff or follow my Metabolism Makeover Course know that I advocate cutting out processed carbs and getting the majority of your carb intake from fruits and veggies, with limited servings of whole grains. That doesn't mean I'm an Atkins follower though. And unlike what the lead paragraph in the article implies, this study didn't prove Atkins is the way to go at all.

This study followed 322 moderately obese people for two years, and broke them into 3 groups. One followed a low-fat diet plan (Metabolism Makeover participants know what I think of that), one group followed a low-carb plan, and one group followed a Mediterranean style diet.

The low-fat diet — no more than 30 percent of calories from fat — restricted calories and cholesterol and focused on low-fat grains, vegetables and fruits as options. The Mediterranean diet had similar calorie, fat and cholesterol restrictions, emphasizing poultry, fish, olive oil and nuts.

The low-carb diet set limits for carbohydrates, but none for calories or fat. It urged dieters to choose vegetarian sources of fat and protein.

So what happened?

The dieters lost between 6.5 on the low-fat plan and 10 lbs on the low-carb and Mediterranean plans.

IN TWO YEARS!

That doesn't mean one diet is better than the other. In fact, it means that none of them are better than the others.

If you've got 322 moderately obese people dieting for two freakin years and the best they can do is lose 10 lbs, then your plan sucks. Plain and simple.

Research like this pisses me off because it sends the wrong message. Since it was funded by an Atkins advocacy group, you certainly won't see any of the researchers telling you the results sucked, but that's the reality of it.

Just by simply eating right and exercising properly, an otherwise healthy, moderately obese person can easily lose 10 lbs in a month or less.

And don't worry all you low-fat advocates, they'll be research next week that says low-fat is the way to go. Just wait.

Researchers need to get out of the lab and into the real world. I don't need idiots like this telling me what works and what doesn't, I see it every day. I can also see that what they did didn't work at all.

If you want to know what really works, go to www.HealthyWeightInnerCircle.com and read "The Ridiculously Simple Rules to Good Nutrition", or better yet, start following the Metabolism Makeover Course.

~Dave

Why Your Diet Doesn't Work

At any given time, more than 60% of people say they are dieting, so if diets really worked, we'd all be pretty damn thin.

But we're not.

Give you one guess why...

Because diets don't work. In fact, they suck.

I've got a video you can watch that will basically explain, in very simple terms, why dieting alone as a means to lose weight doesn't work in the long term. It's about 30 minutes long, but that's because I go into detail and cover lots of info.

And yes, the video is free. Just click the image to the left or see the dieting video here.

So, go get yourself a cold drink and sit back and watch. You'll never go on another diet if you do.

~Dave

Food Label Lies, Part 2

A quick follow up to my previous example of how food companies lie to you. Here are a couple of other good examples, courtesy of the Center for Science in the Public Interest:

Kellogg's Special K Fruit & Yogurt
The ads for this cereal tell us how it "combines the crunch of whole grain goodness, the smooth creaminess of yogurt and the sweet taste of berries..." Notice how the objects in the sentence are 'crunch', 'creaminess', and 'taste'. That's because the cereal really contains more highly processed refined rice than whole grain wheat, no actual berries at all (they're really just dyed apple pieces), and no yogurt (just heat-treated yogurt powder).

Smucker's Simply Fruit
Well, it might be, sort of. It actually contains more fruit syrup than real fruit, and the syrup isn't made from the fruit in the product's name. It is made from apple, pear, or pineapple juice concentrate, which is cheaper than the fruit they tell you is in the jar.

DanActive Immunity Dairy Drink
This is one of my favorites. Dannon tells you that this drinkable yogurt will help to "strengthen your body's defenses." Unfortunately, the reality is that Dannon only did one study to see if drinking this stuff actually kept people from getting sick, and they found out it didn't. But, let's not let that get in the way of clever marketing.

The Center for Science in the Public Interest has a great newsletter, Nutrition Action. You should check it out at www.nutritionaction.com.

~Dave

How Food Manufacturers Lie to You

If you open your cupboard, I'm guessing you'll find a can of non-stick cooking spray. I know there's one in my cupboard.

Look at the front of the can, and regardless of the brand, you'll probably see "For fat-free cooking", "calorie-free cooking spray" or something similar.

Now, turn the can around and look at the ingredients. Basically it is canola oil, flavoring, and propellant. If you look at the bottle of cooking oil you probably also have in your cupboard, you'll see that it has 120 calories per tablespoon, with 100% of the calories coming from fat.

So, how is it that taking canola oil from a bottle and putting it in a spray can removes all of the fat and calories?

It doesn't. That cooking spray has 120 calories per tablespoon and is 100% fat.

So, how is the manufacturer able to get away with lying to you? The law allows them to. You see, FDA regs say that if a food has less than .5 grams of fat PER SERVING, it can be called fat-free.

Take a look at the serving size on your cooking spray: .25 grams. If the serving size is less than .5 grams, there has to be less than .5 grams of fat in it, right?

To point out how ridiculous a serving size of .25 grams is, they even tell you that equals a spray lasting 1/3 of a second. Even if you could hit the trigger, spray, and get your finger off the trigger in 1/3 of a second, you wouldn't cover much of your pan.

But, that doesn't matter, as there are no rules defining serving size. So, food manufacturers can simply manipulate serving sizes, even to ridiculous degrees, to justify the marketing hype on the front label that gets you to buy the product.

Now, I'm not saying non-stick cooking spray is bad. I'm just saying it isn't calorie- or fat-free. In fact, it is 100% fat.

The point is, you can't always believe what is on a food label.

~Dave

Whose Fault is it if You're Overweight?

A new report by a British government-sponsored think-tank states that obesity does not simply result from over-eating and a lack of exercise, but is a consequence of modern life.

"Although personal responsibility plays a crucial part in weight gain, human biology is being overwhelmed by the effects of today's 'obesogenic' environment, with its abundance of energy-dense food, motorised transport and sedentary lifestyles.

"As a result, the people of the UK are inexorably becoming heavier simply by living in the Britain of today."

Excuse me, but that's a pile of crap.

Not only do we have individuals who refuse to take responsibility for their own situations, instead choosing to blame fast food restaurants, soda companies, junk food manufacturers, and whoever else happens to be a convenient target, but now we have the British government encouraging people to abdicate personal responsibility for their weight issues.

Give me a break. I think they created this report just so they could coin the word "obesogenic".

Nobody forces you to eat all of the energy-dense food available at every corner in the form of fast food restaurants. Just because there is a McDonalds on every block doesn't mean you have to eat there.

And motorized transport is now a culprit? Buy a bike. Take a walk. If you are taking your car to go around the block to buy a cheeseburger, that isn't society's fault, pal. Look in the mirror.

And don't even try to tell me that a sedentary lifestyle is caused by anything other than personal choice. Society doesn't glue your lazy ass to the couch to watch Oprah. You do. If you don't exercise, there is nobody to blame but yourself.

And, as expected, you have the pundits and know-it-alls lining up to say that this report proves that governments aren't doing enough to tackle the obesity issue. According to this report, "Tackling obesity, like tackling climate change, requires a range of changes in society, from increasing everyday activity through the design of the built environment and transport systems to shifting the drivers of the food chain and consumer purchasing patterns to favor healthier options."

Puh-lease. Let's over-complicate matters so that we can continue to justify expanding waistlines.

You're overweight? Don't blame McDonalds for making hamburgers or Ford for making inexpensive cars. You, and only you, made the choice to drive a block for a cheeseburger.

~Dave