Internet News: A Web of Fat

If you read yesterday's post about the steady stream of press coverage surrounding the obesity epidemic you'll see that so many of those stories focus on miracle cures and surgical shortcuts (instead of the old "eat right and exercise").

But not all obesity-related news fits that mold. Here's a couple:

News items like these show that there are signs of countering the obesity epidemic, just as long as the focus involves developing weight-loss systems through valid scientific research and not sweeping problems under the rug the with fads, drugs, and surgery. Dr. Fuhrman's approach in Eat to Live is exactly that—adopt a healthy diet for disease protection and sustained wellness. He explains:

Eat to Live gives you the information and the motivation you need to take advantage of this opportunity to improve your health and maximize your chances for disease-free life.

Science and the development of modern refrigeration and transportation methods have give us access to high-quality, nutrient-dense food. In today's modern society, we have available to us the largest variety of fresh and frozen natural foods in human history. Using the foods available to us today, we can devise diets and menus with better nutrient density and nutrient diversity than ever before possible.

You have a clear choice. You can live longer and healthier than ever before, or you can do what most populations do: eat to create disease and premature death.

Foods That Make You Thin

It's pretty clear which foods will let you feel full with the least amount of calories--fruits and green vegetables. Green vegetables, fresh fruit, and legumes again take the gold, silver, and bronze medals. Nothing else in the field is even close.

Caloric Ratios of Common Foods
FoodsCalories Per PoundCalories Per LiterFiber Grams Per Pound
Potato chips of French fries2,6003,0000
White Bread1,3001,5000
Chicken and Turkey (white meat)9001,6000
Whole Grains (wheat and rice)6001,0003
Starchy Vegetables (potatoes and corn)3506004
Green Vegetables1002005

Green vegetables are so incredibly low in calories and rich in nutrients and fiber that the more you eat of them, the more weight you will lose. One of my secrets of nutritional excellence and superior healing is the one pound-one pound rule. That is, try to eat at least one pound of raw green vegetables a day and one pound of cooked/steamed or frozen green vegetables a day as well. One pound raw and one pound cooked--keep this goal in mind as you design and eat every meal. This may be too ambitious a goal for some of us to reach, but by working toward it, you will ensure the dietary balance and results you want. The more greens you eat, the more weight you will lose. The high volume of greens not only will be your secret to a thin waistline but will simultaneously protect you against life threatening illnesses.

Obesity: What a Bloated Web It Weaves

The obesity epidemic in this country has more twists and turns than a McDonald's drive-thru. Everyday the news media is blitzed with a different obesity-related headline. Here are two that caught my eye this morning...

According to Reuters, Medtronic Inc., the world's biggest maker of medical devices; is developing weight control implants to help the company tap into the $100 billion obesity market. Debra Sherman reports:

Doctors and companies across the United States are looking at various technologies to combat obesity, including brain stimulation. These methods, though not completely understood by doctors, may be preferable to bariatric surgery since device-based treatments are reversible and have fewer side effects.

Despite failures so far of some devices in clinical trials, companies are pushing ahead, convinced that medical devices hold the key to battling obesity.

Medtronic is trying to develop a battery-powered gastric pacemaker that causes the stomach to contract, sending signals of satiety to the appetite center in the brain, a small start-up also is working with the famed Mayo Clinic on a device that uses electricity to paralyze the stomach, reducing or stopping contractions that churn food as part of the digestion process.

If shocking your innards isn't disturbing enough, what if the obesity epidemic is actually worse then we think? I think this would surprise anyone, but according to AFP it's true. It's seems telephone interviews aren't satisfactory for fat data collection. A new study explains:

The main tool for measuring obesity in the United States is the Behavioral Risk Factor Surveillance System (BRFSS), which uses telephone interviews with a cross-section of the population to get its data.

But the researchers say that, in these phone interviews, women of all ages often under-report their weight, and young and middle-aged men often over-report their height.

As a result, the calculations for body mass index (BMI)—the yardstick of fat—are being skewed, and the true picture is that America is even chubbier than it thinks.

It seems to me that all these headlines do is make a clear solution murky. In his book Eat to Live Dr. Fuhrman explains that weight loss approaches like "gastric electrocution" are too risky and if you really want to slim down the population start eating to live:

The number one health problem in the United States is obesity, and if the current trend continues by the year 2030 all adults in the United States will be obese. The National Institutes of Health (NIH) estimate that obesity is associated with a twofold increase in mortality, costing society more than $100 billion per year.1

The NIH has reported that those undergoing surgical treatment for obesity have had substantial nutritional and metabolic complications, gastritis, esophagitis, outlet stenosis, and abdominal hernias. More than 10 percent required another operation to fix problems resulting from the first surgery.2

The Eat to Live promise is threefold: substantial, healthy weight reduction in a short period of time; prevention or reversal of many chronic and life-threatening medical conditions; and a new understanding of food and health that will continue to pay dividends for the rest of your life.

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Monday's Health Notes

Here's some health-related news making headlines:

  • Candice Choi of the Associated Press reports many hospitals are turning to technology to ensure patients are eating right during hospital stays.
  • According to Charnicia E. Huggins of Reuters a new study links television watching to obesity in some children.
  • WTOP reports a new study claims teenagers using fad diets to slim down may end up gaining pounds in the long run.

Hoodia Gordonii: Natural Healthy Weight Loss Herb or Snake Oil?

Dr. Fuhrman's colleague Dr. Steven Acocella, MS, D.C., DACBN, Board Certified Clinical Nutritionist, American College of Lifestyle Physicians, and a Diplomat of the American Clinical Board of Nutrition, discusses a popular supplement:

An herbal extract of the Hoodia gordonii cactus was found to be useful in quelling the thirst and hunger pangs of desert nomads during times of famine. The proposed mechanism, according to Dr. Richard Dixey, a spokesperson for Phytopharm Pharmaceuticals, who heads a research team efforting the synthesis of P57, the appetite suppressing component of the plant, explains how it works:

"There is a part of your brain, the hypothalamus. Within that mid-brain there are nerve cells that sense glucose sugar. When you eat, blood sugar goes up because of the food, these cells start firing and now you are full. What the Hoodia seems to contain is a molecule that is about 10,000 times as active as glucose. It goes to the mid-brain and actually makes those nerve cells fire as if you were full. But you have not eaten. Nor do you want to."
Pretty impressive sounding stuff, but does it work? That depends on whom you ask. Naturally, any advertisement is filled with glowing endorsements. But there is only one published, peer-reviewed scientific evaluation of P57 and that was preformed on rats. This study concluded that there was evidence of drug-induced anorexia using the extract from Hoodia1. But before you run out to the health food store consider a few facts of this study. The study was conducted on rats whereby researchers injected huge dosages of P57 directly into the brains (hypothamus) of the animals and then observed their eating behaviors for several days (apologies to PETA). To date there are no credible published human trials. Basing the use of any product on a single animal trial and purely anecdotal information is risky.

Remember, the well known Leptoprin commercial, the "when is a diet pill worth 153 dollars a bottle�when it works" people? In it they state the effectiveness of their product is "backed by two major scientific clinical trials," what they don't tell you (and don't have to tell you) is that its effectiveness has also been debunked, refuted and disproved by 50 other clinical trials! It's up to us, the consumer, to do our own research.

Taking any substance that has not been thoroughly evaluated, or in which studies yield inconsistent or irreproducible results is a poor choice. Professionally I could never recommend, and personally I would never use, anything for which the credible scientific community has not reached a positive consensus. I don't experiment on my patients and I don't rely on social proof.

Smoke and Mirrors Weight Loss
The use of this substance as a weight loss aid really comes down to how you view health. The larger question we need to ask here transcends assessing if Hoodia is safe and effective, if it really works or is it is a scam. If we are desirous of losing weight and improving our health consider this:

Many of the Hoodia manufacturers boast that their product is safe because it is not a drug. And according to the Food and Drug Administration they're right; but relative to what Hoodia actually does in the body (if it really works) they're wrong. Hoodia is not a drug by FDA standards simply because it has not been approved by them (the FDA) to be "safe and effective in the treatment of aliments or conditions." Any substance that has been isolated, concentrated and ingested for the intent of producing a physiological response is a drug. I don't think anyone could have a problem with my definition here. With that said, during my pharmacology clerkship the first thing that my professor said is that every drug, no matter how trivial or potentially lifesaving has damaging negative side effects on the body that always accompany its intended beneficial use. There is always a 'health-tax' to pay with taking any substance. It's the nature of biochemistry and all drugs have negative side effects, no exceptions.

Okay, so let's say a thousand years of Hoodia use by the San tribesmen in the Kalahari Desert have got to give this stuff credibility, their Shaman can't be wrong, and it actually works well. Consider some potential negative side effects specific to taking Hoodia. Hoodia is said to suppress thirst as well as hunger. People taking it run the risk of dehydration which can lead to the development of kidney stones and other fluid related problems. More importantly, specific to weight loss, taking it over time it will do nothing to increase metabolism so you won't burn more calories at rest; as a good aerobic training regime will do for you. So, as soon as you stop taking it the body will go into a highly efficient fat-storage mode and store even more fat at an accelerated rate, the old diet rebound "yo-yo" syndrome. This phenomenon has been seen with every magic diet pill ever used. You've not changed any metabolic set points by taking Hoodia and your brain wants those stored calories back, big time. And, if you just continue taking it, it's possible that you'll begin to lose lean body mass and weight loss at that point can become deceptive and dangerous.

Also, what about those reduced calories you do take in? If you're on a reduced calorie diet style and in caloric deficit (the only way to lose weight) then you'll have to pay very close attention to what you eat to maintain excellent nutrition. A diet that does not contain the full complement of antioxidants, phytochemicals and other micronutrients and the right macronutrients (fat, carbohydrates and proteins) is disease promoting. If you've reduced your caloric intake 40% by using this substance then you'll have to get all of your nutrition from 60% of the amount of food you normally eat.

The problem is that the vast majority of Americans are already not getting nearly enough of the life-extending, health maintaining food elements eating 100% of their present calories to begin with! More food, or rather more higher quality food, not less low quality food is a much better way to get the appetite centers in the hypothalamus to cooperate and to lose weight. "Turning off" hunger can be achieved by not only the caloric component of food, but the bulk volume and nutrients present in the food as well. So, you can "suppress" (or better yet satisfy) your appetite with lower calorie, higher nutrient-dense foods and at the end of the day you've not only controlled your appetite, reduced your calories (and therefore weight) but you've also improved your nutritional status. Now we're talking!

Gee, what foods have all the following attributes at the same time?

A. High bulk, like lots of healthy fiber
B. Are extremely rich in nutrients
C. Are also much lower in calories

If you don't know the answer to this food trivia question we have a lot to talk about!

When it comes to Hoodia or any other quick fix medical breakthrough�flavor of the month diet pill�we just don't get something for nothing and there's always a price to pay. The arsenal in the war against being over fat and against obesity has got to include more than just weight loss; weight loss by itself does not necessarily equate to improved health. I regularly consult with patients that have lost large amounts of weight and are very unhealthy. What's the point of losing a bunch of weight only to develop some other diet-related morbid condition? Any change in body weight, up or down, should always result in an elevation of health and clearly this is not always the outcome of change, the scientific journals are full of such cases. I have seen several patients that have resorted to bariatic surgery (stomach stapling) and lost nearly 100 pounds each and are enduring tremendous nutrition-related health problems. And the damage I seen in victims of the Atkins weight loss scheme could fill volumes, but that's another article. A diet rich in Phen-Phen and Red-Bull can pretty much guarantee you rapid weight loss but it can be a bit hard on the system. Using some gimmick to fool the body to lose weight can result in the perfect body�corpse-weight! Write that down.

The smoke and mirror weight loss results you get from taking herbs and other diet drugs might win the battle short term but because it doesn't result in elevated health we still lose the war. Clearly Hoodia will not improve our nutrition and can further compromise our health over time. The only possible way it might be useful is if we were to learn how to eat healthfully while taking it, but if you learned how to do that you wouldn't need Hoodia anyway. Trust me; I see real weight loss success every day.

Allow me to leave you with the words of that pop-culture icon and high profile celebrity promoter of Hoodia, Anna Nicole Smith: "Hoodia works; it's the new miracle diet pill that aids in weight loss by suppressing appetite!"

Sorry Anna, we're not buying and neither should you. Now, how about you get with the program and go get a copy of Eat to Live by Dr. Fuhrman.

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Blog Discussion: Is All Dieting a Waste of Time?

Dr. Fuhrman dedicates a lot of his book Eat to Live to explaining that diets really don't work--for a number of reasons. His main point is:

A weight-loss program can be considered successful only if the weight loss is permanent, safe, and promotes overall health. Temporary weight loss is of little or no benefit, especially if it compromises your health.

Alas (the blog) recently published a massive essay essentially saying that dieting is a massive waste of time. It touches on a number of studies. If you read it, don't ignore the dozens of comments. There are some important points in there, too.

The essay is summed up in the conclusion like this:

1. No weight-loss diet has ever been scientifically shown to produce substantial long-term weight loss in any but a tiny minority of dieters.

2. Whether or not a weight-loss diet "works," people who go on weight-loss diets are likely to die sooner than those who maintain a steady weight or who slowly gain weight.

3. For fat people (or anyone else) concerned with their health, the best option is probably moderate exercise and eating fruits and veggies, without concern for waistlines. In other words, Health At Every Size (HAES).

4. The model on which most weight-loss diets are based - in which fat people eat like fat people and must learn to eat like non-fat people - is probably a myth.

Dr. Fuhrman is a staunch believer in the importance of weight loss in the name of health. But that doesn't mean this isn't an interesting discussion worth having.

To me, the thing that's missing from most discussions of weight loss, including this one, is the idea of excellent nutrition, that actually improves your overall health as you lose weight. (It's not just about avoiding certain foods--but is rather about gravitating to others.) Many of the important studies showing these kinds of effects have been described previously on DiseaseProof, and are as relevant as ever in this discussion. I'm interested to hear what you think.

The Haggis and Butter Diet?

The Scotsman reports fad diets like Atkins and processed convenience foods are taking Scotland by storm. With more and more Scottish citizens adopting these diet-styles, health correspondent Lyndsay Moss says Scottish bones could be at risk.

A balanced diet including calcium, vitamin D and other minerals is vital for healthy bones, which are less at risk of fracture.

But the National Osteoporosis Society (NOS) warned that many Scots could be putting their bones at risk due to food fads and because they are eating more processed foods than before.

The charity said regimes such as the low-carbohydrate Atkins diet and the cabbage soup diet could mean people are not getting a nutritional balance.

Bone health is one of the less-discussed aspects of low-carbohydrate diets. A great place to find out more about it is at, which addresses bone health several times. Here are some highlights:

  • "Some high-protein, very-low-carbohydrate, weight-loss diets are designed to induce ketosis. When carbohydrate intake or utilization is insufficient to provide glucose to the cells that rely on it as an energy source, ketone bodies are formed from fatty acids. An increase in circulating ketones can disturb the body's acid-base balance, causing metabolic acidosis. Evidence suggests that even mild acidosis can have potentially deleterious consequences over the long run, including low blood phosphate levels, resorption of calcium from bone, increased risk of osteoporosis, and an increased propensity to form kidney stones." Read more.
  • "Urinary excretions of calcium and acids are correlated positively with intakes of animal and nondairy animal protein but are correlated negatively with plant-protein intake." Read more.
  • "The concern with bone health arises from the fact that muscle protein has a high sulphur content. When people eat too much of this meat protein, sulfuric acid forms within our bodies which must somehow be neutralized to maintain proper internal pH balance. One way our bodies can buffer the sulphuric acid load caused by meat is with calcium borrowed from our bones." Read more.
  • "Despite having some of the highest calcium intakes in the world, the Inuit also have some of the worst rates of osteoporosis." Read more.

Less Food, More Life

Denise Grady of The New York Times reports low-calorie diets may lead to longer life. Although due to the difficulty of conducting a large-scale/long-term study, there is no proof a low-calorie high-nutrient diet can prolong human life. But a new study hopes to change that:

A six-month study in 48 people directed by Dr. Ravussin, being published today in The Journal of the American Medical Association, is the first rigorous test of calorie restriction in people who are overweight but not obese. Most participants reduced calories by 25 percent, but some cut back more and ate only 890 calories a day for several months.

"There's never been a study like this one," said Dr. Evan Hadley, director of geriatrics and clinical gerontology at the National Institute on Aging, which paid for the study. He called the results "striking," even though the experiment was only a pilot study for a two-year trial of calorie restriction due to begin in the fall.

Among the main findings of Dr. Ravussin's study was that calorie restriction led to decreases in insulin levels and body temperature. Both are considered signs of longevity, partly because an earlier study by other researchers found both traits in long-lived people. The diet also led to a drop in thyroid hormones and declines in DNA damage.

But Dr. Ravussin and Dr. Hadley cautioned that the study was preliminary, and that it did not prove that calorie restriction could make people healthier or add years to their lives.

"It's an important step along the way," Dr. Hadley said.