Disease Proof : Disease Proof : Health & Nutrition News & Commentary : Dr. Joel Fuhrman

We’ve all got foods we’re powerless to resist. At times, I’ve single-handily made peanut M&M’s an endangered species. Maybe I’m low on leptin. Leptin is a hormone secreted by fat cells that regulates the body’s appetite.

A new study has determined that low levels of leptin—commonly found in people who have lost weight—makes it harder to resist “tempting” foods.

"When you lose weight you've created about the perfect storm for regaining weight," said Michael Rosenbaum of Columbia University Medical Center in New York, whose research appears in the Journal of Clinical Investigation, “Areas of your brain involved in telling you not to eat seem to be less active. You are more responsive to food and you are less in control of it.”

Almost sounds like you’re damned if you do, damned if you don’t! Alright, in case you’re in a panic about leptin now, fear not! Previous research determined that getting plenty of sleep is a great way to increase leptin production and reduce weight gain.

Good. So all I need now is a bag of peanut M&M’s and a pillow. Kidding.

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A new study has determined that calling a child overweight or forcing a diet down their throat doesn’t work, but parents creating a healthier home environment does. Here’s the abstract from Pediatrics:

OBJECTIVE: Our goal was to explore whether parents of overweight adolescents who recognize that their children are overweight engage in behaviors that are likely to help their adolescents with long-term weight management.

METHODS: The study population included overweight adolescents (BMI ≥ 85th percentile) who participated in Project EAT (Eating Among Teens) I (1999) and II (2004) and their parents who were interviewed by telephone in Project EAT I. Cross-sectional analyses were conducted with 314 adolescent-parent dyads, and longitudinal analyses were completed with 170 dyads.

RESULTS: Parents who correctly classified their children as overweight were no more likely than parents who did not correctly classify their children as overweight to engage in the following potentially helpful behaviors: having more fruits/vegetables and fewer soft drinks, salty snacks, candy, and fast food available at home; having more family meals; watching less television during dinner; and encouraging children to make healthful food choices and be more physically active. However, parents who recognized that their children were overweight were more likely to encourage them to diet. Parental encouragement to diet predicted poorer adolescent weight outcomes 5 years later, particularly for girls. Parental classification of their children's weight status did not predict child weight status 5 years later.

CONCLUSIONS: Accurate classification of child overweight status may not translate into helpful behaviors and may lead to unhealthy behaviors such as encouragement to diet. Instead of focusing on weight per se, it may be more helpful to direct efforts toward helping parents provide a home environment that supports healthful eating, physical activity, and well-being.

I think Dr. Fuhrman would agree with this. He explores this topic in his book Disease-Proof Your Child. Check out this excerpt:

Parents are entrusted with the responsibility of securing the selection of healthy foods for the family and preparing the food in a way that makes it desirable. Children are responsible for deciding how much they eat. If they are in an environmental of healthful foods they will have no problem regulating variety and timing. They can choose what they eat, when they eat, and if they will eat. Don’t use food as a reward or punishment. Don’t offer a treat because the child was good or ate well. Offer healthy treats as part of the normal well-balanced diet.

So yeah, raising your child on French fries isn’t a “healthy” environment.

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In order to beat the bulge, Japan has started measuring the waists of people between the ages of 40 and 74 as part of their annual checkup. Norimitsu Onishi of The New York Times reports:

Summoned by the city of Amagasaki one recent morning, Minoru Nogiri, 45, a flower shop owner, found himself lining up to have his waistline measured. With no visible paunch, he seemed to run little risk of being classified as overweight, or metabo, the preferred word in Japan these days.

But because the new state-prescribed limit for male waistlines is a strict 33.5 inches, he had anxiously measured himself at home a couple of days earlier. “I’m on the border,” he said.

Under a national law that came into effect two months ago, companies and local governments must now measure the waistlines of Japanese people between the ages of 40 and 74 as part of their annual checkups. That represents more than 56 million waistlines, or about 44 percent of the entire population.

Those exceeding government limits — 33.5 inches for men and 35.4 inches for women, which are identical to thresholds established in 2005 for Japan by the International Diabetes Federation as an easy guideline for identifying health risks — and having a weight-related ailment will be given dieting guidance if after three months they do not lose weight. If necessary, those people will be steered toward further re-education after six more months.

This seems a little “big brother-ish” to me.

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According to a new study, if you live in a neighborhood with access to healthy food and physical activity, you’re likely to be leaner. Joene Hendry of Reuters reports:

The researchers found that men and women living in neighborhoods with better walking environments and availability of healthy foods were leaner than those living in less physically desirable neighborhoods.

Neighborhoods rated higher in social qualities, such as safety, aesthetics, and social cohesion, were associated with lower overall body mass index among women. However men showed the opposite -- higher body mass index among those residing in highly rated social neighborhoods -- and the investigators say further research must confirm this unexpected finding.

Overall, Dr. Mahasin S. Mujahid of Harvard University's School of Public Health in Boston, Massachusetts notes, these findings add to a growing body of evidence that indicates genes and individual choice, as well as the environments in which people live affect health. Continuing research needs to further assess links between environment and obesity, Mujahid and colleagues conclude.

This falls in line with the majority of the reports I’ve read. Here are some posts that come to mind. Take a look:

• NYC: Supermarkets Packing Up Shop
• Poverty's Diet Strain
• NYC: Healthy Food Not Always Available
• A Tale of Two Cities: New York's Diabetic Dilemma

But, I think if you really want to be healthy, you find a way. You think I like driving 30 minutes to get to Yoga!

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Ali Hale of Diet Blog investigates why your friends, drinking, and stress can hinder your diet. Here’s a bit:

Alcohol
For many of us, good intentions dissolve somewhere in the first glass, and after a few drinks, stodgy comfort food like a big plate of fries or creamy pasta seems far more attractive than a salad.

Friends
Do you have friends who urge you to order dessert, even when you're stuffed, or who insist on sharing their huge tub of popcorn with you at the movies? Perhaps every social occasion involves pizza, humungous bags of chips, or a trip to a new restaurant.

Stress
Whether it's a horrendous day at work, a toddler having a tantrum, an impending visit from your mother-in-law, or a teenager threatening to run away from home, stress often leads straight to the fridge door.

Yup, they’re all important things to consider. Check out these posts for more:

• Alcohol and Eat to Live
• Weight-Loss Strategies: Social Support & Stimulus Control
• An Emotionally Satisfying Environment is Vital

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TMZ is questioning the timing of Kirstie Alley’s weight-gain now that she is starting her own diet plan. Check it out:

After losing over 75 Scientolopounds on Jenny Craig, Kirstie said she was planning to start her very own slim down system that she'd launch next year. But these days it's clear ... Kirstie isn't taking her own medicine.

But how's this for a theory -- she can't sell a weight loss program if there's no dramatic before and after fresh in people's minds. So she balloons up, then slims down, and then sells tons (you'll pardon the expression) of her magic weight loss stuff.

Blah, blah, blah—just another celebutard.

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“Nutritional research today is typically the blind leading the blind. People following nutritional belief systems like religion,” explains Dr. Fuhrman and this study claiming that high protein diets help preserve bone integrity during weight-loss is no different. From the University of Illinois at Urbana-Champaign:

The scientists recruited and randomized 130 middle-aged, overweight persons at two sites—the U of I and Pennsylvania State University. Participants then followed either the higher-protein weight-loss diet or a conventional higher-carbohydrate weight-loss diet based on the food-guide pyramid for four months of active weight loss followed by eight months of weight maintenance.

"Essentially we substituted lean meats and low-fat milk, cheese, yogurt, etc., for some of the high-carbohydrate foods in the food-pyramid diet. Participants also ate five servings of vegetables and two to three servings of fruit each day," Evans said.

Bone mineral content and density were measured with DXA scans of the whole body, lumbar spine, and hip at the beginning of the study, at four months, at eight months, and at the end of the 12-month period.

"In the higher-protein group, bone density remained fairly stable, but bone health declined over time in the group that followed the conventional higher-carbohydrate diet. A statistically significant treatment effect favored the higher-protein diet group," said Matthew Thorpe, a medical scholars (MD/PhD) student who works in Evans's lab and was the primary author of the study.

I asked Dr. Fuhrman about this research and here’s what he had to say. Take a look:

There are so many variables that the conclusions are simplistic. First of all, the vast majority of Americans are severely Vitamin D deficient and their higher protein group was given more Vitamin D fortified milk. Second, the intervention group was encouraged to eat more green vegetables and less sugar, bread and white potato, getting higher level of bone building nutrients, including Vitamin K, and thirdly, the intervention group, though eating less refined carbohydrates were only given a diet a little higher in protein (30 percent) which is not a very high protein diet.


All in all, if they are going to claim some benefit to lean muscle or bone for the higher protein diet, they have to control for Vitamin D, K and other bone supportive nutrients that were higher in the intervention group. Even though this was a poorly designed and poorly controlled study, I basically agree with what they found—that a moderate protein diet with more fruits and vegetable and less refined foods bread and pasta, with attention to more Vitamin D from fortified skim milk will result in better bone mass with dieting compared to a diet not paying attention to these details. However, I think the better results stem from numerous factors, and not likely from a higher percentage of protein and less carbohydrate.

No doubt, this report will whip the low-carb congregation into their usual zealotry.

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New research claims that parents of overweight kids are all talk and no action when it comes to getting their children healthy. More from WebMD:

Minneapolis-based researchers have found that parents need to "talk less and do more" when encouraging their kids to become fit and trim. Dianne Neumark-Sztainer, PhD, MPH, RD, of the division of epidemiology and community health at the University of Minnesota, and colleagues found that parents who correctly recognized that their child had a weight problem talked with their kids about dieting, but this was not helpful.

Previous studies have suggested that parents do not correctly recognize if their child is overweight. Furthermore, little research has been done to determine how parents act when they correctly perceive their child's weight status.

Neumark-Sztainer's team explored whether parents of overweight teens who correctly recognized their child's weight status engaged in behaviors that helped their child's long-term weight management.

I’m no expert—or a parent for that matter—but I’d imagine, like everything else, its all about setting an example. I think Dr. Fuhrman would agree:

No rules only for children. If the parents are not willing to follow the rules set for the house, they should not be imposed on the children…Setting an example supported by both parents is the most important and most effective way for your children to develop a healthy attitude toward food.

Plus, parents and children getting healthy together has to be a great bonding experience—right?

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Change can be hard. Changing your diet can be doubly tough and America’s favorite foods don’t exactly help matters. Dr. Fuhrman explains in Eat For Health:

Modern foods are designed to seduce your taste buds. You have been manipulated by profit motivated food manufacturers. We all have. The artificially concentrated flavors that the processed food industry uses to stimulate the brain’s pleasure center are designed to increase and retain sales. Tragically, the result is that they lead people’s taste buds astray. Artificial, intense flavors cause us to enjoy natural flavors less. Our taste buds become desensitized, and the more we succumb to the heightened, artificial flavors, the less appealing natural, whole foods become.

Now, Shari Roan of The Los Angeles Times asks the question, “Why it's hard to maintain weight loss?” Here’s an excerpt:

"There is a big shift toward understanding long-term weight maintenance," says Paul MacLean, associate professor of medicine at the University of Colorado, Denver. "We have a huge number of diet books and diet programs, and if you do them, you can lose weight. The big problem is keeping it off. The recent estimates are that 5% to 10% of people are successful at keeping weight off on a long-term basis."

But before you throw up your hands and reach for the Twinkies, consider this: Scientists think the truth will set us free -- that understanding the stubborn biological processes at work will lead to ways to fight back and outsmart them.

Exercise, it's known, buffers the post-diet body against regaining weight, in ways that researchers are just starting to comprehend. Certain foods, scientists believe, may help stave off weight regain too. And medications now in development target some of the biochemistry thought to be linked to packing the pounds back on…

…Appetite hormones change too. The hormone leptin, for example, is a major appetite regulator -- it tells the body to stop eating and store fat after meals. Some people may be genetically prone to having lower leptin levels, making them more prone to obesity. But studies also show that, after a weight loss, leptin levels are lower than what they used to be. That means appetite is less easily quelled. It's like a car that has suddenly lost its brakes.

Another hormone, ghrelin, stimulates food intake -- levels in the brain fall lower after a meal. However, after a weight loss, ghrelin levels in the blood generally increase, and the fall-off after mealtimes isn't as marked.

"You lose 10% of your body weight. All of a sudden all these systems kick in to try to keep you from losing weight," says Dr. Ken Fujioka, director of nutrition and metabolic research at the Scripps Clinic in San Diego. "People are mad at themselves or depressed after they regain the weight. But I explain: It's not you. Biology has kicked in now. . . . You are hungry all the time. You think about food all the time."

This is all well and good, but staying determined and keeping your eyes on the prize is a great way to buck to the trend. More from Dr. Fuhrman:

It is not easy to develop new habits, and there is no such thing as a quick shortcut to developing new skills and expertise. When you do something over and over, it creates a pathway in the brain that makes it easier and more comfortable to repeat again. That is one reason why it is so hard to change bad habits. However, if you are motivated to persevere and keep trying, the change becomes considerably easier. The more you make healthful meals and the more days you link together eating healthful foods, the more your brain will naturally prefer to eat that way. Of course, feeling better and losing weight is a great motivator, but through this process, your taste for a different way of eating can be established. It has been shown that a new food needs to be eaten about 15 times for it to become a preferred food. Keep in mind that the more days you eat healthfully, the more you will lose your addiction to unhealthful, stimulating substances, and, with time, you will look forward to, and prefer, a healthy diet. Don’t give up. The only failure is to stop trying.

I’m not an expert, but I think eating and living healthfully gets easier the longer you do it. For me, its as if my instincts changed—know what I mean?

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You don’t read too many nice stories about the West Bank and Gaza Strip—especially on a health blog—but one weight-loss support group is bringing Israelis and Palestinians together. More from Armenian Medical Network:

“I never felt good about myself and my body, and that’s something that women all over the world struggle with,” said Yael Luttwak, an American-born Israeli who started the groups.

"I thought this would be a great way to bring together women who wouldn’t normally meet each other.”

Israelis and Palestinians around Jerusalem are separated by Israel’s West Bank barrier and a network of checkpoints, which Israel says are needed for security, but which Palestinians call collective punishment…

…Israeli women embraced diet support groups decades ago and the Jewish state was one of the first countries to establish a branch of U.S. weight loss group Weight Watchers.

Dieting is a more recent trend in Palestinian society, but it is catching on fast thanks to the influence of Western television shows and given relatively high obesity rates in the West Bank and Gaza Strip.

At the “Slim Peace” groups, women are bound by a common and intimate interest: their bodies.


“Before, the only Israelis I knew were soldiers at checkpoints, I thought they were all brutal,” said Palestinian student Enas Smoom. “But in the group, we forget we are Israelis and Palestinians—we are just women talking about nutrition.”

Maybe I’m just a hopeful liberal and maybe this is just pie in the sky, but it’s a touching story nonetheless. Better health, fostering better relationships—I like it.

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