Diet & Exercise as a Lifelong Lifestyle for a Healthy Heart & MInd

Emphasizing Heart- & Mind-Healthy Foods Instead of Going on a Diet

September 2, 2015

Evelyn Smith

M.S. in Library Science, University of North Texas (2012)

The results of a study published in the August Journal of the American Medical Association emphasizes that supplements don’t prevent or delay cognitive decline.  However, at the same time, circumstantial evidence indicates that older adults who eat a lot of vegetables, have one or two servings of Omega 3 fatty fish in their diet weekly are less likely to be at risk for Alzheimer’s.  This association along with the link between a high Body Mass Index in middle-age and a higher risk for dementia as well as cardiovascular diseases has put a new emphasize on dieting for health rather than just for looks. 

Chew, Emily Y. , Clemons, Traci, and Agrón, Elvira, et al. (2015, August 25). Effect of Omega-3 fatty acids, lutein/zeaxanthin, or other nutrient supplementation on cognitive function: The AREDS2 randomized clinical trial. JAMA. 314(8):791-801. doi:10.1001/jama.2015.9677. [Abstract only].   Retrieved from http://jama.jamanetwork.com/article.aspx?articleid=2429713

Upon noticing that older adults whose diet has a high intake of saturated fat and a low-intake of vegetables were more susceptible to cognitive decline, researchers administered vitamin supplements, which didn’t have any substantial statistical effect on whether they were diagnosed with dementia. In a double-masked randomized clinical trial retina specialists in 82 academic and community medical centers enrolled over 6,000 patients with the mean age at baseline of 72. 7 who were at risk for age-related macular degeneration, which also correlates with a greater risk for Alzheimer’s.  In addition to giving annual eye exams, trained examiners administered cognitive function tests by telephone both at baseline and every two years in a five-year study.  Some of the patients received LCPUFAs (1g.), and /or lutein (10 mg.) /zeaxanthin (2 mg) or a placebo while all study participants received carrying combinations of vitamins C, E, beta carotene, and zinc.    Researchers didn’t observe any significant scores in cognitive functioning between the patients who received supplements and those who didn’t. 

Accordingly, researchers concluded that taking oral supplements of fish or krill oil as well as multi-vitamins doesn’t significantly delay or prevent cognitive decline. 

Bottom Line:  Supplements don’t work, but diet and exercise do. 

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Drinking Water Before a Meal Can 
Quick Start Weight Loss

Of course, for those who want to jump start their weight loss without diet or exercise, researchers have found an easy remedy:

Parretti, Helen M., Aveyard, Paul, and Blannin, Andrew, et al. (2015, August 3).  Efficacy of water preloading before main meals as a strategy for weight loss in primary care patients with obesity: RCT.  Obesity. 23 (9), 1785–1791. doi: 10.1002/oby.21167.  [Abstract only].  Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/oby.21167/abstract

Preloading water before meals leads to a moderate weight loss for obese adults, or so English researchers at the University of Birmingham discovered when they pitted 41 obese adults who drank a pint of water (500 ml.) 30 minutes before their meals against a group of 43 adults who simply were to imagine a full stomach before meals during a 12 week period.  The water preloading group lost 1.3 kg. more weight than those dieters who didn’t drink water before meals.

The media, in turn, has popularized the idea that “preloading” water before a meal is one way to lose weight.

Blackstone, Samuel.  (2015, August 29).  Researchers just found the easiest way to help you lose weight. Details.  Retrieved from http://www.details.com/blogs/daily-details/2015/08/water.html

In a 12-week study conducted by the University of Birmingham, obese trial participants who drank two cups or one pint of water (500 ml.) 30 minutes before each of their three daily meals lost ten more pounds than counterparts who didn’t drink water beforehand, the water drinkers losing 2.87 more pounds than the control group, dropping an average of 9.48 pounds in 12 weeks (Blackstone, 2015, August 29, para. 2-3). 

Reference:

Parretti, Helen M., Aveyard, Paul, and Blannin, Andrew, et al. (2015, August 3).  Efficacy of water preloading before main meals as a strategy for weight loss in primary care patients with obesity: RCT.  Obesity. 23 (9), 1785–1791. doi: 10.1002/oby.21167.  [Abstract only].  Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/oby.21167/abstract

Preloading water before meals leads to a moderate weight loss for obese adults, or so English researchers at the University of Birmingham discovered when they pitted 41 obese adults who drank a pint of water (500 ml.) 30 minutes before their meals against a group of 43 adults who simply were to imagine a full stomach before meals during a 12 week period.  The water preloading group lost 1.3 kg. more weight than those dieters who didn’t drink water before meals.

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A Healthier Diet Loses More Weight Than Exercise Does

Load up on fresh fruits and vegetables!

However, while exercise also helps, smaller portions and healthier meals help dieters lose more weight than exercise does:

Clark, J. E. (2015, April 17).  Diet, exercise or diet with exercise: comparing the effectiveness of treatment options for weight-loss and changes in fitness for adults (18-65 years old) who are overfat, or obese; systematic review and meta-analysis. Journal of Diabetes and Metabolic Disorders, 14 (31). doi: 10.1186/s40200-015-0154-1. eCollection 2015.  [Full text].  Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25973403

Clark’s systematic meta-analysis of 66-populaton-based studies reveals that hypocaloric balance (the amount of calories burned must be more than calories eaten) is necessary for changing body composition, so exercise must accompany diet for weight loss. Moreover, resistance training is a more effective technique for losing weight than endurance training or a combination of resistance and endurance training.  Moreover endurance training is more effective when it is high intensity exercise.

Malhotra, A., Noakes, T., and Pinney, S. (2015, April 22). It is time to bust the myth of physical inactivity and obesity: you cannot outrun a bad diet. British Journal of Sports Medicine.    doi:10.1136/bjsports-2015-094911.  [Full text].  Retrieved from   http://bjsm.bmj.com/content/early/2015/05/07/bjsports-2015-094911.full

Vetted scientific studies have proven that regular aerobic exercise reduces the risk of cardiovascular disease, Type 2 diabetes, dementia, and some cancers by at least 30 percent, but physical activity doesn’t do that much to promote weight loss when compared with maintaining a healthy diet (Malhotra, 2015, April 22, para. 1).  Additionally, up to 40 percent of adults with a normal Body Mass Index also harbor metabolic “abnormalities associated with obesity, including hypertension and cardiovascular disease (Malhotra, 2015, April 22, para. 2).

Furthermore, vetted commercial interests have corrupted the “health-halo” effect that associates diet and exercise, so making healthy food choices takes on more importance than  squeezing in time for exercise when it comes to losing and sustaining weight loss (Malhotra, 2015, April 22, para. 7).

Dieters must also balance these findings with the Mayo Clinic’s recommendations:

Diet and exercise. (2014, April 5).  Healthy lifestyle. Weight loss.  Mayo Clinic. Retrieved from http://www.mayoclinic.org/healthy-lifestyle/weight-loss/basics/diet-and-exercise/hlv-20049483

The Mayo Clinic recommends getting in a minimum of 150 minutes of moderate aerobic exercise or 75 minutes of vigorous aerobic exercise spaced throughout the weeks for dieters who are restricting calories to lose weight successfully (Diet and exercise, 2014, April 5, para. 4).

However, both The New York Times and The Washington Post publicized this new view that diet plays a greater  role in losing weight than exercise does:

Carroll, Aaron. (2015, June 15).  To lose weight, eating less is far more important than exercising more. Because when it comes to reaching a healthy weight, what you don’t eat is much, much more important.  The Upshot.  The New York Times.  Retrieved from http://www.nytimes.com/2015/06/16/upshot/to-lose-weight-eating-less-is-far-more-important-than-exercising-more.html?_r=0

Since exercising consumes far fewer calories than most people think, eating less is more important than exercising. For example, it’s possible to burn 350 calories by swimming laps or jogging for thirty minutes, but a dieter can achieve the same results by cutting out two 16-ounce non-diet sodas (Carroll, 2015, June 15, para. 2-4). 

Exercise can certain benefit overall health, but simply exercising doesn’t prevent obesity (Carroll, 2015, June 15, 5-6). A 2011 meta-analysis reviewing the relationship between physical activity in children found that simply being active is probably not the key reason why children may be overweight.  Furthermore, intervention studies don’t necessarily show that a physically active person is less likely to gain excess weight than a sedentary individual.  Additionally, physical exercise increases appetite, and over time, exercisers ended up burning less energy while escalating their calorie intake (Carroll, 2015, June 15, para. 7-8).

Many people erroneously believer that they can counter the slowing of metabolism with weight loss by exercise, but the resting rating of all dieters slows whether they exercise or do, so weight loss becomes harder to sustain over time That’s not to discount adding exercise to dieting in order to lose weight since exercise increase small increases in weight loss with exercise (Carroll, 2015, June 15, para. 10-11). For instance, two recent studies have found that in the long-run, behavioral weight management programs that combined exercise with diet lead to more sustained weight loss over a year, but over a period of six months, adding exercise to the equation made no difference (Carroll, 2015, June 15, para. 12). 

But when weighing (pun intended) the opportunity cost of whether to  take the time necessary to drive  to the gym and exercise* versus preparing a healthy meal at home, making a home cooked meal is likely to achieve better results (Carroll, 2015, June 15, para. 13). Losing weight is also more likely to succeed if it incorporates a gradual, sustained change in dieting and exercise (Carroll, 2015, June 15, para. 14).  

Exercise naturally provides benefits beyond weight loss since it cuts the risk of cardiovascular disease, diabetes, cognitive decline and depression. But these benefits don’t always apply to weight loss (Carroll, 2015, June 15, para. 15-16).

*Then again, taking a walk or run around the neighborhood or using a stationary bike, treadmill, or elliptical trainer at home might also budget enough time to prepare a home-cooked healthy meal and cram in thirty minutes of aerobic exercise.

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Adopting a Healthy Lifestyle Keeps Off 
the Weight

Since losing and gaining weight are two parts of the same cycle, it’s important to commit to a heart and mind-healthy lifestyle for the long run (pun intended).

Ferdman, Roberto A. (2015, May 4).  Why diets don’t actually work, according to a researcher who has studied them for decades.  Washington Post.  Retrieved from http://www.washingtonpost.com/news/wonkblog/wp/2015/05/04/why-diets-dont-actually-work-according-to-a-researcher-who-has-studied-them-for-decades/

Traci Mann, a psychology professor at the University of Minnesota who has studied dieting more than 20 years, has recently written a book, Secrets from the Eating Lab that details why long-term diet is “actually impossible” (Ferdman, 2015, May 4, para. 4-5). 

In Mann’s eating lab, she either goes out in the world observes how people eat, or else she brings people into her lab, so she can observe them under carefully controlled conditions (Ferdman, 2015, May 4, para. 8).  As for the secret why diets don’t work, Mann contends, all boils down to their lack of willpower—that and biological changes happen that make it “practically impossible” to lose weight and keep it off (Ferdman, 2015, May 4, para. 12 & 18).

1. Neurological changes occur, so dieters actually become aware of food, hence increasing its reward value;
   
2. Meanwhile hormonal changes make dieters feel hungry; 
3. Finally, when dieting (or fasting), the body’s metabolism slows down. Mann thus argues, that “Dieting is actually a lot like starving, physically.

(Ferdman, 2015, May 4, para. 19-23)

If a diet is working, Ferdman counters that the dieter is in a honeymoon stage since in the first 6 to 12 months of a diet, successful dieters usually lose about 10 percent of their starting weight, but after a while, biological changes seize control (Ferdman, 2015, May 4, para. 30-31). 

Part of the problem comes from the terms society uses to define a successful diet, labeling it a success if they lose weight and calling it a failure if the weight comes back on.  Actually, both situations are part of the same diet or weight loss/weight gain cycle because when dieters are distracted, they eat more than non-dieters (Ferdman, 2015, May 4, para. 33-34).

As for willpower, it works well in most instances—except in dieting, Mann claims (Ferdman, 2015, May 4, 36-37).  After all, dieters have lots of temptations throughout the day, and it takes only one slip up (Ferdman, 2015, May 4, para. 38-41).

Mann counsels that no one should try to weigh lower than their wet range and notes that when the dieter loses weight below his or her set range, his or her weight bumps back up into it. Moreover, when one’s weight rises above the set range, the body makes metabolic changes to push it back down (Ferdman, 2015, May 4, para. 43). 

Obviously, however, since most dieters are dieting for looks, Mann recommends that they try to stay within their normal set range. About five percent of all dieters can stay below their set range, but then, they spend most of their time obsessing about their weight (Ferdman, 2015, May 4, para. 44-45). 

Additionally, recent studies have noted that by simply modifying their eating habits overweight postmenopausal women and middle-aged men can lose weight: That means eating out less, cutting out fried foods, and consuming more fresh fruit and vegetables as well as dining on one or two servings of Omega-3 fatty fish each week:

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Gibbs, Barone, Kinzel, L. S., Pettee, Gabriel K., et al.  (2012, September). Short- and long-term eating habit modification predicts weight change in overweight, postmenopausal women: results from the WOMAN study. Journal of the Academy of Nutrition and Dietetics, 112(9), 1347-1355. doi: 10.1016/j.jand.2012.06.012. [Abstract only].  Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22939439

Since standard behavioral obesity treatment produces poor long-term results, researchers proposed focusing on healthy eating behaviors rather than calorie intake.  Accordingly, researchers studied 481 overweight and obese post- menopausal women enrolled in the Women on the Move through Activity and Nutrition Study (WOMEN), noting their weight at baseline, 6 months, and at 48 months. 

At six months, data linked weight loss with skipping desserts, eating at home instead of in restaurants, cutting out sugar-sweetened beverages, and not eating fried foods while increasing [broiled, grilled, or baked] fish consumption for intervention participants while only cutting out desserts and avoiding fried foods in weight loss controls. 

At 48 months, weight loss for both groups correlated with steering clear of desserts and sugar-sweetened beverages, but also with decreased servings of meats and cheese in the intervention participants and eating more servings of fruits and vegetables in their controls. Researchers concluded that modifying eating behaviors can reduce weight, although behaviors differed for both short- and long-term weight change and by randomized group.

The same strategy for long-term weight loss worked for overweight and obese men:

Robertson, C., Avenell, A., and Stewart F., et al.  (2015, June 30).  Clinical effectiveness of weight loss and weight maintenance interventions for men: A Systematic Review of Men-Only Randomized Controlled Trials (The ROMEO Project).  American Journal of Men’s Health, pii: 1557988315587550. [Epub ahead of print].  [Abstract only].  Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/26130729

Searching eight bibliographic databases and four clinical trials’ registers, Robertson, et al, searched for randomized controlled trials for men only with a mean BMI over 30 with a minimum duration of 52 weeks, eventually identifying 14 randomized clinical trials.  Reducing diet produced a great weight loss than physical activity alone, but the most effective interventions combined reducing diets, exercise, and behavior modification.

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Weight Loss Programs Can Help

Form your own support group by dieting with a friend or family member.

Moreover, while those dieters who want to turn to commercial weight loss programs for help, April 2015 reviews have determined that Jenny Craig, Weight Watchers work the best over a year or so while Nutrisystem seems to jump start weight loss.

Gudzune, K. A., Doshi, R. S., and Mehta, A. K., et al. (2015, April 7). Efficacy of commercial weight-loss programs: an updated systematic review. Annals of Internal Medicine. 162(7), 501-12. doi: 10.7326/M14-2238. [Abstract only].  Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25844997

Reviewing Medline and the Cochrane Database from their inception to November 2014, researchers compared the weight loss effectiveness of commercial and proprietary weight loss programs with behavioral counseling services for overweight and obese adults. Jenny Craig counseling resulted in a 4.9 percent greater weight loss at 12 months than controlled education and counseling while going to Weight Watchers achieved a 2.6 greater weight loss than using behavioral counseling did while subscribing to Nutrisystem resulted at a 3.8 percent greater weight loss at 3 months than control/education and counseling. Reviewers thus concluded that physicians “could consider” referring overweight and obese patients to Weight Watchers or Jenny Craig. However, more long-term studies are needed to evaluate Nutrisystem’s long-term effectiveness.

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The reasons for almost all addictions start in childhood.

Understanding Weight Gain Means Coming to Terms with a Traumatic Past

However, no diet works forever in the weight loss and weight gain cycle, although it’s also important to know the psychological reasons behind weight gain:

Hensrud, Donald D. (2004, March). Diet and obesity.  Current Opinion in Gastroenterology. 20(2), 119-124. [Abstract only].  Retrieved from  http://journals.lww.com/co-gastroenterology/Abstract/2004/03000/Diet_and_obesity.12.aspx

• Purpose of review: No diet has emerged that is clearly most effective.

• Recent findings: While low-calorie, low-carbohydrate diets lead to weigh loss, long-term results don’t skew any better than those that call for moderately restrictive diets. Meal replacement programs and dietary patterns low in energy density and glycemic index, however, should be studied further.

• Summary: In lieu of achieving short-term weight loss, diets should emphasize lifestyle changes that promote long-term health.

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Johns, D. J., Hartmann-Boyce, J., Jebb, S. A., et al. (2014, October). Diet or exercise interventions vs combined behavioral weight management programs: a systematic review and meta-analysis of direct comparisons. Journal of the Academy of Nutrition and Dietetics, 114(10), 1557-68. doi: 10.1016/j.jand.2014.07.005.  [Abstract only].  Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25257365

Johns, et al, examined whether physical activity, diet, or the combination of the two is the best tactic for losing weight as well as determining behavioral weight management programs, or single component programs, such as either dieting or exercising only, were better by reviewing meta-analyses of randomized trials of overweight and obese adults. They discovered no significant difference in weight loss from baseline or at three to six months between Behavioral Weight Management Programs (BWMP) and those that concentrated on diet only.  

But at 12 months, a “significantly great weight loss” occurred in the BWMP’s.  Furthermore, this weight loss continued to occur at 18 months when participants combined diet and physical activity. Exercise alone was a less effective method for losing weight than combining both diet and exercise in the short- and long-term*. 

References* (annotated below):

Lewis, Tanya. (2015, August 29).  Here’s the real reason so many diets won’t work.  Business Insider.  Retrieved from http://www.businessinsider.com.au/heres-the-real-reason-so-many-diets-dont-work-2015-8

Summarizing the gist of Charlotte Markey’s Scientific American article Why diet’s don’t work (and what does” (Volume 26, Number 5), Lewis concludes

• · Diets often actually cause [non-obese] dieters to gain weight in the long run (Lowe, 2013, June, Abstract);

• · Breaking a diet can result in binge eating (Polivy, 2010, December, Abstract);

•  Completely cutting out foods from a diet often makes dieters want to eat more of them  (Jakubowicza, 2012, March 10, Abstract);

• Dieting causes stress, and stress often leads to over-eating (Tomiyama, 2010, April 5). 

This means unless one can commit to a healthy, balanced diet that doesn’t deprive the dieter, his or her weight will come back on primarily because weight gain often results from overeating while stressed.

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Losing Weight Means Starting New Healthy Habits

 

Upon acknowledging the reasons why one overeats, the overweight and obese need to adopt new eating habits else dieting will ultimately cause an even greater weight gain.

*Lowe, Michael, R., Doshi, Sapna D., and Katterman, Shawn. (2013, June 24). Dieting and restrained eating as prospective predictors of weight gain.  Frontiers in Psychology. 4, 577.  doi:  10.3389/fpsyg.2013.00577.  [Full text].  Retrieved from http://journal.frontiersin.org/article/10.3389/fpsyg.2013.00577/abstract

A review of 25 studies on weight change, studying non-obese participants with a BMI between 18.5 and 30 revealed that in 75 percent of the studies, dieting “significantly predicted weight gain”.  Researchers theorized two possible explanation for this weight gain:  1) Retrained eating is a more effective way of preventing weight gain than actually dieting; 2) When normal weight individual diet, they do so because they are resisting a predisposition towards weight gain that dieting fails to prevent. 

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Aerobic & Resistance Exercise 

Do Help Fight Fat

A healthy diet and exercise work together!

That’s not to say that aerobic and strength training when combined don’t result in some weight loss:

Nicklas, B. J., Chmelo, E., Delbono, O., et al. (2015, May). Effects of resistance training with and without caloric restriction on physical function and mobility in overweight and obese older adults: a randomized controlled trial.  The American Journal of Clinical Nutrition. 101(5), 991-9. doi: 10.3945/ajcn.114.105270. Epub 2015 Mar 11. [Abstract only].  Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25762810

In a five-month trial of 65 to 79 year-old overweight and obese men and women randomly assigned to a progressive, three days per week moderately intensive resistance training with and without a weight-loss intervention component, body mass decreased in the group that combined resistance training and calorie restriction, but not in the group that participated in resistance training alone. Resistance training improved body composition, muscle strength and physical function in the obese elderly, but the more obese they were at the beginning of the program experienced less improvement. 

However, as previously noted, exercising daily and calorie counting don’t help middle-aged and elderly adults as much as including heart and mind-healthy foods in their diet while cutting out sugary drinks and fried foods does:

Nutritional value more important than calorie count for heart health: study. (2015, August 28, 2015).  Relaxnews.  Retrieved from http://news.yahoo.com/nutritional-value-more-important-calorie-count-heart-health-142931894.html

Nutritionists suggest that it’s better to look at the nutritional value of food instead of counting calories despite pleas from the food and weight loss industries that call for counting calories since dietary “adjustments”, such as adding omega-3 fatty acid fish, like salmon, sardines, and tuna, olive oil and nuts [a. k. a. the Mediterranean diet] can make “significant positive changes to heart health” in a short time” (Nutritional value, 2015, August 28, para. 2-4 & 13).

For example, drinking one sugary beverage daily (at about 150 calories) raises the risk of diabetes, but eating a handful of nuts reduced the risk for cardiovascular disease Four tablespoons of extra virgin olive oil works as well, although this amount of olive oil contains 500 calories (Nutritional value, 2015, August 28, para. 5-7). 

Furthermore, a trial called Action for Health in Diabetes has shown that cutting calories and exercising doesn’t correlate with a reduced risk of cardiovascular disease despite weight loss over 13.5 years (Nutritional value, 2015, August 28, para. 8).

Accordingly, nutritionists are shifting away from counting calories and instead pushing the idea that food quality will reduce obesity and its associated diseases, like Type 2 diabetes, as well as cardiovascular disease. They are also placing the blame for these diseases on bad diet (Nutritional value, 2015, August 28, para. 9-10). 

These findings have also caused some proponents of this viewpoint to ask governments to impose a tax on sugar drinks as well as subsidizing the consumption of fruits, vegetables and nuts (Nutritional value, 2015, August 28, para. 11). 

See also:

Hearti-facts:  Good nutrition reduces the risk of heart disease. (2015). Texas Heart Institute. Retrieved from http://www.texasheart.org/HIC/Topics/HSmart/nutriti1.cfm

The Texas Heart Institute maintains that a well-balanced diet simultaneously reduces the risk of heart disease, lowers cholesterol and blood pressure, and helps dieters lose weight:

1. Decrease portion size, cutting portions in half;
2. Eat more fruits and vegetables, choosing from at least five servings of fresh fruit and vegetables daily;
3. Just say no to sugary sodas and fruit drinks that aren’t 100 percent fruit;
4. Reduce salt intake, reading food labels of canned and packaged products; Reduce saturated fat by eat less red meat and high-fat dairy products;
5. “Treat treats as treats”, saving junk food for special occasions;
6. Substitute more healthy foods for less healthy ones, choosing whole grains, lean meats, and low-fat dairy products.

(Texas Heart Institute, 2015, para. 1-8)

The Texas Heart Institute goes on to educate readers in detail about how to follow a heart-healthy diet and lifestyle.

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Avoiding Binge Eating: Ending Emotional Dependence on Food

Be forewarned, however, that feeling deprived causes binge eating.  Using smaller plates and serving up lots of carbohydrates are ways to sate appetite without causing binge eating. 

*Polivy, Janet, Herman, C. Peter, and Rajbir Deo.  (2010, December). Getting a bigger slice of the pie. Effects on eating and emotion in restrained and unrestrained eaters.  Appetite. 55(3), 426-430. doi:10.1016/j.appet.2010.07.015.  [Abstract only].  Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20691231

Participants in this study all received the same size slice of pizza, but for one-third of them, their slice appeared larger than the one someone else was eating, one third of them received a slice of pizza that they thought was smaller, and a third didn’t see a second slice.  After scarfing down a slice of pizza, everyone could sample some “taste and rate” cookies”.  When restrained-study participants thought they had received a large pizza slice, they usually ate more cookies than their unrestrained counterparts. 

Indeed, going on too low a calorie diet increases both stress and cortisol production.

*Jakubowicza, Daniela, Froyb, Oren, and Wainsteina, Julio. (2012, March 10). Corrigendum to meal timing and composition influence ghrelin levels, appetite scores and weight loss maintenance in overweight and obese adults.  Steroids. 77(4), 323-331.  doi:10.1016/j.steroids.2011.12.006.  [Full text].   Retrieved from

_{http://www.researchgate.net/publication/51896834_Corrigendum_to_Meal_timing_and_composition_influence_ghrelin_levels_appetite_scores_and_weight_loss_maintenance_in_overweight_and_obese_adults_Steroids_77_(2012)_323331}

Weight lost by dieting often results in a “compensatory increase” in hunger as well as decreased ghrelin suppression that causes eventual weight gain.  However, a high protein and carbohydrate breakfast may prevent dieters from regaining weight, according to a randomized study of sedentary, non-diabetic men and women who either ate a low carbohydrate breakfast or a high carbohydrate and protein diet, according to a 32-week study of 193 obese dieters. While at week 16, both groups lost a similar amount of weight (15.1 pounds for the low carbohydrate group and 13.5 pounds  for the high carbohydrate and protein group), but from week 16 to week 32, the low carbohydrate group regained 11.6 pounds while the high carbohydrate and protein group lost an additional 6.9 pounds. 

In other words, Mom was right:  Always eat a good breakfast. Moreover, playing outside after school instead of watching reruns of Gilligan’s Island helped keep off the pounds.

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*Tomiyama, A. J., Mann, T., and Vinas, D. (2010, April 5). Low calorie dieting increases cortisol. Psychosomatic Medicine. 72(4):357-64. doi: 10.1097/PSY.0b013e3181d9523c. Epub 2010 Apr 5. [Full text].  Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/?term=Low+calorie+dieting+increases+cortisol.

Tomiyama, et al, determined that dieting and the restriction of calorie intake is not effective because it increases chronic psychological stress and cortisol production, which, in turn, lead to weight gain after monitoring 121 female participants  whom researchers randomly assigned to one of four dietary interventions for three weeks: A monitoring and restrict group restricted their calorie intake to 1200 calorie a day; a monitoring only group tracked their calories but ate normally; a restricted group was provided with 1200 calories per day, but didn’t track their calories, and a control group ate normally. Restricting calories increased the output of cortisol while monitoring calories increased stress. 

Reference:

Selig, Meg. (2010, October 21).  Why Diets Don't Work . . . And What Does: For lifelong weight loss, lose the diet.  Psychology Today.  Retrieved from https://www.psychologytoday.com/blog/changepower/201010/why-diets-dont-workand-what-does

Meg Selig, the author of Changepower! 37 Secrets to Habit Change Success, is against dieting for weight loss, especially among college students, because following a diet is “a temporary and highly restrictive program of eating in order to lose weight”—a fix that doesn’t work for several reasons (2010, October 21, para. 2-3 & 5):

• Approximately 95 percent of dieters regain their weight within one to five years.  Furthermore, restrictive diets lead to a diet-binge cycle (Selig, 2010, October 21, para. 6).

• Fad diets that often lack the appropriate nutrients don’t teach healthy eating.  Thus, dieters began yo-yo dieting that can cause further health problems (Selig, 2010, October 21, para. 7).

• Why sacrifice the pleasure of eating to lose weight (Selig, 2010, October 21, para. 8).

• ·Dieters are eight times more likely to develop an eating disorder than diners who emphasize a healthy-eating lifestyle (Selig, 2010, October 21, para. 9).

•  Diet drugs and weight-loss potions can cause health problems (Selig, 2010, October 21, para. 10).

• All too often, obesity is caused by early life trauma, so in many cases, overeating isn’t the problem but a solution to a problem (Selig, 2010, October 21, para. 11).

• That said, controlling portions and skipping deserts to look svelte for a special occasion is healthy, but skipping meals and starving isn’t (Selig, 2010, October 21, para. 14).

• Permanent weigh loss means developing a lifelong healthy eating and regular exercise plan (Selig, 2010, October 21, para. 15).

References:

Diet and obesity/weight loss. (2014). Statistics:  Understanding statistics on eating disorders. NEDIC. Retrieved from http://www.nedic.ca/knowthefacts/statistics.shtml

More than one half of all adolescent girls and one third of adolescent boys use unhealthy weight control behaviors to lose weight.  Moreover, overweight teens are more likely to be binge eaters than normal weight teens. Early “body dissatisfaction and weigh change behavior” predict later physical and psychological health problems (NEDIC, 2O14, para. 26-28).

Matz, Judith. (2010, July/August).  In consultation.  Psychotherapy Networker.  Retrieved from http://ns1.psychotherapynetworker.org/magazine/recentissues/2010-julyaug/item/923-in-consultation/923-in-consultation?start=1

Because emotional s tress often triggers overeating, developing a non-dieting approach to overeating is more likely to help overweight individuals lose weight and keep it off than dieting since usually the primary causes of overeating are a feeling of deprivation and the use of food to assuage a sense of loss (Matz, 2010, July/August, p. 1-2). 

To gain control, overweight people needs to end their emotional dependence on food and listen to internal cues about hunger and satiation, This process called “attuned eating” or “intuitive”, “mindful” or “normal” eating takes time.  But eventually, those who originally turned to food for emotional support deal with the psychological problems they need to confront (Matz, 2010, July/August, p. 3-4).

Wylie, Mary Sykes. (2010, September/ October). As the twig is bent. Psychotherapy Networker.  Retrieved from http://www.psychotherapynetworker.org/magazine/currentissue/1107-as-the-twig-is-bent

A “path-breaking epidemiological survey, the Adverse Childhood Experience Study (ACE), discovered quite by accident that surviving a dysfunctional family in childhood can result in later-life medical illness after researchers interviewed over 17,000 Kaiser Permanente members about their childhood experiences as part of a weight-loss program that went awry (Wylie, 2010, September/ October, para. 1-3).

. 

During the mid-1980s, the founder of Kaiser Permanente’s Department of Preventive Medicine started overseeing an obesity-treatment program based on “absolute fasting”.  Originally, the program was a “smashing success” particularly among the “morbidly obese”, although those who had lost a great deal of weight were more likely to drop out, regaining all they had lost (Wylie, 2010, September/October, para. 3-6).

This yo-yo dieting resulted from secrets the truly obese were hesitant to reveal—their childhoods were full of emotional trauma, so overeating wasn’t the problem but an attempted solution to soothe much older distress (Wylie, 2010, September/ October, para. 11-12). 

Although most of Felitti’s colleagues ridiculed his findings, Robert Anda, an epidemiologist with the Centers for Disease Control, asked him to conduct a larger epidemiological study (Wylie, 2010, September/October para. 13).  Hence, Felitti and Anda researched the psycho-social origins of such unhealthy behaviors as overeating, alcohol and drug abuse, smoking and high risk sexual activities, in a study of 17,337 Kaiser Permanente patients, most of whom were middle-aged, middle-class Caucasians (Wylie, 2010, September/October, para. 14-15). 

Stunningly, the effects of mistreatment in childhood had an impact on adult health 40 and 50 years later (Wylie, 2010, September/October, para. 16). Indeed, 66 percent of the sampling had suffered from mistreatment or family dysfunction as children.  Moreover, in the years since the ACE project started, over 60 plus peer-review articles have substantiated these findings (Wylie, 2010, September/October, para. 17-18). 

Thus, childhood adversity increases the risk for a host of illnesses, conditions and disabilities—heart and lung disease, autoimmune disease, liver disease, cancer, obesity, sexually transmitted infections and chronic pain because as adults they are still “hooked” on self-soothing” oral habits, like smoking, drinking, overeating, as well as promiscuous sex, and drug abuse:  These long-term addictions started out as temporary fixes to cure loss of self-esteem and loneliness (Wylie, 2010, September/October, para. 20-22). 

However, as of yet, most physicians are unwilling to accept the idea that biomedical conditions may have originated as physiological stress decades earlier perhaps because they can’t allot the time to turn a checkup into a long session on the psychiatrist’s couch (Wylie, 2010, September/October, para. 23-25). 

Kaiser Permanente doctors, however, with some coaching have learned how to broach sensitive psychological issues with very successful results, including a 35 percent drop in doctor’s visits, an 11 percent drop in emergency room visits, and a three percent drop in hospital admissions (Wylie, 2010, September/October, para. 26).  Even so, without any outpatient follow up, the cycle of ill-health on the way to diabetes and other chronic diseases begins again (Wylie, 2010, September/October, para. 27-28). 

Although the morbidly obese are more likely to have had a traumatic childhood than the general population, almost everyone turns at time to high-calorie comfort foods. But the good news is, it doesn’t really matter what diet overweight adults adopt since any heart healthy diet can help dieters lose weight as long as they reduce portion sizes and/or calorie intake.

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Reduced Calories = Weight Loss

Losing weight means doing some math!

Sacks, Frank M., Bray, George A., Carey, Vincent J., et al.  (2009, February 26).  Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates.  New England Journal of Medicine.  360 (9), 859-873.  doi: 10.1056/NEJMoa0804748.  [Full text].  Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMoa0804748

Researchers randomly assigned 811 overweight adults to one of four diets, all of which met the guidelines for cardiovascular health, but each one emphasized different percentages of fats, proteins, and carbohydrates, while reducing calorie intake.  At the end of two years, all dieters had lost weight regardless of the nutrients emphasized. Satiety, hunger, and satisfaction were similar in all four heart-healthy diets. 

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Bottom Line:  Any diet that reduces calories helps dieters lose weight regardless of the foods it emphasizes. Then again, the “experts” also are more than welling to dispense advice based on their own experience:

Skopec, Christine. (2015, August 29).  The best weight loss advice I have ever received.  Health & Fitness Cheat Sheet.  Retrieved from http://www.cheatsheet.com/health-fitness/the-best-weight-loss-advice-i-have-ever-received.html/1

After speaking with seven health professionals who have also had to battle their own weight gain, Skopec shares their advice:

• Shake things up:  Exercise in a way you’ve never exercised before and do it often;

• Hit the weight room:  The more muscular a body is, the more fat one burns;

• Make your meals more colorful:  Never eat anything white, including white bread,pasta, and rice;

•   Get in the kitchen:  Home cooking givers dieters better control over food choices and portions; 

• Cut back on cardio: Start lifting weights [in addition to getting in about 20 minutes of aerobic exercise daily for the heart];

• Say no to junk: Eliminate processed foods;

• Enjoy yourself:  Have a positive relationship with food.

(Skopec, 2015, August 29, para. 2-8)

When dieting, however, don’t overdo it, else all the weight lost will eventually come back:

Taibesaurg, Gary. (2015, August 29).  Diet advice that ignores hunger. Sunday Review | Opinion.  New York Times.  Retrieved from http://www.nytimes.com/2015/08/30/opinion/diet-advice-that-ignores-hunger.html?_r=0

For 24 weeks during the Second World War, researchers at the University of Minnesota fed conscientious objectors not quite 1,600 calories a day to represent the diet of famine areas in Europe in what today would be considered a low fat, low calorie diet (Taibesaurg, 2015, August 29, para. 1-2).  The men lost an average of a pound of body fat per week over the first twelve weeks, but only averaged a weight loss of a quarter pound a week for the next 12 weeks while their metabolism slowed (Taibesaurg, 2015, August 29, para. 4). They also became depressed, lethargic, and irritable and lost their sex drive while developing “semi-starvation neurosis” (Taibesaurg, 2015, August 29, para. 5).

When this period of starvation ended, and they were allowed to eat more food, they regained their weight, and after 20 weeks of recovery, the men averaged 50 percent more body fat than when they had begun (Taibesaurg, 2015, August 29, para. 6). 

Paradoxically, today most health and government organizations advise the obese and overweight to do what the conscious objector did—Eat less, cut back on calorie, assuming that “the ensuing huger  . . . will be an easily bearable burden . . . not just for 24 weeks, but a lifetime (Taibesaurg, 2015, August 29, para. 7). 

Similarly, researchers for the National Institutes of Health confined obese subjects to a hospital ward, putting them on a diet of around 1,920 calorie a day of either 29 percent carbohydrates and 50 percent fat or 71 percent carbohydrates and 8 percent fat for six days (Taibesaurg, 2015, August 28, para. 8-9).  The subjects lost more weight by restricting fats instead of carbohydrates, although the Food and Agriculture organization of the United Nations maintains that a lower limit of 15 percent fat is the survival limit (Taibesaurg, 2015, August 28, para. 10-11).

Moreover, Taibesaurg laments that the researcher failed to consider whether study participants might be hungrier on one diet than another particularly since calorie deprivation is “unsustainable”  (2015, August 28, para. 13-14).

The trick is to lose weight without hunger, so diets can be sustained indefinitely. This has always been the selling point of carbohydrate-restricted diets since dieters can then eat until they have sated themselves as long as they avoid carbohydrates (2015, August 28, para. 15). 

However this raises some questions, for example, if people on carbohydrate-restricted diets eat less, why aren’t they hungry.  Here, Taibesaurg posits this implies a mechanism for weight loss other than calorie deprivation (2015, August 28, para. 16). 

Unfortunately, however, medical authorities so believe in the eat less, move more theory that they fault the obese for their excess weight—a feat that can’t be kept up in the long run.  “The obesity epidemic suggests that it has failed” (Taibesaurg, 2015, August 28, para. 17-18).  

This means that adhering to a healthy diet and exercise plan is a lifelong commitment that will ensure cardiovascular and cognitive health—not to mention fitting into a small dress size in time for high school reunions.

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Addendum

January 22, 2016

Roizen, Michael and Oz, Mehmet. (2016, January 22). It's official: The best blood pressure number is . . . Sharecare. Retrieved from https://www.sharecare.com/health/circulatory-system/article/official-best-blood-pressure-number?cbr=cor_hhQ12016&cmpid=sc-ra-em-00-up-01212016&eid=1100007902&memberid=14346840&_sid=07d991a9-6f16-4360-bde2-4fa3a3362c4b

Lower is better! Roizen and Oz advocate a healthy blood pressure goal of 115 over 76 (Roizen, 2016, para. 1 & 3).

Six steps to lower it:

1. Get a reading: Every six months, have your blood pressure checked (at a doctor's office [or at a local pharmacy].

2. 
   

   
   

   
   

   
   

   Don't settle for a so-so number.
3. Eat pressure-lowering food:Opt for low-fat or fat-free dairy products and potassium-rich fruits and vegetables.
4. Do a salt check. Eating fresh vegetables instead of processed foods lowers salt content.
5. Hit the walking trail or the gym: Three ten-minutes walks per day is the equivalent of thirty minutes of exercise.
6. Take your meds.

(Roizen, 2016, para. 5-10)