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The Key to Weight Loss Is Diet Quality, Not Quantity, a New Study Finds

Anyone who has ever been on a diet knows that the standard prescription for weight loss is to reduce the amount of calories you consume.

But a new study, published Tuesday in JAMA, may turn that advice on its head. It found that people who cut back on added sugar, refined grains and highly processed foods while concentrating on eating plenty of vegetables and whole foods — without worrying about counting calories or limiting portion sizes — lost significant amounts of weight over the course of a year.

The strategy worked for people whether they followed diets that were mostly low in fat or mostly low in carbohydrates. And their success did not appear to be influenced by their genetics or their insulin-response to carbohydrates, a finding that casts doubt on the increasingly popular idea that different diets should be recommended to people based on their DNA makeup or on their tolerance for carbs or fat.

The research lends strong support to the notion that diet quality, not quantity, is what helps people lose and manage their weight most easily in the long run. It also suggests that health authorities should shift away from telling the public to obsess over calories and instead encourage Americans to avoid processed foods that are made with refined starches and added sugar, like bagels, white bread, refined flour and sugary snacks and beverages, said Dr. Dariush Mozaffarian, a cardiologist and dean of the Friedman School of Nutrition Science and Policy at Tufts University.

“This is the road map to reducing the obesity epidemic in the United States,” said Dr. Mozaffarian, who was not involved in the new study. “It’s time for U.S. and other national policies to stop focusing on calories and calorie counting.”

The new research was published in JAMA and led by Christopher D. Gardner, the director of nutrition studies at the Stanford Prevention Research Center. It was a large and expensive trial, carried out on more than 600 people with $8 million in funding from the National Institutes of Health, the Nutrition Science Initiative and other groups.

Dr. Gardner and his colleagues designed the study to compare how overweight and obese people would fare on low-carbohydrate and low-fat diets. But they also wanted to test the hypothesis — suggested by previous studies — that some people are predisposed to do better on one diet over the other depending on their genetics and their ability to metabolize carbs and fat. A growing number of services have capitalized on this idea by offering people personalized nutrition advice tailored to their genotypes.

The researchers recruited adults from the Bay Area and split them into two diet groups, which were called “healthy” low carb and “healthy” low fat. Members of both groups attended classes with dietitians where they were trained to eat nutrient-dense, minimally processed whole foods, cooked at home whenever possible.

Soft drinks, fruit juice, muffins, white rice and white bread are technically low in fat, for example, but the low-fat group was told to avoid those things and eat foods like brown rice, barley, steel-cut oats, lentils, lean meats, low-fat dairy products, quinoa, fresh fruit and legumes. The low-carb group was trained to choose nutritious foods like olive oil, salmon, avocados, hard cheeses, vegetables, nut butters, nuts and seeds, and grass-fed and pasture-raised animal foods.

The participants were encouraged to meet the federal guidelines for physical activity but did not generally increase their exercise levels, Dr. Gardner said. In classes with the dietitians, most of the time was spent discussing food and behavioral strategies to support their dietary changes.

The new study stands apart from many previous weight-loss trials because it did not set extremely restrictive carbohydrate, fat or caloric limits on people and emphasized that they focus on eating whole or “real” foods — as much as they needed to avoid feeling hungry.

“The unique thing is that we didn’t ever set a number for them to follow,” Dr. Gardner said.

Of course, many dieters regain what they lose, and this study cannot establish whether participants will be able to sustain their new habits. While people on average lost a significant amount of weight in the study, there was also wide variability in both groups. Some people gained weight, and some lost as much as 50 to 60 pounds. Dr. Gardner said that the people who lost the most weight reported that the study had “changed their relationship with food.” They no longer ate in their cars or in front of their television screens, and they were cooking more at home and sitting down to eat dinner with their families, for example.

“We really stressed to both groups again and again that we wanted them to eat high-quality foods,” Dr. Gardner said. “We told them all that we wanted them to minimize added sugar and refined grains and eat more vegetables and whole foods. We said, ‘Don’t go out and buy a low-fat brownie just because it says low fat. And those low-carb chips — don’t buy them, because they’re still chips and that’s gaming the system.’”

In a new study, people who ate lots of vegetables and whole foods
rather than processed ones lost weight without worrying about calories or portion size.

Dr. Gardner said many of the people in the study were surprised — and relieved — that they did not have to restrict or even think about calories.

“A couple weeks into the study people were asking when we were going to tell them how many calories to cut back on,” he said. “And months into the study they said, ‘Thank you! We’ve had to do that so many times in the past.’”

Calorie counting has long been ingrained in the prevailing nutrition and weight loss advice. The Centers for Disease Control and Prevention, for example, tells people who are trying to lose weight to “write down the foods you eat and the beverages you drink, plus the calories they have, each day,” while making an effort to restrict the amount of calories they eat and increasing the amount of calories they burn through physical activity.

“Weight management is all about balancing the number of calories you take in with the number your body uses or burns off,” the agency says.

Yet the new study found that after one year of focusing on food quality, not calories, the two groups lost substantial amounts of weight. On average, the members of the low-carb group lost just over 13 pounds, while those in the low-fat group lost about 11.7 pounds. Both groups also saw improvements in other health markers, like reductions in their waist sizes, body fat, and blood sugar and blood pressure levels.

The researchers took DNA samples from each subject and analyzed a group of genetic variants that influence fat and carbohydrate metabolism. Ultimately the subjects’ genotypes did not appear to influence their responses to the diets.

The researchers also looked at whether people who secreted higher levels of insulin in response to carbohydrate intake — a barometer of insulin resistance — did better on the low-carb diet. Surprisingly, they did not, Dr. Gardner said, which was somewhat disappointing.

“It would have been sweet to say we have a simple clinical test that will point out whether you’re insulin resistant or not and whether you should eat more or less carbs,” he added.

Dr. Walter Willett, chairman of the nutrition department at the Harvard T. H. Chan School of Public Health, said the study did not support a “precision medicine” approach to nutrition, but that future studies would be likely to look at many other genetic factors that could be significant. He said the most important message of the study was that a “high quality diet” produced substantial weight loss and that the percentage of calories from fat or carbs did not matter, which is consistent with other studies, including many that show that eating healthy fats and carbs can help prevent heart disease, diabetes and other diseases.

“The bottom line: Diet quality is important for both weight control and long-term well-being,” he said.

Dr. Gardner said it is not that calories don’t matter. After all, both groups ultimately ended up consuming fewer calories on average by the end of the study, even though they were not conscious of it. The point is that they did this by focusing on nutritious whole foods that satisfied their hunger.

“I think one place we go wrong is telling people to figure out how many calories they eat and then telling them to cut back on 500 calories, which makes them miserable,” he said. “We really need to focus on that foundational diet, which is more vegetables, more whole foods, less added sugar and less refined grains.”

By ANAHAD O’CONNOR      FEB. 20, 2018
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Gut Bacteria can Directly Affect Anxiety, Behavior and Emotional Health

4 Tips to Balance your Gut from a Holistic Therapist.

When treating those with anxiety, my clients and I work together to help balance different aspects of life: body, mind and spirit.  Science is showing us that cultivating good digestive health is a crucial piece of the treatment puzzle. Research is showing that the bacteria in your gut can directly affect your behavior and emotions…. This might be surprising for many, however it’s a critical, and often overlooked factor in treating anxiety. Healing and restoring balance to one’s digestive tract, ideally with the help of an integrative medical doctor can make a huge difference in symptoms. Your digestive tract can be damaged by chronic stress, medication use and exposure to foods that aren’t great for your body (to name a few). Many factors besides poor digestive health may contribute to your symptoms.  Maybe you’re in an unhealthy relationship, suffer from low self-esteem, struggle with panic attacks, or worry needlessly about little things.  No matter what the issues that are contributing to your anxiety, experiencing it can leave you feeling isolated, scared and mentally exhausted. When it comes to treating emotional distress, utilizing multiple agents of change is the most beneficial way to experience relief. For example, when treating anxiety, it’s extremely beneficial not only to receive therapy, but also to change your diet, exercise, patterns of self-talk, methods of self-care and introduce relaxation techniques.  Working on balancing your gut flora can be a very healing addition to the aforementioned therapies. While research is still emerging, science is supporting the idea that your gut bacteria affects your emotional health. Dr. Michael Gershon first brought this groundbreaking science to the public with his lab studies with rodents. He was first prompted to study the connection because of his interest in serotonin; 90% of our serotonin is produced and manufactured in the gut! He wrote, The Second Brain, which describes the role of the digestive tract in regulating emotional health and decision making.

Some fascinating research has been conducted to further this idea. Researchers swapped the bacteria in anxious mice and fearless mice by changing diet, adding antibiotics or adding probiotics. They found that the timid mice actually started taking more risks and acting more gregarious and the opposite also happened: the fearless mice acted more timid. In a 2013 study published in Gastroenterology, researchers studied the effects of probiotics in humans. After 4 weeks of ingesting probiotics, they scanned the brains of each participant. The researchers found subtle signs that the brain circuits involved in anxiety were less reactive.

probiotics

But, how do the brain and the gut communicate? The brain and the gut are in constant communication via the vagus nerve, a large nerve that connects the two. The concept of “gut feeling” and butterflies in your stomach is actually a real thing! In a study conducted in Ireland, researchers found that when the vagus nerve was cut in mice, they no longer saw the brain respond based on changes to the rodent’s gut flora.  Scientists have also begun to study certain neurochemicals that have not been described before being produced by certain bacteria, thus suggesting that gut microbes can produce their own version of neurotransmitters. This is another way that gut microbes may communicate with the brain. Pretty fascinating, right?!

Wondering how to nourish your digestive tract? Here are 4 tips.

1.)    Start eating more and more WHOLE foods. Limit processed foods, sugar, alcohol and caffeine. Choose fruits, veggies, whole grains, beans, and lean proteins.  Check out this article from Dr. Mark Hyman on the subject. Start with small changes. Choose a sweet potato instead of fries, eat half of your dessert rather than the whole plate, or order an open faced sandwich. Changes should feel do-able, not overwhelming and anxiety producing!

2.)    Increase your body/food awareness. Notice how you feel after eating. Take note of fatigue, bloating, anxiety, gas, reflux or any other symptoms that you might be experiencing. This will allow you to start mapping patterns and become aware of what foods might be troublesome for you. If you continually eat foods that don’t react well to your body, it can damage your delicate digestive lining and balance of good bacteria.  Log your findings for at least a week.

3.)    Eat foods rich in probiotics. This can include yogurt, kefir, fermented foods and sauerkraut.

4.)    Reduce Stress. Stress can damage your very thin digestive lining. Practice relaxation techniques, meditate, use positive self-talk and engage in activities that bring joy. Managing stress will help you to heal from the inside out and also reduce anxiety symptoms.

Most of all, if you are struggling with anxiety, reach out for help from a therapist who specializes in anxiety or your doctor. Relief from symptoms is possible!

Wishing you the best of health

By Meghan Toups MS            September 22, 2014

About the Author: Meghan Toups is a frequent contributor on Expanded Consciousness, she is a Nationally Certified Counselor and Licensed Professional Counselor in the state of Georgia. Meghan also received her health coaching certification and training from the Institute for Integrative Nutrition, where she was trained in more than one hundred dietary theories and studied a variety of practical lifestyle coaching methods. 


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12 Nutritionists Share the Top Tips They Give to Clients Trying to Lose Weight

Their best advice, on the house

Nutritionists have a lot of advice to give, especially around weight loss. But what are the number one tips they tell people who are trying to drop pounds?

We tapped 12 nutritionists for the answer—you might be surprised by what they said.

Be Nice to Yourself 
“Talk to yourself as if you were talking to a friend. All too often we revert to negative self-talk, especially when it comes to our bodies. ‘You look so fat in that’ might pop into your head when you talk to yourself, but you would never use such harsh words to someone dear to you. Try to be your biggest fan instead of your worst enemy. That negative talk could lead to apathy, overeating, and dietary sabotage.” —Bonnie Taub-Dix, R.D., author of  Read It Before You Eat It

Ask Yourself if You’re Really Hungry 
“Learn the difference between physical hunger and emotional hunger. Traditional diets cut calories, which can seem like a drastic change if you are used to eating more food than your body needs. When you feel deprived, it’s hard to find the motivation to continue, which is why most traditional diets fail. Instead, focus on fueling your body when you are hungry with healthy, nourishing foods. When you reach for a snack at 2 p.m. because you ‘always’ do, ask yourself if you’re really hungry or just bored, tired, or stressed. If you’re hungry, have a healthy snack. If you’re not, figure out what emotion is really going on and address that. Shifting the focus to this mindset makes weight loss so much easier.” —Alexandra Caspero, R.D., founder of Delicious Knowledge

Stop Dwelling on What You Shouldn’t Eat 
“Focus on the foods and drinks you should be saying ‘yes’ to, rather than focusing on ones you should cut. If your mantra is ‘no junk food,’ it’s likely that junk food—the very thing you are trying to avoid—is top-of-mind. Focusing on eating the healthy foods you love, like roasted cauliflower, pomegranate arils, or Sriracha hummus, makes you think about how to include them in your daily or weekly meals. That will help your unhealthy choices fall to the wayside.” —Tori Holthaus, R.D., founder of YES! Nutrition, LLC

Eat Whole, Not “Health” Foods 
“Weight loss will happen as a side effect of choosing whole foods that provide the nutrients you need. New research demonstrates that foods labeled as ‘healthy,’ like ‘healthy cookies,’ may be contributing to the obesity epidemic because people are more likely to overeat them.” —Brigid Titgemeier, R.D., registered dietitian nutritionist at Cleveland Clinic’s Center for Functional Medicine

weight-loss

Move More 
“Of course we have to watch our calories consumed, but how about focusing on calories expended? According to the Department of Health and Human Services’ Physical Activity Guidelines for Americans, adults need at least 150 minutes of moderate intensity physical activity each week. I recommend trying a combination of things such as strength training, cardiovascular training, and core work to increase activity and lose weight. Keep a journal of your active minutes each week, or use an app, to stay accountable and hit your minute goals. —Jim White, R.D., spokesperson for the Academy of Nutrition and Dietetics, and owner of Jim White Fitness and Nutrition Studios in Virginia

Don’t Ditch the Fat
“It’s a common misconception that you need to cut fat out of the diet to lose weight; however, omega-3s in fatty fish like salmon, and monounsaturated fatty acids in foods such as avocado and olive oil have been linked to healthier waistlines. Eat these healthy fats to increase satiety and lose weight more easily.” —Kelly Pritchett, Ph.D., R.D., assistant professor in nutrition and exercise science at Central Washington University

Make a Plan
“Planning is the key to weight loss, maintaining a healthy weight, and living a healthy lifestyle. Plan out your meals and snacks in advance, grocery shop based on those meals and snacks, prep food ahead of time, and think through the ways you can incorporate your favorite unhealthy foods in moderation. In my experience the people who plan are the ones that succeed.” —Wesley Delbridge, R.D., spokesperson for the Academy of Nutrition and Dietetics

Rework Your Favorite Meals 
“Don’t eliminate the foods you love. Instead, learn how to eat them in a healthier way. For example, don’t stop eating pasta. Add lots of veggies and lean protein, like shrimp, chicken, or beans to your pasta bowl, and avoid heavy, creamed sauces. Remember, the real win in weight loss is keeping the weight off, not just losing it quickly.” —Keri Gans, R.D., author of  The Small Change Diet

Make Changes You Can Stick With 
“Find a diet that is a lifestyle change you can embrace forever. Studies show that ‘diets’ don’t work because people don’t stay on them. A diet shouldn’t be something you go ‘on’ and ‘off.’ It should be something sustainable. It should be a way of eating for life—an eating pattern that doesn’t make you feel hungry, deprived, or obsessed with food.” —Sharon Palmer, R.D., author of Plant-Powered for Life

Follow Your Own Path 
“There is no one meal plan that will lead to sustainable weight loss in everyone. People have to find what works for them, based on their own needs and preferences. —Maria Elena Rodriguez R.D., program manager of The Mount Sinai Health System’s Diabetes Alliance

Don’t Forget Calories 
“No matter what plan you’re following, if you take in too much energy, it will get stored. When you’re aware of roughly how many calories you’ve eaten for breakfast and lunch, you’ll know if you can have some dessert after dinner. It’s kind of like a budget.” —Holly Herrington, R.D., dietitian at the Center for Lifestyle Medicine at Northwestern Medicine

Take Things Slow
“Don’t try to change everything about your diet at once. Start by making one improvement in what you’re eating or one improvement in how much you’re eating, but don’t try to change both at once. Ease into it, and you’ll find that the healthy changes you make become much more doable.” —Georgie Fear, R.D., author of “Lean Habits for Lifelong Weight Loss”

K. ALEISHA FETTERS    January 19, 2016