Major new study - Not all foods are equal

Isocaloric does not equal isometabolic. Those are the big words for the day. 

Not all calories are equal. There are now officially good foods and bad foods. "Eat less, exercise more" is officially disproven as the key to weight loss. Exercise matters, of course, but what you eat matters more.

A major study following upwards of 100,000 well-educated Americans for more than a decade was just released by Harvard University. The study did not stop with diet alone but also focused on exercise and other daily habits.

The abstract from the New England Journal of Medicine is dense with statistics but the plain words speak very plainly. Eating potato chips, potatoes, sugar sweetened beverages, unprocessed red meats and processed meats will make you gain weight over the years. Eating vegetables, whole grains, fruits, nuts, and yogurt will not.

From the NY Times article by Jane Brody:

The new research, by five nutrition and public health experts at Harvard University, is by far the most detailed long-term analysis of the factors that influence weight gain, involving 120,877 well-educated men and women who were healthy and not obese at the start of the study. In addition to diet, it has important things to say about exercise, sleep, television watching, smoking and alcohol intake.
       
The study participants — nurses, doctors, dentists and veterinarians in the Nurses’ Health Study, Nurses’ Health Study II and the Health Professionals Follow-up Study — were followed for 12 to 20 years. Every two years, they completed very detailed questionnaires about their eating and other habits and current weight. The fascinating results were published in June in The New England Journal of Medicine.

The analysis examined how an array of factors influenced weight gain or loss during each four-year period of the study. The average participant gained 3.35 pounds every four years, for a total weight gain of 16.8 pounds in 20 years.

“This study shows that conventional wisdom — to eat everything in moderation, eat fewer calories and avoid fatty foods — isn’t the best approach,” Dr. Dariush Mozaffarian, a cardiologist and epidemiologist at the Harvard School of Public Health and lead author of the study, said in an interview. “What you eat makes quite a difference. Just counting calories won’t matter much unless you look at the kinds of calories you’re eating.”
       
Dr. Frank B. Hu, a nutrition expert at the Harvard School of Public Health and a co-author of the new analysis, said: “In the past, too much emphasis has been put on single factors in the diet. But looking for a magic bullet hasn’t solved the problem of obesity.”

Also untrue, Dr. Mozaffarian said, is the food industry’s claim that there’s no such thing as a bad food.
       
“There are good foods and bad foods, and the advice should be to eat the good foods more and the bad foods less,” he said. “The notion that it’s O.K. to eat everything in moderation is just an excuse to eat whatever you want.”

The study showed that physical activity had the expected benefits for weight control. Those who exercised less over the course of the study tended to gain weight, while those who increased their activity didn’t. Those with the greatest increase in physical activity gained 1.76 fewer pounds than the rest of the participants within each four-year period.

But the researchers found that the kinds of foods people ate had a larger effect over all than changes in physical activity.

“Both physical activity and diet are important to weight control, but if you are fairly active and ignore diet, you can still gain weight,” said Dr. Walter Willett, chairman of the nutrition department at the Harvard School of Public Health and a co-author of the study.

As Dr. Mozaffarian observed, “Physical activity in the United States is poor, but diet is even worse.”

New England Journal of Medicine abstract:
Within each 4-year period, participants gained an average of 3.35 lb (5th to 95th percentile, −4.1 to 12.4). On the basis of increased daily servings of individual dietary components, 4-year weight change was most strongly associated with the intake of potato chips (1.69 lb), potatoes (1.28 lb), sugar-sweetened beverages (1.00 lb), unprocessed red meats (0.95 lb), and processed meats (0.93 lb) and was inversely associated with the intake of vegetables (−0.22 lb), whole grains (−0.37 lb), fruits (−0.49 lb), nuts (−0.57 lb), and yogurt (−0.82 lb) (P≤0.005 for each comparison). Aggregate dietary changes were associated with substantial differences in weight change (3.93 lb across quintiles of dietary change). Other lifestyle factors were also independently associated with weight change (P<0.001), including physical activity (−1.76 lb across quintiles); alcohol use (0.41 lb per drink per day), smoking (new quitters, 5.17 lb; former smokers, 0.14 lb), sleep (more weight gain with <6 or >8 hours of sleep), and television watching (0.31 lb per hour per day).

Amy Winehouse - another victim

I am strangely moved by the death of Amy Winehouse. It brings to mind the 27-year-olds that my generation lost: Janis Joplin, Jimi Hendrix, Jim Morrison.

But, more than that, it highlights something Freud talked about, an idea I find incomprehensible but intermittently sense as true. There is some dark link between certain pleasures and love of death.

Addiction kills. There comes a time when when what started out as "fun" slides into self-destruction.  Any addiction is a progressive, deadly disease. And, frankly, that includes food addiction.

Amy herself seemed to glimpse the idea that health is the antidote to addiction. But she rejected it, still hoping that "fun" would become fun again.

From journalist Chris Wilman's interview with Winehouse.

Q: The label went with another single before "Rehab," and I wondered if it's because they were nervous because Americans are conflicted with our attitudes about consumption.

A: "I don't know. Everyone knows that there's certain things that aren't good for you, but there's a fine line between enjoying yourself and being completely healthy. Or do you know what I mean? You can only be healthy to a point, where you're not having fun anymore. Does that make sense?"

I no longer believe that being healthy means you are not having fun.

But then I am no longer 27 either.

Progress, not perfection

Looking forward very much to tonight's first class with Jane Van Benthsen. We are starting a 12 week series of education and motivation.

I am a total believer in the power of supporting groups to accelerate and solidify any change a person is trying to make. Together we can do far more than we can alone.

Meanwhile, I found these pictures on Facebook that let me judge how far I have come. I was disappointed with how I looked in June -- until I compared it with how I looked last Christmas.

God is good.

The June picture was taken in Atchinson by the Missouri River.
The very next day this spot was under water. And not by just a little.

Exercise plays a role

In addition to changing the kind of food I am putting into my body, I trying to change the way I move my body as well. One of the promises of the program is that you will feel more energetic and that exercise will be something that you want to do, not something that you are forced to do.

I am waiting for that magic moment.

But I will say that this evening I actually exercised on my own. No class. No teacher. No schedule. Just because I wanted to.

This is the first time in a long time.  Once in a row.

I moved along with the Dragon's Way Qigong DVD.  The Dragon's Way is a stress reduction and weight loss program by Dr. Nan Lu, founder of the Traditional Chinese Medicine World Foundation. The idea is to open up the various joints in the body and to allow energy to flow. It promotes flexibility in the hips, knees, ankles, waist, arms and neck.

Dr. Lu makes it look easy - but I have sweat running down my back by the time the 20 minute exercise cycle is finished.

I can't balance on one leg for the life of me. I suppose that will come. In time. If I keep after it.

Just for full disclosure: in addition to want-to exercises, I go to two Pilates classes a week. This is for core strength and flexibility.

I find I need a scheduled class to make me show up at the gym. The gym at work offers Pilates classes and I take them so I will actually walk through the door of the gym. Other than that, I buy memberships and do not go.

And I kind of like Pilates because, in my experience, nothing targets core musculature as well as Pilates does.

I sure am the worst one in the class, though. Maybe I can be in the running for Most Improved. Or Most Humbled.

This is NOT me. It is a pretty good picture of The Hundreds, though. Ask me about The Hundreds. Whew.

I follow up Pilates with a 40 minute routine on the weight machines. No one makes me do this either. It is kind of a dessert for me. I like working with weights.

Right now, then, I have two structured exercise days a week. This is not enough. I am looking for something else to work in.

I am hoping that somehow someday I will find an exercise program or sport to fall in love with.

Our story so far

It's about two months into this journey. Where am I exactly?

Food: I am sticking to Dr. Joel Fuhrman's basic plan of gluten-free, sugar-free(ish), animal-free, low salt, low oil, high veggie eating. I am more or less doing OK on it. I am not doing too well on the four fruits per day or on the pound of cooked vegetables per day. I am probably over-eating on grains and beans - chiefly lentils. But I am not giving it up.

Weight-loss: Down about 20 pounds. Have been at the same weight for almost two weeks - due, I think, to under-eating vegetables and over-eating grains and beans.

Arthritis: It was arthritis pain that got me in to all this. During my late-April, early-May trip to Wales, I was less able than anyone on the trip, even an 80-year-old woman with a hip replacement -- and two canes. Man. This led to considerable emotional pain in addition to the physical pain. And we all know that pain drives change.

The desire to change led me to this plan of eating. It is supposed to reduce all sorts of inflammation - including arthritis.

The verdict? I wish there was such a thing as a painOmeter. If I had one, I could say, for example, that I was a 47 in early May and am a 34 now.

But I can only report anecdotally.

I feel somewhat more pain-free.

(It is my understanding that human beings are incapable of fully remembering pain. We can remember that we felt pain. But cannot re-experience it. Good thing, too. But it makes even my subjective evaluation a little imprecise.)

I seem to be able to walk better. At least I do not stop to contemplate and evaluate before attempting to walk. I just set out walking, much as I imagine "normal" people do. I seem to experience less pain trying to sleep. I have not had to take Advil in order to sleep in weeks.

As an example of the improvement, the other day while having a shiatsu massage I was able to lie on my back without putting a pillow under my knees. That is a Big Deal to me. It has been a very long time since I was able to do that.

In general, I am encouraged.

Blood Pressure: Another claim of the diet is that it will reduce high blood pressure. I had mine taken the other day and was disappointed in the result.

I ran out of blood pressure meds while on vacation and did not refill the prescription, hoping for a change brought on by diet and exercise. No such luck. At least so far.

I had my prescription refilled on Sunday.

I will report more as I know more.

Support System: I am convinced that people need a support group in order to be successful in making any significant change. So I am seeking one out.  Or perhaps it is seeking me?

I saw the movie Fat, Sick and Nearly Dead before heading out on vacation. There I met Jane Van Benthusen of the Kansas City Raw Foods Union and Green St. Goods who was speaking at the screening. She told her story of losing 80 pounds and curing her cervical cancer through an earth-based diet, using raw foods and juice.

That movie was the beginning of my mental change. So Jane has been a distant presence and Facebook acquaintance throughout this journey.

On July 12 she is starting up a weekly Health and Happiness support and motivation group at the Westside Temple. (She is doing a Sunday night group in Lee's Summit as well. I just live closer to the Westside than to Lee's Summit.)

She promised to share recipes, motivation and little treats. I could use some recipes, motivation and little treats. I plan to be there. It is only a 12 week commitment so it is not too scary.

Oh, and I am going to start up juicing again in a few days, I think. Maybe a three or four day juice fast to get back on track? Stay tuned.