Go Kaleo » Weight Loss https://gokaleo.com Are you as tired of fad diets as I am? Thu, 14 Nov 2013 05:18:15 +0000 en-US hourly 1 http://wordpress.org/?v=3.7.1 What to Expect When You Stop Dieting Part 2: How Do I Do This https://gokaleo.com/2013/08/16/what-to-expect-when-you-stop-dieting-part-2-how-do-i-do-this/ https://gokaleo.com/2013/08/16/what-to-expect-when-you-stop-dieting-part-2-how-do-i-do-this/#comments Fri, 16 Aug 2013 20:57:02 +0000 https://gokaleo.com/?p=1570 Continue reading ]]>
Screen Shot 2013-08-16 at 10.16.52 AM
I really like Ellyn Satter‘s definition of ‘Normal Eating’:

 

Normal eating is going to the table hungry and eating until you are satisfied. It is being able to choose food you like and eat it and truly get enough of it -not just stop eating because you think you should. Normal eating is being able to give some thought to your food selection so you get nutritious food, but not being so wary and restrictive that you miss out on enjoyable food. Normal eating is giving yourself permission to eat sometimes because you are happy, sad or bored, or just because it feels good. Normal eating is mostly three meals a day, or four or five, or it can be choosing to munch along the way. It is leaving some cookies on the plate because you know you can have some again tomorrow, or it is eating more now because they taste so wonderful. Normal eating is overeating at times, feeling stuffed and uncomfortable. And it can be undereating at times and wishing you had more. Normal eating is trusting your body to make up for your mistakes in eating. Normal eating takes up some of your time and attention, but keeps its place as only one important area of your life.

In short, normal eating is flexible. It varies in response to your hunger, your schedule, your proximity to food and your feelings.

Some of the things I interpret from Satter’s description:

  • normal eating is being aware of hunger and satiety signals
  • eating foods you enjoy without guilt and shame
  • eating mostly nutritious food but having flexibility to include foods purely for pleasure
  • being aware of the emotional drives to eat, and allowing for them without guilt or shame
  • there is no one ‘right’ meal pattern – eat when works for YOU and your needs
  • being able to indulge without the compulsion to binge
  • eating to support your energy needs over time – with flexibility to eat more some days and less other days as your appetite and activity dictate
  • not obsessing over ‘slip-ups, cheats and mistakes’
  • not fixating on food and eating to the degree that it impacts your quality of life

Getting from here to there can seem like an insurmountable task though, especially when your ‘normal’ is following arbitrary, restrictive rules that someone else made up. Many very wise people have written about working toward Intuitive Eating (I linked to Ellyn Satter above, there is also Geneen Roth, Gwyneth Olwyn (who’s website I link to fairly regularly), the good people at Eat More to Weigh Less, Matt Stone and others, all of whom bring very valuable insight to the table. The recommendations I make here echo many of the recommendations of these other people, and I encourage you to explore their websites and publications.

I’d like to begin by referring you BACK to the first installment of this series, and reiterate the importance of seeking medical treatment if you have symptoms of disordered eating or malnutrition. Refeeding can be dangerous, even life-threatening, if your body is in a state of starvation. Medical supervision is necessary.

Many people, however, are not starving, they simply have a history of unnecessary restriction and unstable eating patterns. The goal here is to get out of the restriction mindset and stabilize your eating habits. I’m going to give you some guildelines to do that. The first order of business is stabilization. You may or may not lose weight here, you may even gain a little. I’ll discuss some of the normal stages of recovery in the next installment of this series. Weight change is not our initial focus, stabilization is. Once your eating and weight are stable, we can begin making small changes, if you want to change your weight. Again, our first task is stabilization. Some people stabilize in a few weeks, others take months, much is dependent on your history and health. The more extreme your dieting history, and the more unstable your health, the more likely it is that you need to be working with a treatment team.

So, here are some guidelines:

  • Acknowledge that there is an appropriate number of calories that your body needs to support your activity and a healthy weight. I talked about the fatal flaw in the ‘calories don’t matter’ paradigm so common in the fad diet world, and the very serious consequences of eating too few calories in my Adrenal Fatigue post here. Your body needs calories, and probably more than you realize, to support a healthy weight. Many fad diets short change you in the calorie department. A calculator that factors in your activity will give you a more realistic idea of your calorie needs than many of the calculators on dieting websites. Some of the best I’ve found are this one at Fat Secret, the Health-Calc here, and Scooby’s calculator here. If you’ve been dieting all your life, the numbers you see here will probably surprise you. Determine your calorie requirements, and eat to support them. It doesn’t have to be exact every day, but aim for a window near the figure the calculators give you. That way you will be supplying your body the energy it needs to meet the demands of day to day life. While eating intuitively is a goal, many people have lost touch with their hunger and satiety signals. Being aware of calorie intake can be a stepping stone toward reconnecting with those signals, by guiding proper portion sizes and ensuring adequate nutrient intake.
  • If you’ve been restricting for a long time, ease your calories up. Many ED professionals recommend adding 200-300 calories every 3 days or so until you reach your required intake. I’ve known people who’ve added calories as slowly as 25 calories per day per week, which I think is unnecessarily slow. I think it’s important to get to an adequate intake as soon as possible. 100 calories per day per week seems to be a good half-way point. So for example, you’d eat 1600 per day for a week, then 1700 per day for a week, then 1800 for a week, etc, until you get to your target. If you’re in treatment, follow your treatment team’s advice. Some people begin eating to their requirements right away, and I think this is probably best if you haven’t been highly restrictive.
  • Eat foods you want to eat*. Yes, seriously. Lift arbitrary restrictions. Some people believe that if they allow themselves to eat what they want, they will eat nothing but junk food. Some people DO eat nothing but junk food for a little while. The vast majority of people very quickly realize that eating nothing but junk food gets tedious, and their energy flails, and they begin to crave more nutritious foods. Every now and then a person comes along who really can eat nothing but junk food indefinitely – I believe that these people are dealing with disordered eating issues that require professional treatment. Most people enjoy a wide variety of foods including many that are very nutritious. Eat what you enjoy! Nutritious and indulgent, there is a place in a healthy diet for both. *If you are allergic to a food, that would qualify as a medical reason not to eat it. Avoiding foods that make you sick is obviously a reasonable ‘restriction’.Likewise, if you have a medical condition (such as Diabetes) that necessitates a specific dietary approach, work with your doctor and a Registered Dietician to implement that diet. Do NOT rely on ‘nutritionists’, diet books or bloggers for medical treatments.
  • Pay attention to how your body responds to the food you eat. This is really the only way to evolve into a way of eating that supports your unique goals and needs. Does it fill you up? Does it give you energy? Does it make you feel good? Bad? Do you LIKE it? Diet Culture has created many food villains, but there are very few foods that are inherently bad regardless of context. Even refined sugar and processed foods can be beneficial under some circumstances, such as recovery from starvation and malabsorption issues stemming from GI conditions, and as fuel for intense physical activity.
  • Get enough protein. This is really the only ‘food rule’ I follow, as it seems to be generally true across the board. If you are physically active, if you are recovering from restrictive dieting, if you are trying to lose weight…any of these conditions and more will increase your protein needs. The current DRI recommendation is quite modest, only .66 – .8 grams of protein per kg of bodyweight per day, but there is some indication that this is inadequate, and sports physiologists have long made higher recommendations. 1.3 – 1.8 grams per kg of bodyweight per day is probably a more realistic goal, and if you are engaging in strenuous activity or losing weight, increasing to 1.8+ grams per kilogram of bodyweight per day will probably be beneficial. I simplify this for my American clients by giving them a target of 1 gram per pound of bodyweight per day; this is more than they absolutely need, but few people actually meet that target, and aiming that high tends to ensure that they do meet their minimum requirements. Get your protein from protein rich foods you enjoy. If you eat mostly plant protein, you will need to eat a little more to ensure your body is able to get what it needs as plant protein is slightly less bioavailable. This doesn’t make it inferior, it just raises your intake requirements. There is nothing wrong with using a protein supplement if you’re having trouble getting enough from food alone. I give some tips for choosing a good protein supplement here.
  • Be patient. Changing your habits takes time, and there will be starts and stops and plateaus and mistakes along the way. These are all part of the process. It can take months, even a year, to see major changes, especially if you’ve been very restrictive in the past. Work toward consistency, balance and stability. That is the goal in the beginning: consistency, balance and stability. Weight change will come later, and it will be easier when you’re consistent, balanced and stable.
  • Move away from guilt and shame. They have not served you in the past. They serve no purpose now. Allow for mistakes and setbacks, not as things to avoid, but as things to learn from.
  • Find a supportive community. Join us in our Eating the Food facebook group, or join the Your Eatopia or Eat More to Weigh Less communities. knowing that you are not alone, and that what you are going through is normal, is one of the most profoundly empowering gifts you can give yourself. And later, down the road, you can be there for others beginning their journey.

Escaping dieting is not easy, and it’s not always pleasant. It’s probably one of the hardest things you will ever do. In my next installment, I’ll discuss some of the normal physiological responses to refeeding. Some are wonderful, others can be downright awful. You don’t have to go through it alone. Many of us have been through it and can offer perspective and support.

Up Next: Part 3

____________________________________

Related Posts:

]]>
https://gokaleo.com/2013/08/16/what-to-expect-when-you-stop-dieting-part-2-how-do-i-do-this/feed/ 14
How I Lost Weight https://gokaleo.com/2013/06/29/how-i-lost-weight/ https://gokaleo.com/2013/06/29/how-i-lost-weight/#comments Sun, 30 Jun 2013 03:19:12 +0000 https://gokaleo.com/?p=1467 Continue reading ]]> Picture 66I’ve posted numerous times here on my blog about how I lost weight. Here and here, for instance. My stalkers STILL accuse me of lying. All. The. Time.

I lost weight by eating fewer calories than I burned.

Swear to God.

I tried a few different diets. I tried veganism, I actually did pretty well on it, because I was getting plenty of carbs (which gave me lots of energy to exercise), and because I really enjoyed the food. Veganism didn’t make me lose weight though. Eating fewer calories than I burned made me lose weight.

I tried paleo. I didn’t do very well on it, I wasn’t getting enough carbs and my energy was in the toilet. I didn’t recover well from workouts, and I didn’t WANT to workout because I had no energy. I didn’t really like the food. I actually gained a few pounds on paleo. Paleo didn’t make me gain weight though. Eating more calories than I burned made me gain weight.

I tried the USDA’s MyPlate dietary recommendations. I did well, because the plan allowed me to eat foods I enjoyed, and because it gave me a realistic and sustainable calorie target (2600 a day). I lost weight on MyPlate. But MyPlate didn’t make me lose weight. Eating fewer calories than I burned made me lose weight.

Most of the time, though, I didn’t follow any specific plan. Most of the time, I just ate what I wanted. Sometimes I wanted to eat lots of salads and green smoothies. Other times I wanted to eat ice cream and scones. Still other times I wanted to eat fish and yogurt. Usually, I ate a little bit of everything. I kept track of my calories, and I made sure to get enough protein every day. I aimed for roughly 2800 calories a day, because that is the number of calories that support a weight of about 160 pounds at my current activity level. And I aimed for 100-150 grams of protein a day, to support muscle retention and recovery.

Other than that, I ate what I wanted. Sometimes salad, sometimes ice cream.

Swear to God.

The diet gurus tell us that we have to give ourselves eating disorders in order to lose weight. We do not. My stalkers tell me that I can’t possibly be as lean and fit as I am without being obsessive and strict with my diet. They are wrong. I am not obsessive and strict with my diet, beyond making sure I’m eating the appropriate number of calories to support my weight and activity (2800-3000 calories on an average day) and an adequate amount of protein to support my training. If I want ice cream, I eat ice cream. If I want fish and yogurt, I eat fish and yogurt. If I want salad, I eat salad (I like salad and eat it pretty often). I eat a wide variety of mostly healthy foods, but I am not obsessive, I am not ‘strict’, and I don’t spend my life fixated on food. You do not have to either.

Swear to God.

]]>
https://gokaleo.com/2013/06/29/how-i-lost-weight/feed/ 99
I Am Overweight. https://gokaleo.com/2013/05/20/i-am-overweight/ https://gokaleo.com/2013/05/20/i-am-overweight/#comments Tue, 21 May 2013 06:14:10 +0000 https://gokaleo.com/?p=1252 Continue reading ]]> Just over a year ago I published my most shared blog post to date: I’m Calling for a New Paradigm. My experience during what I now refer to as my ‘Fitness Model Diet’ fundamentally changed my approach to weight loss and fitness. I’d like to share some of the internal shifts I’ve made in the last year, and relate them to the trends I observe in the Fitness Industry.

First a brief review of my Fitness Model Diet. Over the course of 12 weeks, I dropped from a weight of 160 to 148 (at my lowest) and a body fat percentage of 12%. I hovered between 148 and 152 for about 2 months, and began to experience some symptoms of underweight and undereating, in spite of being at a scale weight that qualified as healthy and consuming 2200-2400 calories a day, which most people would consider not only adequate but probably quite indulgent. Perhaps more concerning, I also began to develop symptoms of body dysmorphia, a sign of disordered eating. I recognized what was happening to me and ended my experiment. To read a more in depth account of my experiences, click on the post I linked above, as well as this one, the follow up I wrote a couple months later.

In the months following, I increased my calories to where they’d been before my experiment and regained weight to 160 pounds. My symptoms resolved very quickly and my health and weight have been stable ever since. (More recently I’ve decided to purposely gain more weight in order to add some lean mass and hopefully see strength gains in the gym, I’ll discuss this further down).

My biggest takeaway from this whole experience was a new understanding of body fat; not only it’s role in maintaining metabolic health, but the disordered view our culture has of it. While it’s clear that in great excess body fat can impact health negatively, what is less commonly understood is that a certain amount of body fat is essential for health, particularly in women. Body fat is not an inert substance. In addition to insulating internal organs and storing energy, it plays a role in the production of hormones (including leptin, estrogen and resistin), and regulation of endocrine function. Just as too much body fat can throw hormonal regulation out of balance, so also can too little.

In the last year, I’ve taken a step back from the pursuit of fat loss that had been my primary focus for several years. I’ve begun to evaluate the messages the Fitness Industry sends with a more critical eye. What I see really disturbs me.

Fat Loss at All Costs

A simple Google search of the terms ‘diet’ and ‘fitness’ reveals that fat loss is THE defining goal of virtually every fitness and diet program. Try to find a ‘success story’ that doesn’t hinge on the visible reduction of body fat. Fat loss is, quite simply, THE barometer of success in this world. When fat loss is achieved, the program is deemed successful. Most programs are marketed specifically as fat loss plans. We are, as a culture, myopically obsessed with fat loss.

The human body requires a certain degree of ‘fatness’ for proper endocrine function. Women need more fat than men, and some women need more fat than others. As the body approaches that lower limit of adequate fat reserves, it initiates endocrine adaptations that inhibit further loss (downregulation of metabolism, loss of reproductive function, catabolism of lean mass, etc), such that the leaner a person is, the more extreme the measures they will need to engage in in order to see continued fat loss. The fitness and diet industry are ready with products to sell! Programs that place extreme restrictions on calories and macronutrients, and exercise routines that require extreme degrees of intensity or duration, usually combined. And it works! These extreme diets force the body to drop even more fat, with spectacular aesthetic results that are illustrated in dramatic before and after photos.

A clear message emerges from these dramatic images: Fat loss is good! Weight loss is success! Fat is bad! Weight gain is failure!

The end result is that healthy people at healthy weights internalize the message that they need to lose weight, because they don’t look like the bodies in the after pictures, so clearly they aren’t successfully managing their weight! They engage in increasingly extreme dietary restriction. Enough is never enough. There is always more fat to lose, another diet that promises fat loss success. Smaller and smaller we get.

I’ve experienced this mentality over and over during the last year as my weight has steadily increased. Every time I post on my facebook page about my weight gain, I get advice about how to turn it around. Even when I say specifically that I am gaining weight on purpose, I still get advice about how to lose weight. It’s like my words don’t even register beyond the weight gain. If I’ve gained weight it must be bad, and I must want to change it. The concept of a person, especially a woman, intentionally gaining weight is completely foreign. Even when I say ‘I am gaining weight on purpose’, a few people always seem to hear ‘help me figure out how to lose weight’. It is surreal. One person posted elsewhere that my diet ‘clearly isn’t working for her, since she’s gained 10-15 pounds recently’. See that? Weight gain = failure. End of story.

Obviously there are many people for whom fat loss is a healthy goal. When weight and body fat become a threat to a person’s health, weight and fat loss is important. But there comes a point at which the hyperfocus on fat loss becomes unhealthy. When a person is at a healthy weight, pursuing fat loss is no longer a health-promoting goal, it is at best an aesthetic pursuit, and at worst a risk to long-term health. The body will resist losing those last pounds of essential fat, and forcing the issue can set up a metabolic state that leads to adverse health outcomes and potentially even trigger eating disorders. Fat loss isn’t always good.

So, over the last year I’ve shifted my own goals, and I’ve also reevaluated the approach to weight loss I use with clients. I’ve been eating at a small calorie surplus and am now hovering right around 170 pounds. I have, essentially, gained 20 pounds in the last year. My current weight puts me just over the ‘healthy weight’ cut off on the BMI scale, I am officially overweight. In the last year, the primary focus of my training and diet has been strength and mass gains. I have gained some lean mass, and I’ve also gained some fat. This is not a failure. I am not planning to ‘cut’ after some arbitrarily approved ‘bulking’ period. In fact, as of right now, I have no plans to lose weight or fat, ever again. I do not wish that all my gains had been muscle. There is nothing wrong with gaining some fat. It does not make me inadequate or undesirable or unhealthy. Even having a BMI that qualifies as overweight doesn’t make me any of those things. My weight is just a number. A data point. It is not a value judgement. Do you want to see the body that a year of eating lots of food and focus on GAINS has produced?

Screen Shot 2013-10-16 at 8.47.47 AM

By the numbers, this body is overweight. I am part of that ’70% of Americans are overweight or obese’ statistic. Maybe we need to re-evaluate the numbers and statistics.

For reference, here is the body that restriction and focus on fat loss produced:

148 pounds, 12% body fat.

148 pounds, 12% body fat.

Neither body is ‘better’. Some people will find my current body more attractive, others will find my leaner body more attractive, others still will find both hideously unattractive. It’s ok. I’m not here to tell you one body type is better than another, or fish for compliments, or try to garner anyone’s approval for the choices I make for my own body.

What I AM here to tell you is that there is another way. That fat loss doesn’t HAVE to be your goal. That all different body types can be healthy and beautiful. That you can be more if you want to. That less isn’t the only acceptable option. That if the endless pursuit of fat loss isn’t making you happy, isn’t improving the quality of your life, isn’t working…you can choose another approach. Choosing another approach isn’t failure. It is simply different, and there is a place in this world for different. We are not all shaped the same.

These days when clients approach me for weight management coaching, the first thing I have them do is really evaluate where they are. Many, many people who believe they need to lose weight are actually, objectively, already at a healthy weight. Trying to force their body to shed more weight, more fat, may not be the most health- and joy-affirming option. Taking an approach of building a stronger foundation may be a more sustainable, and ultimately more enjoyable, choice. Choosing to end the relentless pursuit of fat loss is not an admission of defeat, it is not a failure. It can be a very healthy, very positive statement of self-respect.

I can’t tell you which body you should like better, but I CAN tell you which one eats ice cream, kills workouts and has more sex. The overweight one.

___________________________________________________________________________________________________

Join the conversation on my Facebook page!
___________________________________________________________________________________________________

For more information on some of the topics discussed here:

Body Fat
Minnesota Starvation Experiment
Endocrine Response to Anorexia
Endocrine Response to Typical Dieting

My blog posts on related topics:

Adrenal Fatigue as a Cover for Starvation
Healthy Diet or Disordered Thinking?
Body Composition: That 'Last Five Pounds', and How to Deal With 'Problem Areas'

]]>
https://gokaleo.com/2013/05/20/i-am-overweight/feed/ 76
Guest Post: Kaleolani’s Story https://gokaleo.com/2013/05/13/guest-post-kaleolanis-story/ https://gokaleo.com/2013/05/13/guest-post-kaleolanis-story/#comments Mon, 13 May 2013 16:28:03 +0000 https://gokaleo.com/?p=1247 Continue reading ]]> I ‘met’ Kaleolani about a year ago via my facebook page. She continues to inspire me every day with her positive, life-affirming approach to her life and her health. When confronted with serious medical issues, she took a thoughtful and long-term approach to healing, by paying attention to how her own unique body responded to different treatments. Formerly diagnosed with Type 2 Diabetes, Kaleolani has made long-term lifestyle changes that support her metabolic health. She’s now off her diabetes medication and has normal metabolic function. Like my last Guest Blogger Jennifer, I find Kaleolani’s story inspiring and hopeful.

Kaleolani’s Story

kaleolanithumbWhen I was asked by Amber to write a piece, I was giddy, and honored and scared to death. :-) Where would I start? What was I going to talk about? So I decided, very simply, to start at the beginning. I was born and raised in Hawai’i (hence my first name). I could say I was a surfing beach bunny, sitting around eating fish and poi, and laying in the sun getting my tan. The fact is, I don’t surf, deep ocean water scares me, I love poi but not so much the fish and I find laying out boring. Somewhere along the way between childhood and today, I also developed an eating disorder. I have compulsive eating disorder or binge eating. When most people think of an eating disorder they think of someone who is starving themselves or binging and purging. An eating disorder doesn’t always fit that mold. For me it was the coping skill I used for my feelings, for my emotional protection, and to make it through my daily life.

I met a wonderful man, we got married and due to his job, I moved away from home. Through other ups and downs of life, I know I suffered a few times from depression, including depression brought on by the C-section I had with my first daughter. It wasn’t what you’d call an ideal pregnancy and her birth was far from the fairy dust sprinkled, birth miracle of your favorite movies or TV show. We moved again. I had a second baby; got sick and things took a down hill turn. We moved again, and I didn’t realize that the bottom was so very far down or that I’d end up sinking down there and hitting rock bottom.

One day I went to the doctor’s for a check up, something I avoided because I was told all of my ills were due to my weight. At this particular visit, my new to me doctor, informed me I was pre-diabetic. No! Only one person in my family had been diabetic. This does not run in my family. We had other diseases, cancer, high blood pressure, high cholesterol, but not diabetes. What was I supposed to do with this? Well the very same thing I did with everything else. I ran the other way and ate to push it down.

My doctor did talk to me about my weight. I am 5’2″ and I had gotten up to about 360 lbs. :-) That’s pretty short and round like. When she approached it, it was not in the same way that others had done before, but she really listened. She heard me when I said I’d tried every single diet, when I said I always came out of it feeling like I was the biggest failure in the world, when I said I had been listening to a couple of friends talk about compulsive eating and it seemed to fit every thing I was feeling and doing. She listened to me when I said I’d bought a book and cried as I read because it felt like I had written it myself. She then put me in touch with a totally awesome therapist. I was only able to spend 6 months with my therapist until we had to move again.

When we moved I decided it was time to live my best life right now. No more waiting for that magic miracle diet to help me shed all the pounds and make me a perfect size 2. By now I’d have been happy with the perfect size 20. I got a seat belt extender for my car, donated all of my clothes that didn’t fit and threw away the last scale in the house. I also found a new doctor in our new home. I needed help because I was tired all the time and couldn’t drive without falling asleep. I couldn’t stay up for more then 2 hours. I also had my first ambulance ride to the ER one morning, scared to death I was having a heart attack because I couldn’t breath and the pain in my chest was unbearable.

My totally new, totally awesome doctor sent me for blood tests, did a physical and sent me to a pulmonologist for a sleep study. Turns out, I have severe sleep apnea. The blood tests came back and, oh, by the way, I’ve now got full-blown diabetes. No time to panic as I was already panicking thinking I would die while sleeping with my daughters would be the ones to find me dead in the morning. I didn’t know what to do so I dumped all the things that could possibly cause me an issue with my blood sugar. I dumped all grains, all starchy vegetables, all fruits, and nearly all sugar. I got set up with my CPAP machine, took my Metformin and then I set about figuring out what to do with this disease I knew nothing about.

Insurance wouldn’t pay for a visit to a nutritionist. I did a better thing. I asked a diabetic friend, well, more like I cried all over my computer and begged my diabetic friend for any help. I can’t begin to tell you what my angel of a friend did for my peace of mind. She gave me wonderful advice and tips. I took them to heart. I wasn’t prescribed a glucometer, but I went out and got one from CVS. The great staff there was so helpful, showed me how to use it, and told me I didn’t need the latest and greatest one with bells and whistles. I needed the simplest one, with the cheapest test strips and off I went. I found myself a chiropractor and an acupuncturist. I wanted all of my bases covered. They were going to help me with all other physical and emotional aspects and most importantly, try to help my body heal my pancreatic function.

I tested everything I ate. I ran through testing strips like they were water. I began to exercise, which was not easy. After 2 C-sections and my illness my back was out of whack. I was in pain all the time and dealing with a second round of plantar fasciitis. My right knee would not bear any weight by itself. I walked, or tried to. I could make it maybe 1 1/2 minutes before I hurt so much I had to stop. I walked a small path behind our condo. It would take me about 20 minutes to walk something that should have taken 3. I saw a video for DDP Yoga and I got the tapes. I did the things my friend told me to do. Her most wonderful advice ever was to walk. She said if I ate something that spiked my blood sugar, which happened a lot at the beginning, to walk. If you move the big muscles in your body, it would move the sugar floating around in there, instead of sitting there making me feel high.

I had been getting horrible headaches before and the Metformin helped with that. I could visually see and physically feel when my blood sugar was going up too high and too fast. My walking was getting better. Finally, after a couple of months, I got rid of the last bit of sugar in my diet. I gave up chocolate. I knew it wouldn’t be a lifetime move, but I had to give it up for the time being to let my body heal.

Two weeks before my 3-month appointment with my doctor, I started to get headaches again when I took the Metformin. I decided to stop taking it. I got another blood test. My blood sugar numbers were dropping. My doctor was looking for my A1C numbers. According to diabetes.org A1C is: “A test that gives you a picture of your average blood glucose control for the past 2-3 months. The results give you a good idea of how well your diabetes plan is working.” She agreed when I told her I didn’t want to take the Metformin and try to control things with diet and exercise. Did I say yet how awesome she is?

I slowly started to add back in some whole starches like potatoes and some black and brown rice. I was sleeping so much better with my CPAP and life was amazingly different already. I found new recipes to help with my cravings as I still was dealing with my eating disorder. There’s a fine line to balance with making sure I’m doing what’s needed for health and balancing it out emotionally. I do not restrict my eating because for me, that is a sure way of creating a need for a binge. Paleo and primal web sites helped me tremendously. I still ate dairy and still had starches but I needed to learn a different way of baking to avoid wheat. I had a NEED for cookies.

I saw my doctor every three months. I got a blood test each time to check my A1C levels and various other things. I kept seeing my chiropractor and acupuncturist. My levels kept going to down closer to the normal range. I kept doing what I was doing.

My physical changes were phenomenal. I thought I wasn’t an outdoors person. I really was. I love walking in nature. I just don’t want to sit in nature or eat in nature (:-) I am not an al fresco diner), but moving through nature, I could do. My daughters and I found some trails to walk and we did as often as we could. I walked a bigger loop near our condo. I noticed, as I was doing my DDP, and standing in a lunge position, my right knee was able to go lower then it had before. I was taking pictures to track progress, and there was a visible difference in how I looked, how my clothes fit. I still didn’t use a scale and had to stop taking measurements. It wasn’t working for me emotionally to do this. I got derailed a bit by a weight loss challenge that I shouldn’t have joined, but it did teach me that restricting or surrounding myself with people who do, does not work for my peace of mind.

I then decided I wanted to try running. After getting the ok from all my medical people, I followed my intuition and got myself a pair of Vibram 5 Finger shoes and started to try to jog. I had read somewhere something about John Bingham and how he said he waddled when he jogged. That so fit. My friend told me she called it wogging. I loved it. I got some new wogging pants, sewed some skirts to wear over the pants and tried to see what I could do. I started very slowly and I’m still slow, but low and behold, the person who thought she hated running, LOVES it. Turns out, I just hated running for PE.

Today, I had my 1-year check up. My A1C numbers have me in the normal range. Not diabetic, not pre-diabetic but the normal range. I eat sprouted wheat bread when I want, I have some maple syrup on sprouted wheat pancakes, I have some sugar, and I still have my rice, my potatoes and everything else, including my chocolate. I have lost about 60 lbs. In the process I finally was able to lose my fear of what the food would do to my body. I still deal with my eating disorder one day at a time. I am living every day, and eating the chocolate, and wogging because I love it. I can walk a flight of stairs, I can run a few sprints, I can do actual squats without holding onto anything. I still have a ways to go physically, emotionally and mentally, but it’s no longer a race against a disease but a way to a better life. It’s always been about putting one foot in front of the other and finding a solution to the problem at hand. Now though, I look forward to seeing what new thing I’ll be able to do tomorrow, living my best life now.

Aloha,
Kaleolani Garcia
Homeschooling, stay at home mom of 2 and Coast Guard spouse.

]]>
https://gokaleo.com/2013/05/13/guest-post-kaleolanis-story/feed/ 24
HCG, Intermittent Fasting and Ketosis: the Unholy Trinity of Metabolic Downregulation https://gokaleo.com/2013/04/22/hcg-intermittent-fasting-and-ketosis-the-unholy-trinity-of-metabolic-downregulation/ https://gokaleo.com/2013/04/22/hcg-intermittent-fasting-and-ketosis-the-unholy-trinity-of-metabolic-downregulation/#comments Mon, 22 Apr 2013 20:05:06 +0000 https://gokaleo.com/?p=1227 Continue reading ]]> Today, for a change, I’m not going to hit you with a bunch of studies. I’m just going to tell you what I’ve learned through experience with my clients and readers. Then I give you a couple links to check out if you want to read some more sciency stuff.

My client base is made up largely of women who’ve already run the diet gauntlet. By the time they get to me, most of these women have essentially been on one diet or another for years, or even decades. They’ve done it all. They’re experts at losing weight. Trouble is, the weight always comes back. With each successive diet, they ultimately find themselves fatter and sicker. I don’t put my clients on diets: they’ve already been, to a one, on all the diets. I get my clients off diets. Get them eating a humane, sustainable amount of food, with a focus on supporting their activity and honoring their personal tastes and cultural traditions. The vast majority of my clients stabilize fairly quickly and begin making forward progress, once they wrap their minds around eating to support their metabolic health.

There are a few clients, though, who have a much harder time stabilizing. Their weight won’t budge, or it fluctuates wildly. They don’t seem to be able to build muscle mass as effectively. They begin to store more fat around their belly than they have in the past. They experience edema. They deal with anxiety and insomnia and other symptoms of starvation, even when their calorie intake is adequate. It is as if their bodies refuse to emerge from the starvation response (see my Adrenal Fatigue post for more info on the starvation response). This goes on for months, even when calories and macronutrients are all adequate and consistent. I’ve had several clients who’ve experienced this, and every single one of them had a history of one or more of the three diet philosophies that I’ve taken to calling the ‘Metabolic Downregulators’. Those three diet philosophies are: HCG, Intermittent Fasting, and Ketosis.

All three of the Metabolic Downregulators appear to provoke the starvation response by design. The first symptom of the starvation response is rapid weight loss. Subsequent symptoms are endocrine adaptations that slow the body’s metabolic processes and insure against famine by shoring up fat reserves, stopping reproductive function and reducing metabolically expensive lean mass. IF and ketosis seem to be able to do this even in the absence of a caloric deficit. HCG, of course, simply relies on extreme calorie deprivation. That initial rapid weight loss is what the dieter fixates on, and when the weight loss stalls out they wonder what they are ‘doing wrong’, and double down on the diet in an effort to get the weight dropping again. This only compounds the metabolic downregulation, and the dieter ends up exhibiting all the symptoms of starvation AND excess fat stores.

Like I said, I’m not going to throw studies at you today (I’ll let Alan Aragon, Anthony Colpo, Stephanie Ruper and others do that). I’m simply sharing the observations I’ve made amongst my clients and readers.

My clients who’ve succeeded in downregulating their metabolic function need much more time to repair and stabilize than others who’ve followed less extreme diet philosophies. 6 months is not uncommon. Some women need a year or more. The longer a person’s body has been in the starvation response, the longer it’s going to take to recover. This is a frustrating reality. The temptation to return to extreme dieting can be great. I encourage those of you who are experiencing this to remember that the diets ultimately failed, and it is exactly those diets that brought you to where you are today. There is a better way. Consistently and dependably giving your body the nutrition and energy it needs to be healthy and active will allow it to emerge from the starvation response and heal from the damage the diets have done. But it takes time. Be patient! The long-term benefits are worth it.

If you’ve gone through this, please share your experiences in the comments so that people just beginning the healing process know they are not alone. There is a vast support network out there for those ready to start on the path out of the restriction maze. Please reach out, from wherever you are, to support each other and to find the help you need.

I will add to this list as I find additional resources.

http://www.alanaragon.com/an-objective-look-at-intermittent-fasting.html

http://www.paleoforwomen.com/shattering-the-myth-of-fasting-for-women-a-review-of-female-specific-responses-to-fasting-in-the-literature/

http://anthonycolpo.com/why-intermittent-fasting-isnt-all-its-cracked-up-to-be/

]]>
https://gokaleo.com/2013/04/22/hcg-intermittent-fasting-and-ketosis-the-unholy-trinity-of-metabolic-downregulation/feed/ 120
Calorie Shaming https://gokaleo.com/2013/04/16/calorie-shaming/ https://gokaleo.com/2013/04/16/calorie-shaming/#comments Tue, 16 Apr 2013 20:06:21 +0000 https://gokaleo.com/?p=1208 Continue reading ]]> As if it weren’t bad enough that we are shamed from every direction for having normal, healthy human bodies, as soon as we decide to take back the power over our health and well being, and begin the process of learning to nourish ourselves properly to support our activity, so begins the calorie shaming.

What am I talking about? I cover several main themes on my facebook page, and the last week or so I’ve been focusing on eating enough calories. Here are a few of the comments people have left on my posts just in the last day, these are directed at me and my food choices:

“Ask yourself why you must defend your need to have [sugar]?” (left in response to my post about sugar being an awesome fuel for my workouts)

“Uh, hello? 3000 calories a day is not normal or healthy intake! Unless you are running a marathon every day.” (in response to my post that 3000 calories a day is not unreasonable for an active healthy adult – it’s about how much I eat. Not everyone needs quite that much, but many do.)

“3000 calories is a large amount of food if you are a healthy eater. Fresh fruits and veggies and lean proteins do not have many calories. What to you do? Eat a cheese burger on a big bun and than go running and call yourself healthy?” (same post as above)

The message here is that eating this much food is undesirable, unhealthy, bad.

How someone can look at my pictures and then criticize my eating philosophy as unhealthy and ineffective is beyond me. Well, I’ll take that back, we’ve seen very clearly that people who don’t want to hear the truth can make up some pretty amazing stories to rationalize away my success and ease their cognitive dissonance. These comments make me shake my head. Some have said to just ignore them, but I think it’s really important to highlight them and TALK about them. Disordered thinking is so deeply ingrained in or culture, I think that a lot of people reading comments like these won’t recognize the disorder, and will internalize it. That’s how our culture has conditioned us.

The good news is that the vast majority of responses my posts about this topic get are positive. Comment after comment from people who’ve increased their calorie intake to a more sustainable level and seen fitness, body composition and even weight loss progress where before they were frustrated. But these negative comments can be powerfully subversive, and have the potential to derail a person just beginning the recovery process. So I am talking about it. As you begin to emerge from the dark of the diet maze, you will be subjected to calorie shaming. It will come from all directions: the media, your friends, your SELF. Recognize it for what it is. It is not healthy.

You deserve a healthy strong body, and you can not starve yourself healthy and strong.

 

 

 

]]>
https://gokaleo.com/2013/04/16/calorie-shaming/feed/ 42
Taking Up Space https://gokaleo.com/2013/04/10/taking-up-space/ https://gokaleo.com/2013/04/10/taking-up-space/#comments Wed, 10 Apr 2013 16:53:48 +0000 https://gokaleo.com/?p=1198 Continue reading ]]> TUS-3Db

From the Amazon description:

'Can I get an 'AMEN!'?! This is so simple, and makes so much sense! If you have to white-knuckle your way down to a weight and struggle miserably to maintain it, how is that 'ideal'? About a month ago I found Go Kaleo, started tracking my food, upped my protein and calorie intake, and I've lost weight AND inches! All that weight training I've been doing is finally noticeable! But the miracle is that I'm not obsessed with food every day, I'm not fighting cravings and feeling hopeless, like if I lost my focus for one minute I'd blow it. I'm not afraid of food anymore! I feel like Go Kaleo has let me in on the 'secret' to being healthy' You are changing lives.' ~Denise

In a weight loss world where grueling 1200-calorie diets are the mainstream standard for weight loss, accompanied with long lists of evil foods to avoid, Amber Rogers, aka 'Go Kaleo' is the voice of reason.

Being healthy and finding your healthy weight simply doesn't work when it's hard. It works best when it's easy. Go Kaleo puts practicality and sustainability first ' two concepts often completely eliminated from popular diets in pursuit of quick, albeit impermanent results.

While most recommend eating as little food as possible and doing as much exercise as one can bear, Taking Up Space advocates finding the MAXIMUM amount of calories and minimum number of paranoid restrictions that still gets results.

In the book, Go Kaleo talks about her incredible 80-pounds of slow, effortless, hunger and craving-free weight loss that never came back ' all on a steady diet of 2800 calories a day with a few good workouts a week. No big cravings for carbs, meat, fat, or sweets ' as these were things that she was eating in ample abundance every day.

After reaching a healthy goal, what did she do? She increased calories even more only to find that this allowed her to build toned muscle and shed more fat than ever before.

Taking Up Space also contains some passionate and important discourse on getting past the illusions created by fake tans and Photoshop, and realizing that what everyone is increasingly thinking are 'flaws' are actually quite normal aspects of human physiology.

This book sets a new standard in approaching weight loss in a lasting way. It is the future of how better health and better bodies will be attained once the rest of the world realizes how counterproductive extreme approaches really are.
''You can get better, you can get stronger, you can get healthier, you can be MORE. You can't restrict, reduce, eliminate your way to any of these things. Yes, you can lose weight, but there is a healthier, saner, more sustainable way to do it.' ~Go Kaleo

If you’re a regular reader of my blog, you’ll recognize many of the themes I cover in this book. I’ve tied several of my more important posts together to create a more cohesive guide that will give you the basics on energy balance, maintenance of a healthy weight, self respect and self care, and a path forward out of the diet maze.

Be sure to check out my facebook page and the Eating the Food facebook group for support in putting the concepts in this book into practice.

To purchase Taking Up Space as a downloadable pdf:

To purchase Taking Up Space for Kindle:

]]>
https://gokaleo.com/2013/04/10/taking-up-space/feed/ 11
Moderation is Evidence-Based https://gokaleo.com/2013/03/19/moderation-is-evidence-based/ https://gokaleo.com/2013/03/19/moderation-is-evidence-based/#comments Tue, 19 Mar 2013 16:54:46 +0000 https://gokaleo.com/?p=1130 Continue reading ]]>
I have a rather revolutionary opinion on what the primary goal of any weight loss program should be (well, I don’t think it’s revolutionary, but I’ve been told it is by others…). And that opinion flies in the face of human nature. Human nature wants immediate and dramatic results. Unfortunately, immediate and dramatic results often come at the expense of long-term metabolic health, and lead to equally immediate and dramatic weight regain once one stops doing the things that produced the immediate and dramatic results. And rest assured, one WILL stop eventually, because the things that produce immediate and dramatic results are rarely sustainable or safe.

No, as far as I’m concerned, the primary goals of any weight loss program (aside from weight loss of course) should be:

-preservation of lean mass (muscle, bone, organ)
-preservation of metabolic health (which lean mass preservation supports)
-successful long-term (ie, permanent) maintenance of a healthy weight once it is achieved

The methods that promote those goals end up being, by most people’s standards, pretty moderate.

Extreme Diets Produce Extreme Results

You know what they say, ‘everything in moderation’? Moderation catches a lot of flack in the fad diet world. We’ve got gurus declaring entire food and macronutrient groups off limits, other gurus advocating replacing multiple meals a day with powdered supplements, others recommending inhumanely low calorie intakes, and now I’m seeing more and more extreme mono-diets (diets consisting of only one food such as potatoes, fruit, milk or even just water, perhaps with a splash of flavor from spices, or broth). Any of these techniques can produce rapid weight loss for a number of reasons: dehydration, extreme calorie deficit producing loss of lean mass along with fat, low palatability producing a spontaneous calorie reduction, etc. Unfortunately, along with rapid weight loss frequently comes loss of lean mass (1, 2) and a reduction in resting metabolic rate (RMR) (3), which together prime the body for subsequent rapid fat gain when ‘normal’ eating behaviors are resumed. In other words, losing lean mass and depressing one’s RMR are a great way to get fatter in the long run.

If a person can reach a healthy weight with lean mass and RMR intact, they stand a much better chance of maintaining that loss in the long-term. So how do we minimize lean mass loss and protect metabolic function? There is a massive body of evidence supporting exercise during weight loss a means to preserve both lean mass AND healthy metabolic function. In my opinion, any successful weight loss program will prioritize supporting the establishment of habitual regular physical activity, and will progress at a pace that will allow for the preservation of the greatest degree of lean mass as possible. See what I did there? Framed healthy weight loss as a process of sustaining and supporting, rather than reducing and restricting. This is an important distinction.

Preservation of Lean Mass

The results of this study indicate that slow weight loss preserves lean mass better than rapid weight loss. To keep weight loss at a pace that supports lean mass preservation, the calorie deficit needs to be very modest. The larger the calorie deficit, the greater the percentage of weight lost will be lean mass.

Resistance training during weight loss also preserves lean mass. This study indicates that while creating a calorie deficit through food restriction produces a greater total weight loss, creating a deficit through physical activity actually produces a greater loss of fat, and preserves lean mass. This study on 118 women examined the body composition results from weight loss produced either by diet alone, or by diet and exercise. Each group lost about the same amount of weight, but the diet plus exercise group lost more fat, and didn’t lose any lean mass. Exercise in general, and resistance training specifically, protect lean mass during weight loss and so are an essential component of any program aimed at promoting long-term success.

Preserving Healthy Metabolic Function

While there are myriad aspects of metabolic health, the one I’m most concerned with for this post is resting metabolic rate (RMR), the amount of energy the body expends at rest. Total body weight is one determinant of RMR, and so weight loss generally will produce a drop in RMR. However, it appears that exercise can mitigate that drop. This study (that I linked above) even suggests a minor increase in RMR over the control group in the diet plus exercise group. This one also indicates that resistance training can increase RMR, even in the context of weight loss. The last thing anyone should want is to get to a healthy weight but find themselves with an RMR in the toilet. When RMR is depressed, calorie intake must be kept low to prevent weight regain. Who wants to be on a diet for the rest of their life? With strength training and slow weight loss via a very modest calorie deficit, RMR can stay high enough to afford a humane and sustainable calorie intake once a healthy weight is achieved.

Successful Long-Term Maintenance

We’ve looked at ways to preserve lean mass and RMR during weight loss, now lets look at ways to support long term maintenance once a healthy weight is achieved. The National Weight Control Registry, which tracks people who’ve successfully lost and kept off weight, shows that in addition to making permanent changes in diet (I’ll talk about diet a little more in a minute), virtually everyone who is successful at maintaining weight loss exercises regularly. This study indicates that the more active a person is during weight loss, the less likely they are to regain lost weight. I suspect this is due to both improved metabolic function and the establishment of habitual exercise. Exercise protects RMR and lean mass, AND promotes successful maintenance.

What about diet? In my opinion, diet should be as expansive and unrestrictive as possible while still allowing for (slow) weight loss. This means maintaining a very modest calorie deficit (I prefer a deficit of 500 calories or less), and only restricting foods, food groups and macronutrients if there is a real medical need. In this study, including a daily treat had no negative effect on weight loss and body composition results. In this one, altering the diet to be less restrictive produced a greater adherence to an exercise program, improving the subject’s weight loss outcomes:

“…exercise regimens of moderate to high level of intensity proved counter-productive as weight-reducing strategies for an obese sedentary subject. This was due to the limited energy reserves (specifically, muscle glycogen) available to such individuals. However, when the diet was changed from a balanced composition to one that was highly loaded with carbohydrates, it became possible to sustain the intense exercise regimen over the experimental period, and achieve a significant drop in body weight. The results underscore the significant interaction effects between diet composition and physical activity, and emphasize the critical role that diet composition can have in exercise-based treatment interventions.”

The lesson here: to promote the important goals of lean mass and RMR preservation, and long term successful weight maintenance, regular exercise needs to be an integral part of any successful weight loss program. To promote adherence to an exercise program, diet should be as moderate and sustainable as possible while still allowing slow weight loss. As this review of obesity literature concluded:

“While energy restriction in isolation is an effective short-term strategy for rapid and substantial weight loss, it results in a reduction of both fat and muscle mass and therefore ultimately predisposes one to an unfavorable body composition. Aerobic exercise promotes beneficial changes in whole-body metabolism and reduces fat mass, while resistance exercise preserves lean (muscle) mass. Current evidence strongly supports the inclusion of resistance and aerobic exercise to complement mild energy-restricted high-protein diets (note from me: protein, like exercise, helps preserve lean mass, so be sure you’re getting plenty) for healthy weight loss as a primary intervention for [obesity].”

 

Rapid results are appealing, but more often than not they are short-term, and in the end losing weight quickly can sabotage your lean mass and RMR. There is a great deal of consensus in the scientific community that exercise and moderation in diet are the safest, most sustainable interventions for long term weight loss success. My own results certainly support this, by creating a very modest calorie deficit and prioritizing physical activity, I’ve been able to reach and maintain a healthy weight without any drastic or extreme dietary or exercise measures. Moderation in diet and exercise have worked for me, and work for my clients. And moderation is supported by a massive body of scientific evidence. Moderation isn’t sexy, but it works.

If you’d like to read more, please check out my new eBook, Taking Up Space. I discuss all these concepts and more, and provide guidelines for implementing them into your life.

]]>
https://gokaleo.com/2013/03/19/moderation-is-evidence-based/feed/ 23
Sugar and Diabetes Risk: Perspective on the Study https://gokaleo.com/2013/03/01/sugar-and-diabetes-risk-perspective-on-the-study/ https://gokaleo.com/2013/03/01/sugar-and-diabetes-risk-perspective-on-the-study/#comments Fri, 01 Mar 2013 22:38:07 +0000 https://gokaleo.com/?p=1076 Continue reading ]]>

A few days ago, a new study on sugar and diabetes risk hit the news and BOY has it been exciting! Mark Bittman ran an op-ed piece titillatingly titled ‘It’s the Sugar, Folks‘ that has been widely circulated among the Real Food, carb-gnostic, and fad diet communities. It sure sounds, based on the press this study has received, that we’ve definitively proven that sugar is the culprit behind diabetes and other ‘diseases of Western Civilization’. Hooray! We have our answer. And a path forward is clear, lets simply eradicate sugar and all our problems will go away!

I’m not going to pick apart the study (you can read it for yourself here). I suspect others will do that better than I could (Alan Aragon, I’m lookin’ at you). And truth be told, this is the kind of study I like. It’s large and mathy. The study authors put a lot of thought into it and controlled for multiple factors that are frequently ignored. I’m willing to accept their conclusions at face value, because I think their conclusions are fair and well supported. What I’m going to do is put those conclusions into perspective so you can decide how to apply them to your life.

First, lets talk about what those conclusions are and what they’re based on. This study examined the statistical correlation between sugar availability (availability, not consumption. Although it stands to reason that consumption is probably reflected by availability) and diabetes prevalence on a population scale. That means that they measured how much sugar was available in a population’s food supply and correlated it with diabetes rates in that population. Lets frame that with something you’re familiar with: the BMI scale. The BMI scale measures the statistical correlation between weight-to-height ratio and mortality risk. Most people know that the BMI scale is actually a very poor indicator of an individual person’s risk because it takes only two data points (out of thousands) into account. On a zoomed out, population scale level, a pattern emerges that as a population’s average BMI increases so does it’s mortality risk, but it’s very difficult to apply that statistical correlation at an individual level because so many other factors come into play in determining an individual’s risk (such as genetics, physical activity, body composition, diet quality, medications, epigenetics, gut microbiota, etc). This study is showing exactly the same kind of zoomed out, statistical correlation.

The main conclusion of the study was that for each 150 calories of sugar availability per person in a population’s food supply, there was an increase of roughly 1% in diabetes prevalence in that population. 150 calories of sugar is about 1 soft drink, so basically, for every soft drink’s worth of sugar per person per day, diabetes risk went up 1%. Remember though, this is at a population level. It’s very difficult to apply this at an individual level because of mitigating factors (like genetics and physical activity and weight and body composition etc), but lets imagine that we can. Lets pretend that we can safely say that for every soft drink you consume a day, your diabetes risk increases by 1% (we can’t say that based on this study, we’re pretending here). Got that? Your diabetes risk increases by 1%.

Lets put that risk into perspective. This study found that low levels of physical activity conferred a 71% increased risk of impaired glucose tolerance (a precursor to diabetes) over high levels of physical activity across ethnicities, cultures and genders. In this study, inactive individuals had more than a 100% increase in prevalence of diabetes over those who got 150 minutes or more of exercise a week. In this study, inactive lean women were at twice (100% more) the risk of diabetes as lean active women, and obese inactive women had 16 times (1600%) the risk of lean active women. This study on almost 6000 men showed that for every 500 calories expended per week on physical activity (that’s like an hour of brisk walking), diabetes risk decreased by 6%. This study suggests that inactivity confers a 30% increased risk of Type 2 diabetes in women. These risk ratios make that 1% increase from sugar look pretty measly, don’t they?

My take on the whole thing? Sugar may be relevant. This study certainly raises some questions that should be further explored in clinical and epidemiological settings. I suspect, though, that sugar only becomes problematic under certain conditions and in certain individuals. That is certainly what my research has led me to believe. If you are metabolically healthy, regularly physically active, eat a nutritious diet and maintain a healthy weight and body composition, you probably don’t need to worry about having some sugar here and there. If you are NOT metabolically healthy, are obese, are sedentary or have a genetic predisposition to diabetes, you should probably be mindful of your sugar consumption (but you should ALSO be mindful of increasing your activity level, losing excess body fat, and optimizing your energy balance, as those things will improve your metabolic function and may ultimately make sugar much less of an issue for you).

Here’s the big problem with the way this study is being interpreted in the media: sugar is not THE problem. Sugar may be (and probably is, under some circumstances) A problem, one of many. But if we’re going to treat sugar as THE problem, and then ‘solve’ that problem by simply eliminating sugar, we’re missing the forest for the trees. Well, for one tree. A bush really. Inactivity is a bigger problem than sugar, and fixating on sugar gives the inactivity a free pass. To improve metabolic health we really need to address all the problems. Don’t get hung up on Sugar As The Bad Guy. You cheat yourself out of vibrant good health, and miss out on some yummy and perfectly appropriate desserts.

]]>
https://gokaleo.com/2013/03/01/sugar-and-diabetes-risk-perspective-on-the-study/feed/ 13
Paleo Magic? https://gokaleo.com/2013/02/21/paleo-magic/ https://gokaleo.com/2013/02/21/paleo-magic/#comments Thu, 21 Feb 2013 14:00:42 +0000 https://gokaleo.com/?p=1050 Continue reading ]]>

Click me! To see study.

This study is making the rounds of the paleosphere, so I thought I’d take a moment to look into it and see if it lives up to it’s claims that a paleo-’type’ diet ‘has strong and tissue-specific effects on ectopic lipid deposition in postmenopausal women’ (‘ectopic lipid deposition’ = fat deposits on organs and skeletal muscles).

I got my hands on the full text and had a look. Quick synopsis: researchers put 10 overweight and obese, sedentary, post-menopausal women on a diet that they call ‘paleolithic type’ and measured changes to several metabolic and anthropometric measures. The main areas they were looking for changes were fat deposits in the liver and skeletal muscles, and insulin sensitivity, but they measured several other things as well, including:

-weight
-BMI
-waist circumference and waist-hip ratio
-blood pressure
-cholesterol
-insulin
-blood glucose
-cortisol

The diet:

“All meals were prepared by the food service at Ume University Hospital and were weighed and frozen after preparation. The diet included lean meat, fish, fruit, vegetables (including root vegetables), eggs and nuts. Dairy products, cereals, beans, legumes, refined fats and sugar, added salt, bakery products and soft drinks were excluded. Participants were instructed to complement the provided food with other included food items from the list, ad libitum. To enable preparation of additional complete meals at home, the women received 14-day menus together with recipes and instructions regarding portion sizes. They were also advised to
use only rapeseed (canola) or olive oil in food preparation.”

The diet worked out to roughly 30% protein, 40% fat (predominantly PUFA as saturated fat was limited in this study by design, and most of the fat the subjects consumed came from nuts, fish and canola and olive oils. Wait, canola oil? DO YOU EVEN PALEO?). They ate to appetite and documented their intake.

The results were quite good. The subjects lost an average of 10 pounds, blood pressure improved, both waist circumference and waist-hip ratio decreased, and heart rate decreased! And there was indeed a reduction in liver fat! Good stuff! Lets look a little deeper at that. From the study:

“The dietary regimen resulted in a significantly reduced energy intake (520 kcal/day reduction) despite the ad libitum approach. This may be one of the factors contributing to the striking decrease in liver fat content. A series of studies have indeed shown that hypocaloric diets reduce the amount of liver fat.”

Layman’s terms: the subjects spontaneously ate about 500 calories less per day than they had been eating before the study (I talk about why diets high in protein and fiber, like the one in this study, can lead to a spontaneous reduction in caloric intake here. Protein and fiber are satiating and highly thermic foods. Diets rich in protein and fiber, paleo or otherwise, are very good at producing a spontaneous caloric deficit. It’s not magic, it’s science). It’s been established that hypocaloric diets (hypocaloric = fewer calories consumed than burned) reduce liver fat. Rut roh. Are they saying it might have been the calorie reduction that decreased liver fat, not the magic of paleo? Why yes, yes I think they are.

Speaking of which, you know what else a caloric reduction decreases? Weight. Could it be that the subjects lost weight because they were eating fewer calories? That’s certainly where my money is. The study authors note that the weight loss seems out of proportion to the degree of calorie reduction but then go on to acknowledge:

“Possible explanations include over-reporting of energy intake, increased thermogenic effects of protein (versus other macronutrients) and loss of glycogen which may contribute to loss of body water during the study period. Of note, increased
urinary volumes were commonly reported among participants during this intervention.”

Layman’s terms: maybe the subjects were overreporting their food intake. Maybe there’s something to the Thermic Effect of Food dealio (if you didn’t read my post that I linked above on food thermogenesis, you can do it now). Or maybe, just maybe, the low-carb diet they were on did what low-carb diets always do: flushed out several pounds of water weight as the body’s glycogen stores depleted. The subjects did report peeing more, after all.

So, we looked at the anthropometric changes the diet produced, lets take a look at the metabolic changes. Some good news. Blood glucose and insulin both decreased, and total cholesterol, LDL and triglycerides decreased. HDL also decreased though (that’s the good cholesterol), and cortisol increased (cortisol is a stress hormone). So the metabolic measures were a mixed bag, but overall more good than bad. Not so fast though, glucose, insulin and cholesterol all respond favorably to weight loss, as does blood pressure. Could these improved markers be a response to the subjects’ weight loss, which was a response to reduced calorie intake? That conclusion is certainly supported by decades of credible science.

Back to the original aim of the study: to determine if a paleo diet reduces liver fat and increases insulin sensitivity. Liver fat did decrease, but it turns out that whole-body insulin sensitivity didn’t change, nor fat deposition in skeletal muscles:

“…lipid content in skeletal muscles, as determined by 1H-MRS, was unaltered, as was peripheral insulin sensitivity…”

Because:

“…exercise regimens must be included to demonstrate effects on muscle/whole-body insulin sensitivity…”

Layman’s terms: to improve insulin sensitivity you gotta move yo’ ass.

Bottom line: paleo is, as fad diets go, pretty decent. It encourages eating nutritious, whole foods, and accentuates protein and vegetables (staples of weight loss diets from the beginning of time). But it’s not magic. The positive outcomes experienced in this study fall right in line with decades of credible science showing similar outcomes from weight loss due to reduced caloric intake. I’m not hating on paleo: paleo is a healthy diet. But promoting the myth that eating paleo will magically reduce weight and improve metabolic markers is irresponsible for one very big reason: it won’t work for everyone, because not everyone will spontaneously eat fewer calories on a paleo diet. Some people will even eat MORE calories on paleo. And when those people don’t magically lose weight and get healthier, they may blame paleo. Or they may blame themselves. They may think they’re just not ‘paleo-ing’ hard enough. Let be honest: paleo is a healthy diet, and some people may lose weight and see health improvements on it because they spontaneously eat less. But it’s the eating less that is responsible for the weight loss, and if you’re NOT one of the people that spontaneously eats less on paleo, it’s not because paleo is bad, or because you’re doing it wrong, or because you’re destined to be fat or whatever else people have come up with to rationalize away undesired results. Paleo is a pretty decent way of eating but it’s not magic, it can’t rewrite the laws of physics.

Improving the quality of your diet is GREAT, and paleo can help some people do that. There are other ways of improving the quality of your diet, though, and there are other ways of optimizing your calorie intake. Lets sweep away the dogma and magical thinking and be realistic. This study shows what countless other studies have shown before it: that calories matter, that food quality ALSO matters, and that exercise is essential for healthy metabolic function. If paleo provides a framework that helps you succeed in those aras, that is fantastic! But it’s one possible helpful tool out of many, and what works for some doesn’t work for others, we must look critically at the causative factors here (calories, weight loss, exercise) if we want to create a balanced and effective path forward and help more people achieve better health.

 

 

]]>
https://gokaleo.com/2013/02/21/paleo-magic/feed/ 22