Sunday, May 8, 2011
Warm Wishes for Mother's Day
As we honor Mothers and Motherhood today please accept my heartfelt wishes for a day of joy and memory making as you celebrate the special relationships in your life. Thank you for being a treasured part of my life through our LivingAfterWLS connection.
"Let us be grateful to people who make us happy, they are the charming gardeners who make our souls blossom."
-Marcel Proust
For You I
Ask Me a Question
On May 13th, I'll be recording a podcast with Chris Kresser of The Healthy Skeptic. Chris interviewed me about a year ago, and I thought it went well. Chris is a good host and asks interesting questions.
This time around, we're going to do things a bit differently. I'll start with a little overview of my current thoughts on obesity, then we'll answer reader questions. The show is going to be mostly about obesity and related matters, but I may answer a couple of questions that aren't related to obesity if they're especially interesting. There are two ways to leave questions: either in the comments section of this post, or the comments section of Chris's post. The show will air on May 24th.
Read more »
This time around, we're going to do things a bit differently. I'll start with a little overview of my current thoughts on obesity, then we'll answer reader questions. The show is going to be mostly about obesity and related matters, but I may answer a couple of questions that aren't related to obesity if they're especially interesting. There are two ways to leave questions: either in the comments section of this post, or the comments section of Chris's post. The show will air on May 24th.
Read more »
Saturday, May 7, 2011
Pasta Italiano
(makes 4-6 servings)
Ingredients:
- ½ lb. lean ground turkey
- 1 bell pepper, seeded and thinly sliced
- 1 can (14-½ ounce) crushed tomatoes
- 1 can (14-½ ounce) chicken or vegetable broth
- 1 tbsp paprika
- 1 cup cauliflower florettes
- 2 cups uncooked pasta
- 2 cups broccoli florettes
Preparation:
- Crumble ground turkey into skillet. Brown over
medium heat for about 2 minutes, stirring occasionally. Add paprika and pepper strips, cook for 2-4 minutes. - Add crushed tomatoes, broth, and pasta to the skillet.
- Bring mixture to a boil, cover, reduce heat and simmer for about 15 minutes.
- Remove lid (be careful) and arrange broccoli and cauliflower over the pasta.
- Replace lid and cook for about 10-15 minutes.
Make 6 Servings:
Weight loss recipes Amount Per Serving(1/6 of recipe (266 g)): 219 Calories, 17 g Protein, 29 g carbohydrates, 3 g Dietary Fiber, 4 g fat, 1 g saturated fat, 30 mg cholesterol, 417 mg sodiumFriday, May 6, 2011
Pasta Delight
(makes 4 servings)
Ingredients:
- 2 cups pasta, cooked, drained and rinsed
- 1 tbsp vegetable oil
- 1 large broccoli tree, chopped into small pieces or 1 (10 oz.) package of chopped frozen broccoli
- 1 carrot, cut into thin strips
- 3 cloves garlic, finely chopped
- ½ cup green peas
- 1 tbsp Italian seasoning
- ¼ cup Parmesan cheese
Preparation:
- Cook pasta according to package instructions.
- In a large-sized skillet, sauté vegetables and garlic in vegetable oil for about 10 minutes, stirring often.
- Add cooked pasta and Italian seasoning to vegetables and gently combine with a large-sized spoon or spatula.
- Sprinkle Parmesan cheese over pasta mixture, cover and cook for about 2-4 minutes.
Make 4 Servings:
Weight loss recipes Amount Per Serving(¼ of recipe (186 g)): 203 Calories, 9 g Protein, 29 g carbohydrates, 5 g Dietary Fiber, 6 g fat, 2 g saturated fat, 5 mg cholesterol, 205 mg sodiumFood Reward: a Dominant Factor in Obesity, Part II
How to Make a Rat Obese
Rodents are an important model organism for the study of human obesity. To study obesity in rodents, you have to make them fat first. There are many ways to do this, from genetic mutations, to brain lesions, to various diets. However, the most rapid and effective way to make a normal (non-mutant, non-lesioned) rodent obese is the "cafeteria diet." The cafeteria diet first appeared in the medical literature in 1976 (1), and was quickly adopted by other investigators. Here's a description from a recent paper (2):
Investigators have known for decades that the cafeteria diet is a highly effective way of producing obesity in rodents, but what was interesting about this particular study from my perspective is that it compared the cafeteria diet to three other commonly used rodent diets: 1) standard, unpurified chow; 2) a purified/refined high-fat diet; 3) a purified/refined low-fat diet designed as a comparator for the high-fat diet. All three of these diets were given as homogeneous pellets, and the textures range from hard and fibrous (chow) to soft and oily like cookie dough (high-fat). The low-fat diet contains a lot of sugar, the high-fat diet contains a modest amount of sugar, and the chow diet contains virtually none. The particular high-fat diet in this paper (Research Diets D12451, 45% fat, which is high for a rat) is commonly used to produce obesity in rats, although it's not always very effective. The 60% fat version is more effective.
Consistent with previous findings, rats on every diet consumed the same number of calories over time... except the cafeteria diet-fed rats, which ate 30% more than any of the other groups. Rats on every diet gained fat compared to the unpurified chow group, but the cafeteria diet group gained much more than any of the others. There was no difference in fat gain between the purified high-fat and low-fat diets.
So in this paper, they compared two refined diets with vastly different carb:fat ratios and different sugar contents, and yet neither equaled the cafeteria diet in its ability to increase food intake and cause fat gain. The fat, starch and sugar content of the cafeteria diet was not able to fully explain its effect on fat gain. However, each diets' ability to cause fat gain correlated with its respective food reward qualities. Refined diets high in fat or sugar caused fat gain in rats relative to unpurified chow, but were surpassed by a diet containing a combination of fat, sugar, starch, salt, free glutamate (umami), interesting textures and pleasant and invariant aromas.
Although the cafeteria diet is the most effective at causing obesity in rodents, it's not commonly used because it's a lot more work than feeding pellets, and it introduces a lot of variability into experiments because each rat eats a different combination of foods.
How to Make an Obese Human Lean
In 1965, the Annals of the New York Academy of Sciences published a very unusual paper (3). Here is the stated goal of the investigators:
It's a machine that dispenses bland liquid food through a straw, at the push of a button. They don't give any information on the composition of the liquid diet, beyond remarking that "carbohydrate supplied 50 per cent of the calories, protein 20 per cent and fat 30 per cent. the formula contained vitamins and minerals in amount adequate for daily maintenance."
Volunteers were given access to the machine and allowed to consume as much of the liquid diet as they wanted, but no other food. Since they were in a hospital setting, the investigators could be confident that the volunteers ate nothing else.
The first thing they report is what happened when they fed two lean people using the machine, for 16 or 9 days. Both of them maintained their typical calorie intake (~3,075 and ~4,430 kcal per day) and maintained a very stable weight during this period.
Next, the investigators did the same experiment using two "grossly obese" volunteers. Again, they were asked to "obtain food from the machine whenever hungry." Over the course of the first 18 days, the first (male) volunteer consumed a meager 275 calories per day. The second (female) volunteer consumed a ridiculously low 144 calories per day over the course of 12 days, losing 23 pounds. Without showing data, the investigators remarked that an additional three obese volunteers "showed a similar inhibition of calorie intake when fed by machine."
The first volunteer continued eating bland food from the machine for a total of 70 days, losing approximately 70 pounds. After that, he was sent home with the formula and instructed to drink 400 calories of it per day, which he did for an additional 185 days, after which his total weight loss was 200 lbs. The investigators remarked that "during all this time weight was steadily lost and the patient never complained of hunger or gastrointestinal discomfort." This is truly a starvation-level calorie intake, and to eat it continually for 255 days without hunger suggests that something rather interesting was happening in this man's body.
This machine-feeding regimen was nearly as close as one can get to a diet with no rewarding properties whatsoever. Although it contained carbohydrate and fat, it did not contain any flavor or texture to associate them with, and thus the reward value of the diet was minimized. As one would expect if food reward influences the body fat setpoint, lean volunteers maintained starting weight and a normal calorie intake, while their obese counterparts rapidly lost a massive amount of fat and reduced calorie intake dramatically without hunger. This suggests that obesity is not entirely due to a "broken" metabolism (although that may still contribute), but also at least in part to a heightened sensitivity to food reward in susceptible people. This also implies that obesity may not be a disorder, but rather a normal response to the prevailing dietary environment in affluent nations.
A second study by Dr. Michel Cabanac in 1976 confirmed that reducing food reward (by feeding bland food) lowers the fat mass setpoint in humans, using a clever method that I won't discuss for the sake of brevity (4). I learned about both of these studies through the writing of Dr. Seth Roberts, author of The Shangri-La Diet. I'd also like to thank Dr. Stephen Benoit, a researcher in the food reward field, for talking through these ideas with me to make sure I wasn't misinterpreting them.
I'd like to briefly remark that there's an anatomical basis for the idea of two-way communication between brain regions that determine reward and those that control body fatness. It's well known that the latter influence the former (think about your drive to obtain food after you've just eaten a big meal vs. after you've skipped a meal), but there are also connections from the former to the latter via a brain region called the lateral hypothalamus. The point is that it's anatomically plausible that food reward determines in part the amount of body fat a person carries.
Some people may be inclined to think "well, if food tastes bad, you eat less of it; so what!" Although that may be true to some extent, I don't think it can explain the fact that bland diets affect the calorie intake of lean and obese people differently. To me, that implies that highly rewarding food increases the body fat setpoint in susceptible people, and that food with few rewarding properties allows them to return to a lean state.
In the next few posts, I'll describe how food reward explains the effectiveness of many popular fat loss diets, I'll describe how this hypothesis fits in with the diets and health of non-industrial cultures, and I'll outline new dietary strategies for preventing and treating obesity and certain forms of metabolic dysfunction.
Rodents are an important model organism for the study of human obesity. To study obesity in rodents, you have to make them fat first. There are many ways to do this, from genetic mutations, to brain lesions, to various diets. However, the most rapid and effective way to make a normal (non-mutant, non-lesioned) rodent obese is the "cafeteria diet." The cafeteria diet first appeared in the medical literature in 1976 (1), and was quickly adopted by other investigators. Here's a description from a recent paper (2):
In this model, animals are allowed free access to standard chow and water while concurrently offered highly palatable, energy dense, unhealthy human foods ad libitum.In other words, they're given an unlimited amount of human junk food in addition to their whole food-based "standard chow." In this particular paper, the junk foods included Froot Loops, Cocoa Puffs, peanut butter cookies, Reese's Pieces, Hostess Blueberry MiniMuffins, Cheez-its, nacho cheese Doritos, hot dogs, cheese, wedding cake, pork rinds, pepperoni slices and other industrial delicacies. Rats exposed to this food almost completely ignored their healthier, more nutritious and less palatable chow, instead gorging on junk food and rapidly attaining an obese state.
Investigators have known for decades that the cafeteria diet is a highly effective way of producing obesity in rodents, but what was interesting about this particular study from my perspective is that it compared the cafeteria diet to three other commonly used rodent diets: 1) standard, unpurified chow; 2) a purified/refined high-fat diet; 3) a purified/refined low-fat diet designed as a comparator for the high-fat diet. All three of these diets were given as homogeneous pellets, and the textures range from hard and fibrous (chow) to soft and oily like cookie dough (high-fat). The low-fat diet contains a lot of sugar, the high-fat diet contains a modest amount of sugar, and the chow diet contains virtually none. The particular high-fat diet in this paper (Research Diets D12451, 45% fat, which is high for a rat) is commonly used to produce obesity in rats, although it's not always very effective. The 60% fat version is more effective.
Consistent with previous findings, rats on every diet consumed the same number of calories over time... except the cafeteria diet-fed rats, which ate 30% more than any of the other groups. Rats on every diet gained fat compared to the unpurified chow group, but the cafeteria diet group gained much more than any of the others. There was no difference in fat gain between the purified high-fat and low-fat diets.
So in this paper, they compared two refined diets with vastly different carb:fat ratios and different sugar contents, and yet neither equaled the cafeteria diet in its ability to increase food intake and cause fat gain. The fat, starch and sugar content of the cafeteria diet was not able to fully explain its effect on fat gain. However, each diets' ability to cause fat gain correlated with its respective food reward qualities. Refined diets high in fat or sugar caused fat gain in rats relative to unpurified chow, but were surpassed by a diet containing a combination of fat, sugar, starch, salt, free glutamate (umami), interesting textures and pleasant and invariant aromas.
Although the cafeteria diet is the most effective at causing obesity in rodents, it's not commonly used because it's a lot more work than feeding pellets, and it introduces a lot of variability into experiments because each rat eats a different combination of foods.
How to Make an Obese Human Lean
In 1965, the Annals of the New York Academy of Sciences published a very unusual paper (3). Here is the stated goal of the investigators:
The study of food intake in man is fraught with difficulties which result from the enormously complex nature of human eating behavior. In man, in contrast to lower animals, the eating process involves an intricate mixture of physiologic, psychologic, cultural and esthetic considerations. People eat not only to assuage hunger, but because of the enjoyment of the meal ceremony, the pleasures of the palate and often to gratify unconscious needs that are hard to identify. Because of inherent difficulties in studying human food intake in the usual setting, we have attempted to develop a system that would minimize the variables involved and thereby improve the chances of obtaining more reliable and reproducible data.Here's a photo of their "system":
It's a machine that dispenses bland liquid food through a straw, at the push of a button. They don't give any information on the composition of the liquid diet, beyond remarking that "carbohydrate supplied 50 per cent of the calories, protein 20 per cent and fat 30 per cent. the formula contained vitamins and minerals in amount adequate for daily maintenance."Volunteers were given access to the machine and allowed to consume as much of the liquid diet as they wanted, but no other food. Since they were in a hospital setting, the investigators could be confident that the volunteers ate nothing else.
The first thing they report is what happened when they fed two lean people using the machine, for 16 or 9 days. Both of them maintained their typical calorie intake (~3,075 and ~4,430 kcal per day) and maintained a very stable weight during this period.
Next, the investigators did the same experiment using two "grossly obese" volunteers. Again, they were asked to "obtain food from the machine whenever hungry." Over the course of the first 18 days, the first (male) volunteer consumed a meager 275 calories per day. The second (female) volunteer consumed a ridiculously low 144 calories per day over the course of 12 days, losing 23 pounds. Without showing data, the investigators remarked that an additional three obese volunteers "showed a similar inhibition of calorie intake when fed by machine."
The first volunteer continued eating bland food from the machine for a total of 70 days, losing approximately 70 pounds. After that, he was sent home with the formula and instructed to drink 400 calories of it per day, which he did for an additional 185 days, after which his total weight loss was 200 lbs. The investigators remarked that "during all this time weight was steadily lost and the patient never complained of hunger or gastrointestinal discomfort." This is truly a starvation-level calorie intake, and to eat it continually for 255 days without hunger suggests that something rather interesting was happening in this man's body.
This machine-feeding regimen was nearly as close as one can get to a diet with no rewarding properties whatsoever. Although it contained carbohydrate and fat, it did not contain any flavor or texture to associate them with, and thus the reward value of the diet was minimized. As one would expect if food reward influences the body fat setpoint, lean volunteers maintained starting weight and a normal calorie intake, while their obese counterparts rapidly lost a massive amount of fat and reduced calorie intake dramatically without hunger. This suggests that obesity is not entirely due to a "broken" metabolism (although that may still contribute), but also at least in part to a heightened sensitivity to food reward in susceptible people. This also implies that obesity may not be a disorder, but rather a normal response to the prevailing dietary environment in affluent nations.
A second study by Dr. Michel Cabanac in 1976 confirmed that reducing food reward (by feeding bland food) lowers the fat mass setpoint in humans, using a clever method that I won't discuss for the sake of brevity (4). I learned about both of these studies through the writing of Dr. Seth Roberts, author of The Shangri-La Diet. I'd also like to thank Dr. Stephen Benoit, a researcher in the food reward field, for talking through these ideas with me to make sure I wasn't misinterpreting them.
I'd like to briefly remark that there's an anatomical basis for the idea of two-way communication between brain regions that determine reward and those that control body fatness. It's well known that the latter influence the former (think about your drive to obtain food after you've just eaten a big meal vs. after you've skipped a meal), but there are also connections from the former to the latter via a brain region called the lateral hypothalamus. The point is that it's anatomically plausible that food reward determines in part the amount of body fat a person carries.
Some people may be inclined to think "well, if food tastes bad, you eat less of it; so what!" Although that may be true to some extent, I don't think it can explain the fact that bland diets affect the calorie intake of lean and obese people differently. To me, that implies that highly rewarding food increases the body fat setpoint in susceptible people, and that food with few rewarding properties allows them to return to a lean state.
In the next few posts, I'll describe how food reward explains the effectiveness of many popular fat loss diets, I'll describe how this hypothesis fits in with the diets and health of non-industrial cultures, and I'll outline new dietary strategies for preventing and treating obesity and certain forms of metabolic dysfunction.
Thursday, May 5, 2011
Pasta with Peas and Basil Cream Sauce
(makes 4 servings)
Ingredients:
- 6 oz. bowtie, penne or your favorite pasta
- 1 cup fresh or frozen peas, drained
- 1 (12 oz.) can of non-fat evaporated milk
- 1 tbsp all-purpose flour
- 2 tbsp fresh thyme, chopped
- 1 clove garlic, smashed and finely chopped
- 2 oz. prosciuitto, chopped
- ¼ cup shredded Parmesan cheese
Optional garnishes (Nutrition Facts are calculated without these items):
- 1 tbsp shredded Parmesan cheese
- Fresh ground black pepper
- 1 tbsp fresh thyme, chopped
Preparation:
- In a serving bowl, cook pasta according to package instructions, drain, then set aside.
- While the pasta is cooking. In a mediusized saucepan, add about ½ cup of water and bring to boil. Cook peas for about 10 minutes then drain and discard remaining water in saucepan. Return peas to saucepan.
- Whisk together the milk and flour in a small-sized bowl then pour over the peas. Add the thyme and garlic then stir to combine. Raise heat to medium and stir until thickened.
- Add the Parmesan cheese and prosciutto and continue stirring until cheese is melted and mixture is combined then pour over the pasta.
- Toss pasta until well-coated with the sauce then serve with optional garnishes.
Make 4 Servings:
Weight loss recipes Amount Per Serving(¼ of recipe (200 g)): 331 Calories, 22 g Protein, 51 g carbohydrates, 3 g Dietary Fiber, 4 g fat, 2 g saturated fat, 19 mg cholesterol, 609 mg sodiumWeight loss in Pregnancy
Exercising during pregnancy can help control weight and relieve back pain and circulatory problems. However, some exercises are contraindicated in this phase.
Pregnancy is not a good time to start doing any sport. Women who are accustomed to can continue to do so, provided your pregnancy is normal and the activity does not require major efforts in exercise of the mother or have a risk that the mother suffers a fall or trauma.
Exercise Tips
* We must reduce the intensity, can not exceed 110-120 beats per minute.
* We must stop if you feel symptoms of fatigue (cramps, contracture ...) or breathing difficulties, as it may be lacking oxygen to the baby.
* In the third quarter is better not to play sports.
* The exercise is completely contraindicated if complications arise during pregnancy.
* The competitive sport is strongly discouraged.
What sports practice
* Swimming: is a beneficial exercise during pregnancy, except styles of breaststroke and front crawl, which could cause back pain. You can swim in the sea where the water is clean, warm and no big waves. On the beaches filled with people in which people play the ball, the pregnant woman is not very safe.
* Gymnastics: gymnastics if pre-pregnancy weight, you can do so in a normal pregnancy. Of course, the meetings should be shorter, the pregnancy abdominal exercises less intense and much lighter weight.
* Tennis is one sport inconvenient. Are discouraged from week 20 th, or sooner if complications arise. Never try to compete or hard ball.
* Skiing: skiing is also contraindicated because the risk of falls is very high and sudden and intense efforts are needed.
I can do aerobics?
If aerobics before becoming pregnant, you can continue doing some exercises ( pregnancy abdominal exercises ), but without trying to keep pace with the group and taking some precautions:
* Avoid jumping.
* Control of heart rate.
* Rest at the slightest sign of fatigue.
* Consultation with a gynecologist if I should or not do certain exercises with the increase in the gut.
A gentler alternative is the aquayim (gymnastics in the water) because the impact and stretching are mitigated by the absence of gravity that produces water and exercise in pregnancy becomes relaxing.
Is it wrong to run?
If you're used to running, you can continue to do so long as you have in mind:
* Get off the frequency and speed. In addition, you must stop at the first signs of fatigue.
* The shoes have to be special for the impact of the foot to the floor is not very sharp.
* The land can not be too hard or have steep slopes.
Pregnancy is not a good time to start doing any sport. Women who are accustomed to can continue to do so, provided your pregnancy is normal and the activity does not require major efforts in exercise of the mother or have a risk that the mother suffers a fall or trauma.
Exercise Tips
* We must reduce the intensity, can not exceed 110-120 beats per minute.
* We must stop if you feel symptoms of fatigue (cramps, contracture ...) or breathing difficulties, as it may be lacking oxygen to the baby.
* In the third quarter is better not to play sports.
* The exercise is completely contraindicated if complications arise during pregnancy.
* The competitive sport is strongly discouraged.
What sports practice
* Swimming: is a beneficial exercise during pregnancy, except styles of breaststroke and front crawl, which could cause back pain. You can swim in the sea where the water is clean, warm and no big waves. On the beaches filled with people in which people play the ball, the pregnant woman is not very safe.
* Gymnastics: gymnastics if pre-pregnancy weight, you can do so in a normal pregnancy. Of course, the meetings should be shorter, the pregnancy abdominal exercises less intense and much lighter weight.
* Tennis is one sport inconvenient. Are discouraged from week 20 th, or sooner if complications arise. Never try to compete or hard ball.
* Skiing: skiing is also contraindicated because the risk of falls is very high and sudden and intense efforts are needed.
I can do aerobics?
If aerobics before becoming pregnant, you can continue doing some exercises ( pregnancy abdominal exercises ), but without trying to keep pace with the group and taking some precautions:
* Avoid jumping.
* Control of heart rate.
* Rest at the slightest sign of fatigue.
* Consultation with a gynecologist if I should or not do certain exercises with the increase in the gut.
A gentler alternative is the aquayim (gymnastics in the water) because the impact and stretching are mitigated by the absence of gravity that produces water and exercise in pregnancy becomes relaxing.
Is it wrong to run?
If you're used to running, you can continue to do so long as you have in mind:
* Get off the frequency and speed. In addition, you must stop at the first signs of fatigue.
* The shoes have to be special for the impact of the foot to the floor is not very sharp.
* The land can not be too hard or have steep slopes.
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