Thursday, July 26, 2012

Macronutrient extreme diets may not be healthy.

How our bodies use and store the energy of the calories of the macronutrients (carbohydrates, proteins and fats) we put into it is a complex process. The diet industry has been pretty good at confusing most of us by its use of these complexities to justify their method. We have every end of the spectrum when it comes to diets touting specific diet ratios of these macronutrients to help us lose weight: low-fat/high carbohydrate, low carbohydrate/high protein, low carbohydrate/high fat, etc. They all claim they work and show scientific research they work, how can that be?

With calorie control, most diets will work to lose weight, for a short time. Also some people, no matter what macro nutrient ratio they use can lose weight (hint: it’s not the diet, but the genetics their mom and dad gave them that is working for them). Also remember when most people talk about diet success, they are referring to weight loss. Weight loss is healthy for us, if it is the excess body fat above a healthy range we carry around. But what if I just lost muscle mass? I would be losing weight, but do you see where this is not healthy. So a diet successful in losing weight may not always be healthy for us. Also understand even if we do lose some of the excess storage fat with our diet, it may still not be healthy for us due to increase in other health risk factors.

A recent study in the June 27, 2012 issue of the Journal of Medical Association demonstrated some of the ill health effects of these restriction type diets. Those people on these restriction diets have been found to have increase in heart disease risk factors, chronic inflammatory markers and stress hormone production (none of those are good things if you want to live a long healthy life). Senior author Dr David S Ludwig (New Balance Foundation, Obesity Prevention Center) told heartwire in an interview (this may be some of the best suggestions about diet in just a few sentences I have ever read):

"Extreme restriction of fat or carbs can have bad effects. The best long-term approach will be to avoid restriction of any major nutrient--either fat or carbohydrate--and instead focus on the quality of nutrients. This is not to say that the number of calories isn't important, but it's now saying we should also pay attention to the quality of those calories. So the argument that the food industry likes to make--that all foods can be part of a healthful diet as long as you watch calories--is really misleading at best. Relatively unprocessed, low-glycemic-index foods are best, things that our grandmother would recognize. Choose relatively unprocessed foods whenever you can and cut back on white bread, white rice, potato products, prepared breakfast cereals, and, of course, concentrated sugars."

So as we can see that restriction diets may help us lose weight, but they may be making us unhealthier. What is the proper ratio of macronutrients one should be using? This is going to vary for all of us (again due to that genetic thing mom and dad passed on to you). Typically a general range to start with is 50% carbohydrates, 30% proteins, and 20% fats. But remember each calorie of the macronutrient is not the same. Carbohydrates should come from low glycemic index foods (think the natural stuff not the processed stuff that comes in a box or a bag). Proteins should be from lean sources and from multiple sources (think fish, chicken, turkey, and some red meat). Fats need to be of the monounsaturated, polyunsaturated and Omega 3 fatty acid type, while avoiding the saturated and trans fat types. Then you can play with the ratios “a little” to see if it helps you feel better and get a little better weight control. When we say “a little”, we mean probably no more the 5-10% any one direction with any one macronutrient. Extremes of anything usually are never healthy for us and a diet pushing the macronutrient ratios to extremes are no exception to this simple healthy rule to follow.

Thursday, July 19, 2012

Smoking or inactivity, which is worse?

Voluntary physical inactivity now tops smoking for association to non-communicable diseases tied to premature death. This recent report was published (July 2012) in a series of articles in the journal The Lancet looking at the global problem of inactivity and obesity. Amazingly our self-selection and decision to be inactive is causing disease and shortening our lives slightly more than one’s choice to smoke. I know some will say; they have the right to choose to do with their body what they want. While this is true, unfortunately those choices our costing our society billions of dollars in unneeded health care costs. And that choice is taking days away from our loved ones with premature death. While it may be difficult to get many inactive people to change their ways, the research report showed that if we could get just 1 person active out of every 4 inactive people then 1.3 million deaths could be prevented every year.

The risks associated with smoking have been known for a long time and heavy media and public awareness campaigns have been under way for many years to alert people to these risks. You can’t buy cigarettes without seeing the large warning label on it. You see billboards and TV ads on a regular basis alerting us and trying to get people never to start or stop smoking if they already have. Also many good programs and efforts are in place to assist those that do smoke to help them break the addiction and try and become smoke free. The money spent on these things is well worth it, because we know the expense of taking care of health related problems with smoking far outweighs the cost of these awareness campaigns. Maybe it is time to start some campaigns similar to those when it comes to inactivity?

We here in America have always been known for our innovation and bringing many things to the rest of the world; democracy, space travel and now…inactivity. According to the latest information 31.1% of the world’s adults are sedentary and do not meet the minimum recommendations for activity in a week. Current minimum requirements are 150 minutes of moderate activity (i.e. walking) per week. Here in America we top the scales at 43.4% of us not meeting these requirements, and it looks as if the rest of world is following our example with increased inactivity in many other parts of the world.

Are you getting in 30 minutes of physical activity a day? Did you realize a choice to be inactive carries just as much risk for disease and premature death as someone who smokes? Exercise and being physically active has substantial health benefits, just 30 minutes a day is all it takes to become a healthier you. Maybe we here in America we can reverse our trendsetting with inactivity and look to become more active. Being a world leader is usually a good thing; leading it to an earlier death is not so good.

Friday, July 13, 2012

Understanding calcium supplementation for bones

Bone health is important to all of us and it gets lots of press and publicity on how to maintain it throughout our life span. Sometimes this info can be confusing to say the least. We know that bones need calcium to stay strong and healthy, as this is one of the primary building blocks to build bones. Bone is a living tissue just like all of your other tissues, so it needs a constant supply of nutrients and activity to keep rebuilding. When we lack these nutrients (such as calcium) and activity we can develop osteoporosis, where your bone mineral density decreases and increases your risk for fractures. Calcium supplementation is a common treatment for this, but it has come under some scrutiny lately because of potential side effects from it. Let’s try to separate the fact from the fiction with some of the reporting that has gone on.

New research has shown potential increased heart attack risk with calcium supplementation. Don’t panic and stop your supplementation just yet, but do read on to understand pro’s and con’s. First lets clarify what you may have read or heard from the press or others. Some reports have gone so far as to say calcium supplementation increases heart attack risk by 50%. While this is true, it is a stretch, realize that heart attack risk in the study went from just over 1% for those that didn’t supplement, to a little over 2% if you do. So the risk is 50% more, but still very small overall. But don’t be fooled in thinking that if you take calcium it will solve all your problems with osteoporosis and fall risk. Some studies show that supplementation only reduces your fall risk by 10%. So taking a calcium supplement helps, just don’t fool yourself to thinking you are out of the woods when it comes to fall risk. Research has been pretty consistent to show that if you get your calcium naturally (milk based products, broccoli, cabbage to name a few good sources) through diet you will get greater benefits and no side effects as to if you get it through supplementation. Another thing research has shown that if you hit your later years low on calcium and bone density it is hard if not almost impossible to catch up. You might slow the decline of bone density loss with improved diet or supplementation, but you are better off getting enough in your younger years then trying to play catch up.

So what’s the take home? If you supplement calcium, do it under a physician’s care to look at benefits and risks for you. Better yet, get enough calcium through a proper diet and start early in life to limit risks of osteoporosis throughout your life. Also don’t forget other things that can help: exercise, don’t smoke, avoid excessive alcohol, have an overall healthy diet and maintain proper weight control. Sounds like good advice for lots of health issues your bones included.