Sunday, February 27, 2011

When being fluffy is a good thing

Last week a headline on the BBC website informed us that "Cholesterol does not predict stroke in women".   The gist of a recent Danish study quoted in the article was that triglycerides are a more effective predictor than LDL measurements.

What I found stunning about this headline is that scientists have been aware of the limitations of cholesterol measurement since the 1950's.  The public, on the other hand, is bombarded with regular messages to reduce their "bad" or LDL cholesterol, and increase HDL or "good" cholesterol. 

What is not commonly known unless you dig deeper into the nutritional scientific literature, is that there are different classes of lipoproteins, which can be fractionated according to their density:  smaller LDL particles, known as VLDLs (very low-density lipopoteins), are more atherogenic in nature.  Because they are smaller, they can more easily form plaque in the arteries, leading to blockages that increase stroke and heart attack risk.  Triglycerides are a major component of these VLDLs.

Some people have a relatively higher concentration of large, fluffy LDL particles in their blood stream and these are not as harmful as their dense brethren.

This explains why a high LDL reading that isn't broken down any further is not a good risk predictor.

I was very interested to read the abstract of the study itself.  In my opinion, it imparts a subtly different message:
Current guidelines on stroke prevention have recommendations on desirable cholesterol levels, but not on nonfasting triglycerides. We compared stepwise increasing levels of nonfasting triglycerides and cholesterol for their association with risk of ischemic stroke in the general population.
What is going on here?

From what I can see, the study simply suggests changing the guidelines to provide reference ranges for triglyceride levels.  

That's very different than announcing, in 2011, that cholesterol is a useless measurement tool.  However, I do think the BBC headline was dramatic enough to attract my attention, while a more accurate one may have been almost too boring to look at.  Besides, maybe it's time to inform the public that knowing your cholesterol level is only of marginal relevance.
Gary Taubes' book, "Good Calories, Bad Calories"

I can't say enough about what a good read this is.  You can get the gist of the book from the online pdf notes, but I would recommend reading the whole book.








In the "average American diet",
...with 35% of calories from fat, one in three men will have the atherogenic pattern B profile [both high triglycerides and low HDL].  On a diet of 46% fat, this proportion drops:  only one man in every five manifest the atherogenic profile.  On a diet of only 10% fat, of the kind advocated by diet doctors Nathan Pritikin and Dean Ornish, two out of every three men will have small, dense LDL and, as a result, a predicted threefold higher risk of heart disease.  The same pattern holds true in women and in children, but the percentages with small, dense LDL are lower... the more saturated fat in the diet, the larger and fluffier the LDL--- a beneficial effect.
This apparent nutritional heresy is a quote from chapter 9 of

Tuesday, February 15, 2011

More on conflicting opinions

I have long been fascinated by Dr. Neal Barnard's Physicians Committee for Responsible Medicine and check out the website periodically to see what has changed.  If you haven't heard of this group, they advocate a vegan low fat diet, and claim the healthiest way to lose weight effectively is through calorie restriction.  

There is a fairly extensive recipe section on the site which is worth looking at, in the interests of being fair and balanced.  What initially put me off was that they saute onions in water (admittedly there are many other recipes that don't use onions and therefore don't involve this technique).  My initial thought was that if you want to convince people to go vegan, you'll be a lot more successful if you make the recipes appealing.  I found it hard to believe that this would be tasty, and, again in the quest for balance, I tried it.

I was as disappointed at the outcome as I expected to be. 

Today, I found myself checking out this site again, and soon found myself on a subsequent link titled Atkins Diet Alert.  The majority of the links in the Expert Opinions section are broken, but there is a 2004 article referencing a study performed by an obesity researcher named Gary Foster, from the University of Pennsylvania.  The conclusion includes a quote by Foster:

Ideally, five years down the road, with lots of scientific data behind us, we would be in a position to recommend diets tailored to individuals such as, say, diabetics, meat lovers, or those with difficulty sticking to a low-fat diet.
Since we are now a little more than five years down the road, I decided to google Dr. Foster, and found a 2010 study published in the Annals of Internal Medicine, titled "Weight and Metabolic Outcomes After 2 Years on a Low-Carbohydrate Versus Low-Fat Diet."  This study concluded that:
Successful weight loss can be achieved with either a low-fat or low-carbohydrate diet when coupled with behavioral treatment. A low-carbohydrate diet is associated with favorable changes in cardiovascular disease risk factors at 2 years.
There is also a commentary written by Dr. Ornish, another well-known low fat proponent.   The last paragraph is, in my opinion, really important for everybody who might be wondering where the Grain Ride fits into the wide spectrum of weightloss methodologies:
It's not low-fat vs. low-carb.  Atkins-type diets may have some benefits because the typical American diet, and many low-fat diets, are very high in refined carbohydrates. Even better is to consume a diet that is low in refined carbohydrates as well as low in saturated fat, trans fats, and animal protein, includes beneficial fats such as omega-3 fatty acids, and high in fruits and vegetables in their natural, unrefined forms.
The Grain Ride approach, after all, is not the same as the Atkins Diet.  It's not about high protein or high fat.  It's also not about calorie restriction.  

The main principles of the Grain Ride approach are elimination of processed foods, refined sugar and foods with a high starch content, including wheat.  

All the other rules are, to a large extent, details.

Sunday, February 13, 2011

Low Carb vs Low Calorie Diets

There is a lot of conflicting dietary advice out there, and this just makes it more difficult and confusing for anybody who wants to lose weight.  Here's the simple way I like to look at it:

  1. I'm not aware of any proven diet that "allows" junk or processed foods.
  2. Similarly, white flour and sugar are also common elements that are no-no's.
  3. If you have excess weight because you enjoy eating and cooking (I certainly do), there's no doubt you're going to have to give up something.  The question is what.
So that leaves you with two main choices:
  1. You can go on a low-fat, calorie restricted diet.  By restricting fat intake, you will most likely be substituting this with a fair amount of carbohydrates, and frequent meals.  If you stick to it, you will most likely lose weight.  There are enough diet studies showing that this can be done.
  2. Alternatively, you can cut the carbs.  This will result in a diet that is richer in fat and calories than the calorie-restricted diet, but you will also lose weight.  Not only do I know this for a fact because it's what is working for me, but there is also a growing mountain of nutritional research to back up the health benefits of this approach.
I am surrounded by a mind-boggling array of papers, medical blogs and books all pointing to sugars in the diet (especially those from wheat and processed sugar) as the root causes of triglycerides in the bloodstream, type 2 diabetes, heart disease and weight gain.

You can read them too, but dry research isn't necessarily going to motivate you enough to reverse your creeping weight gain.

What concerns me more is the simple fact that meals should be enjoyable.  Otherwise a diet isn't going to be sustainable for the average person.

What works for our family is a diet that is relatively unrestricted as far as fats are concerned.  I don't consciously count my protein intake, but I do eat it at almost every meal.  I am somewhat concerned about the potential for kidney damage in the long term, but it appears that this might be more of an issue for people with kidney disease. 

What's left?  Well, having cut out wheat, processed sugar, tropical fruit and other foods rich in starches, my plate is filled with colourful vegetables and a modest amount of protein (eggs, cottage cheese, yoghurt, fish, meat, etc).

It's quite hard to overeat the fats that are added to make a meal more interesting.  You'll find those fats make you quite full, and (after your initial carb withdrawal) you won't really be interested in reaching for something sugary or starchy after an hour or two.  It actually becomes easy to say no when somebody passes around a box of chocolates or cookies.

You won't have to say no when it comes to a slice of cheese, a spoon of guacamole, a handful of nuts or a large Greek salad topped with feta cheese.  After a while, you'll notice that eating out is not nearly as hard as it might seem, and it's very feasible to keep it up in the longer term.

Best of all, if you're somebody who really enjoys cooking and eating, this approach allows you to continue enjoying the use of your kitchen.  You're just doing it a little differently.

Saturday, February 12, 2011

Before & During : Rob



This week, I received the following email from Rob:
I started this change at 297 lbs 42" waist and a nice big gut.  Keep in mind that at this weight I was in the gym at least 3 days a week and still NEVER lost any weight.
I started this lifestyle change when I observed the progress of my Mom and Dad, Lorie and Bob Hill. 
I have taken before pictures to show my stomach and back.  This change began on November 11th 2010 and as of today I have lost 40 lbs, weighing in at 257 lbs on Feb 9th 2011. Now down to a 38" waist will some room to spare.


I feel great and have a first goal weight of 250lbs.  My long term goal weight is 230 lbs.  Keep in mind I am 6' 4" with a muscular build underneath all the insulation so I do not wish to conform to the typical "BMI" recommendations as they don't account for someone with muscle above an average individual.
I simply work with how I want to look and how I feel.


Only 7 more pounds to get to my first goal weight.  Then 20 more and I will be happy at 230.


Wish me luck!!!




Thursday, February 10, 2011

Sweeteners

One of my dilemmas is sweeteners.

I don't add any sugar to anything I eat.  Ever.  I do think your taste adjusts over time, so this is far from disastrous, especially when you don't use flour, because that means that you don't bake nearly as much as everyone else (I do still bake a little for the children and we have sugar in the cupboard.  It just doesn't cross my lips).

But sometimes it's nice to sweeten some dishes just a little, even though it's less so than before we stopped eating grains.

So that's when I wonder what the best sweetener is.  I sometimes use a little honey, though the chemical composition of honey is very similar to sucrose, and has the same blood-sugar reaction.  I also have a jar of unsulfured molasses.  I like the taste, and  it's very rich in iron.    But it's still sugar.  So what I wrote above about not eating sugar anymore probably doesn't ring very true.

There are times I use a little Splenda, because it has no calories.  I'm not terribly keen on it.  I have looked for studies that show concerns with it, and haven't found anything convincing.  But it is a processed food, and I really believe a huge part of the success of this way of eating is in keeping to the most basic ingredients.

Stevia is another option.  I don't happen to have any in the house, which is the main reason I'm not currently using it.  I suppose when my big bag of Splenda is empty, I'll probably switch to stevia, and I'm very keen to grow some this year.

What do you use to sweeten your food?

Tuesday, February 8, 2011

Broccoli


There's nothing shabby about this filling broccoli dish.  I started with steamed broccoli florets, splashed them with Kikkoman soy sauce, crumbled over some feta cheese and garnished it with a couple of goji berries. 

I'm sure toasted walnuts or almonds would taste wonderful instead of goji berries. 

Sunday, February 6, 2011

Before & After: Lorie





This is what Lorie says about her remarkable transformation: 
The before was taken in the summer of 2009, after seeing that picture I decided I needed to lose some weight.  All I could manage was to lose 9 pounds and I went from 162 to 153.  I could never seem to get any more weight off until I started the Get off The Grain Ride in September 2010.  Today I weigh 130 pounds.   

Friday, February 4, 2011

How the Food Guidelines have changed

Here's a fascinating bit of nutritional history:  The Baltimore Sun has a slide show showing various food guidelines from 1894 to the present.

Look what was recommended in 1943 - notice that there are 2 or more portions of bread and cereal, and 4 or more of fruit and vegetables, other than potatoes:

(click on these images to see them more clearly)


 In 1956, the bread and cereal ration doubled, to 4 or more per day;  they still recommended the same amount of fruit and vegetables, but now potatoes are included:




By 1992, we were being encouraged to eat a whopping 6-11 portions of bread and cereal per day, and the 3-5 vegetable servings include potatoes.  Also, take a look at the key, which shows a little upside down triangle to denote added sugars.  These are included throughout the food pyramid (by the way, you might want to ask yourself why the USDA added refined sugar here at all - was there a nutritional reason for this, or could it have something to do with special interest groups with deep pockets?):


While there isn't any way of determining from the above whether the portion sizes changed at all over the years, isn't it fascinating how bread, cereal, rice and pasta have taken on so much more importance in our diet in the past 60 years or so?

If anything, given how large restaurant portions have become, it's hard to believe  officially recommended portion sizes have declined.  Though if they are smaller today, clearly this hasn't been well communicated to the public at large.

Is it any wonder we have become so carb-addicted as a society?

Making your own yoghurt


Making your own yoghurt has many benefits.  As I will show in this tutorial, it is dead simple to do, and doesn’t cost more than the price of the milk you use.  You don’t need any fancy equipment – I even stopped using a thermometer after I accidentally broke my last one a while ago.

A lot of marketing dollars are thrown at expensive products containing beneficial bacteria that are described as live or active cultures or probiotics.  They are trying to make us believe we need to consume their specially formulated products to be healthy; however, most people don't realize how easy it is to make their own yoghurt, and the kind you make at home doesn't have any added sugar, gelatin, flavourings or other additives.  

Some time ago, CBC Marketplace tested the bacterial levels found in commercial probiotic products.  It’s an interesting read, and only serves to reinforce that making your own fresh yoghurt makes a lot of sense if you’re interested in its health benefits.  The bacteria in yoghurt die off the longer you keep it, so it’s a good idea to ensure you consume it really fresh.

This is all you need:
  • a bag of fresh milk (I use skim)
  • starter culture:  some good quality plain yoghurt or the remainder of your last batch
  • optional:  some powdered milk powder.  A tablespoon or two added to the milk makes the yoghurt a little thicker
  • a cooler
  • clean containers for making your yoghurt in.  You can use glasses, mason jars, a jug or any other clean container you can find. 


 Make sure the containers you are using are really clean.  You don’t want any contaminants so if they have been standing on the shelf for a while, give them a rinse – no need to dry though.

Start by heating the milk.  I microwave it for 10 minutes, which is enough time to kill any bacteria present in the milk.  If your microwave oven isn’t very strong, you might want to leave it in a little longer.  I have tried making yoghurt without this step and it hasn’t been as successful.  Even though the milk is pasteurized, I suspect the wrong bacteria start creeping in soon after, and these can interfere with the success of your batch.  Technically, you want the milk to reach 85-90oC (185-195oF), though as I mentioned above, I no longer have a thermometer.


Now cover the milk and leave it to cool down to a little above body temperature.  Again, if you want to be technical, you should aim for 40-43oC (105-110oF).  I sometimes put the milk outside to speed up the process, which takes about an hour.  If you’re going to use your finger to test the temperature, make sure it’s really clean.



You don’t need a lot of starter yoghurt culture to make your new batch.  If I am making it in individual glasses, I use about a teaspoon per cup or so of milk.  The container I am using here is a large wide mouth mason jar, and I use about 2 generous tablespoons.  The measurement really doesn’t have to be exact.



 Give it a gentle stir.  If the starter culture is lumpy, you may need to break it up a little with the spoon.  At this point you can also add a couple of spoonfuls of powdered milk for extra creaminess.


 Next, pour some hand warm water - approximately the temperature you would bathe a baby in - into the cooler.  There needs to be enough to create a warm bath, yet not so much that the container floats.  

 
Carefully place the container with the yoghurt in the cooler and cover it to prevent any drops from the condensation from dripping back into the yoghurt.


 Close it up and leave it to rest overnight.  Twenty four hours is fine.  Just don’t open the cooler during the first eight hours.

 
The next morning, take out the fresh yoghurt and check to see if it has thickened.  If it is too thin for your liking, cover it back up and leave it for another 4 or 5 hours.  Chances are, it will have thickened sufficiently by then.



And voila!  This is what your fresh yoghurt will look like.  It has thickened beautifully.  You can pour off the watery liquid (this is the whey and it is nutritious) and use it in  smoothies or your baking (not that I'm doing much baking any more these days).  You can also stir it back into the yoghurt if you like. 

If the batch doesn’t thicken, don’t throw it away!  You can still use it in any recipe that calls for buttermilk or sour milk.  Also think about what you may have done wrong:  was the water too hot, or the starter culture too old? Did you open the cooler before the first 8 hours were up?  Try making it again and you are sure to find success.

Thursday, February 3, 2011

Bob's 46 Pound Success Story -- Update

If you've been following this blog, you'll have seen Bob's before & after photos.  Well, you need to know that he's now passed the 57lb mark.  Even better, his entire family (7 people) got off the grain ride and are currently at a combined 220lb of weight loss.

Congratulations!

Eating for Life

Dr. Stephan du Toit is a South African transplant to Valemount, BC, who has been achieving remarkable weightloss and health results for his patients, with a program named Eating for Life.  He says he lost a lot of weight himself with his approach, and after keeping it off, realized this would be of benefit to his patients.

Details are sketchy, because he believes patients need to be closely monitored, but the broad outline seems to be very similar to what the Grain Ride is about:  cutting out sugars, while encouraging unstarchy vegetables, and meat, eggs and cheese.

The theory behind this is to eliminate the sugars behind the bloodsugar highs and lows that rule the lives of most people on the Standard American Diet, influencing not only their weight, but also their sleep and mood swings.

Participants eat three meals a day, spaced five hours apart, with no snacking, which is a complete turnaround from the conventional dieting advice of numerous snacks throughout the day.  Because Dr. du Toit's regime restricts the amount of sugar in the bloodstream, his approach is effective without leading to hunger, though he notes that the first three weeks are the hardest, as the body adjusts to its new routine.

Read more on page 2 of The Valley Sentinel and this article in the Rocky Mountain Goat.  Also, check out this YouTube piece:


More detailed resources

If you're looking for a great book to read on the subject of the carbohydrate link to obesity, you'll be interested in Good Calories, Bad Calories, by Gary Taubes, available at Indigo at $13.72 for members.

Or, if you'd like to take a look at what it's about first, you can read the extensive notes to the book online for free at this download.

Tuesday, February 1, 2011

PāNu

PāNu is a great site for good information on the Paleo diet, which, in many ways, espouses the same principles as Grain Ride.  The fact that it's written by an MD lends it credibility, but more than that, I like its commonsense approach.  It has a wealth of background information on the nutritional science behind the approach, and answers questions like "how much carbohydrate do we need?".  You will find all the background information on the different types of carbs (you really need to distinguish between glucose, fructose, inulin and cellulose aka fibre, because they're all different) that you ever wanted to know.

Instead of counting calories, Harris recommends a 12 step approach.   Some snippets:

  • Eliminate sugar and all foods that contain flour. 
  • Eliminate gluten grains. Limit grains like corn and rice, which are nutritionally poor.
  • 2 or 3 meals a day is best. Don't graze like a herbivore.
  • Most modern fruit is just a candy bar from a tree. Go easy on bags of sugar like apples. Stick with berries and avoid watermelon which is pure fructose. Eat in moderation.
  • Eliminate legumes
He also eats up to 4 pastured eggs a day and just 5% of his calories come from carbohydrates.  This is very different from the Standard American Diet (SAD)  - but don't take my word for it:  go check out the site for the whole story.