Proof that counting calories works for weight loss

It's pretty clear that energy in-energy out dictates weight loss and gain, with the exception of medication side effects and certain pathological conditions. But I lived in denial for a long time that I was the reason for my inability to lose weight, or to maintain any weight loss I did achieve. 

I wrote about my own struggles with weight and how I lost 75 pounds on a calorie restriction diet at Medium. 

It hasn't been easy, and I am still struggling to make the changes permanent. But for those who are struggling, I hope my journey gives you a little hope that it is possible to succeed.

I did a lot of reading about calorie restriction diets before jumping in a few years ago and the exercise regimen I used was, and is, light - walking and simple yoga stretches. Be sure to discuss any potential heart, joint, or muscle problems with your doctor before starting an exercise regimen, as well as any supplements you may need for whatever diet you choose to adapt.

Dieting is only temporary, but lifestyle changes in how you approach nutrition can make any gains permanent.

Citrus fruit and stroke risk

Photo by Figiu, Wikimedia

The Atlantic had an interesting article this month (March 2012) about citrus fruit and stroke risk. The article discusses a study showing that women benefit from flavanones in citrus fruit, protecting them against ischemic stroke, reducing their risk by 19 percent.

Flavanones are a specific flavonoid found in citrus, such as oranges and grapefruit. Other flavonoids are found in red wine, dark chocolate, vegetables, and other fruits. However the results were specific to the subtype found in citrus. Previous research found that vitamin C is associated with a similar risk reduction.

Another caveat is that increasing fruit juice intake is not recommended - it's high in sugar. Best to just eat more fruit.

The data was from the Nurses Health Study. The idea that flavanones are healthy isn't new as research in 2005 sought to determine the mechanism underlying their antioxidant effect.

Dietary antioxidants can reduce stroke risk

Research has shown again and again that antioxidants are beneficial to the human body. But it's really about the buzz word "antioxidants". It seems like some new food or concept, but antioxidants are just vitamins and minerals - something your parents kept telling you to eat as a kid!

 

What are antioxidants?

 

Antioxidants are chemicals that protect cells from free radicals, atoms formed by some chemical reactions with oxygen (like the oxidation of low density lipoprotein, the LDL form of cholesterol), which can occur naturally or in response to environmental exposures to toxins, such as cigarette smoke. Antioxidants are usually found in foodstuffs (Nuts, grains, fish and poultry, green leafy veggies, fruits) and include several vitamins, including vitamin A, E, and C, as well as lycopene, lutein, and selenium. Increased intake of antioxidants is thought to protect against a number of disorders, including heart disease and cancer, and recent research has shown potential for protection from stroke. However, supplementation and dietary intake appear to offer differential effects with supplementation not providing the same benefits.

 

Studies on stroke in women

A 2000 study published in the American Journal of Clinical Nutrition, which examined antioxidant intake and stroke mortality in more than 34,000 postmenopausal women, found that vitamin E, acting as an antioxidant, may protect against death from stroke, but only if ingested via food. In 2011, a study published in the American Heart Association journal Stroke found that a greater total dietary antioxidant intake reduced stroke incidence in more than 36,000 peri-menopausal and post-menopausal women, regardless of cardiovascular disease status. Women without cardiovascular disease had a 17 percent lower risk of stroke, and women with cardiovascular disease had a 45 percent lower risk of hemorrhagic stroke. Approximately half of the antioxidants ingested by the women in the study were from fruits and vegetables, but the other half was from a variety of foods including grains, tea and chocolate .

Studies on stroke in men

Findings in men are not as prevalent, or as significant. Stroke is sometimes categorized in the broader category of cardiovascular disease. One study published in the journal Stroke in June 2011 looked at antioxidant intake and cardiovascular disease in Asian men and women, specifically in Japan. The only significant findings were in women – vitamin C decreased the risk of mortality from cardiovascular disease. However, a 2000 study published in the Stroke did find that dietary beta-carotene intake (the precursor to vitamin A) decreases the risk of stroke in male smokers.

Why antioxidant supplements may not work

Supplements may not show the same benefits because they focus on a single vitamin or antioxidant. The beneficial effect is most likely caused by the interactions between antioxidants and/or their cumulative effects. Clinical trials found that supplementation may work in those with increased levels of oxidative stress, perhaps by boosting the free radical scavenging process, but that those with normal oxidative stress levels benefit most from dietary intake.

Dark chocolate and stroke prevention

The high proportion of cocoa solids in dark chocolate bestows the treat with some of the healthier properties attributed to the cacao bean. Research has shown that flavinoids in cacao help prevent blood clots by affecting platelet function, and flavan-3-ols in the chocolate can lower blood pressure. More recent research has shown that catechins (epicatechin specifically) can help limit the damage caused by stroke.

Oral rehydration solution: Bangladesh solution to dehydration

Dehydrated children cared for by the US Navy

The human body is made up of 50-70 percent water, and human blood plasma is 91 percent water, making up more than half the blood volume. Water plays a role in human cell structure and nutrient transport, as well as maintaining blood pressure, blood pH, and ion balances within the tissues. Dehydration is the result of water loss - the body simply cannot maintain its functions and causes illness. Similar to summer dehydration by sweating, a person who suffers from a diarrheal disease also loses water, but through the intestines and bowel. Worldwide, up to 4 million children die each year from diarrhea.

Oral rehydration salt-sugar solution (ORS) is a simple at-home concoction containing “a pinch of salt, a fistful of sugar, a half liter of water”. The solution was first taught in Bangladesh households 26 years ago, after being tested in a cholera outbreak in 1971.

The oral rehydration solution replaces the lost water, but it also provides ions and minerals that help the absorption process and the maintenance of homeostasis within the body, minimizing the severity of the diarrhea’s effects on the sufferer. Bangladesh has been a beneficiary of the efforts of aid organizations that have been teaching households how to mix the solution, which is sometimes referred to as "Poor man's Gatorade". It has integrated into the regular treatment of diarrheal disease, as well as hydration after exertion in the hot sun, preventing dehydration from other factors. However, the International Center for Diarrheal Disease Research still treats 100,000 patients a year, because the ORS is not a cure for what causes diarrhea, only a treatment for dehydration.

Water is an important treatment of dehydration in developed countries, but when electrolytes require replenishment or fresh water is not available, enriched drinks are an option. Avoid alcohol, caffeine, and sugary drinks to avoid further dehydration. See the CDC for more information about the importance of water to the human body.

Caffeine: A troubling component of "energy" drinks

In 2006, energy drinks were a $5.4 billion market in the U.S. alone. Each year, more than 900 million gallons of energy drinks are consumed, and the market is growing. In 2008, a research group at Johns Hopkins University School of Medicine painstakingly compiled the caffeine content and per ounce dose of top selling energy drink brands sold in the U.S. The content of hundreds of brands on the market range from 50 mg to 505 mg per can or bottle (compared to an average of 77 mg in a 6 oz cup of coffee). Caffeine limits set by the U.S. Food and Drug Administration are 0.02%, which are not followed. Energy drink manufacturers exploit a loophole introduced by the 1994 Dietary Supplement Health and Education Act, often referring to the supplemental or beneficial qualities of their product.

Energy Citrus Vitamin Water is one of the lowest caffeine-containing energy drinks with 50 mg in a 20 ounce serving (2.5 mg/oz). Moderate caffeine drinks are Tab Energy with 95 mg caffeine in 10.5 ounces (9.1 mg/oz), SoBe Adrenaline Rush with 79 mg in 8.3 ounces (9.5 mg/oz), and Amp with 75 mg in 8.4 ounces (8.9 mg/oz).

The top selling energy drinks have similar doses, but are larger volume with higher total caffeine in a sitting – 16 ounce cans of Full Throttle, Rockstar, and Monster have 144, 160, and 160 mg caffeine, respectively (9 and 10 mg/oz). Red Bull has 80 mg in 8.3 ounces (9.6 mg/oz).

Higher concentration energy drinks contain slightly higher amounts of caffeine, but in small volumes – one ounce shots of Powershot and Ammo have 100 and171 mg caffeine, respectively (100 and 171 mg/oz).

The highly caffeinated energy drinks contain two to five times the recommended dose of caffeine for consumption (no more than 100-200 mg should be ingested in a 3 or 4 hour period). NOS contains 250 mg in 16 ounces (16.3 mg/oz); Cocaine Energy Drink contains 280 mg in 8.4 ounces (33.3 mg/oz); WiredX344 contains 344 mg in 16 ounces (21.5 mg/oz); WiredX505 contains 505 mg in 24 ounces (21 mg/oz); and Fixx contains 500 mg in 20 ounces (25 mg/oz).

(Selection of energy drinks and their caffeine content taken from Reissig, Strain, and Griffiths, Caffeinated energy drinks - A growing problem, Drug and Alcohol Dependence, 2008. See the publication for a full list).

Caffeine limits set by the U.S. Food and Drug Administration are 0.02%, which are not followed. Energy drink manufacturers exploit a loophole introduced by the 1994 Dietary Supplement Health and Education Act, often referring to the supplemental or beneficial qualities of their product. Research has shown troubling side effects, such as caffeine dependence and heart problems, to energy drink consumption. Even habitual coffee drinkers have been found to suffer adverse effects. Drinking some of the higher caffeinated energy drinks, or multiple less caffeinated drinks, can lead to caffeine intoxication, which is characterized by anxiety, nervousness, insomnia, gastrointestinal problems, being jittery, and irregular heartbeat.

Dependence is a physical or mental need for a substance, resulting in disability when the body becomes reliant on what a substance provides. In the case of energy drinks, or even coffee, the substance is caffeine. There is currently lax regulation in regards to labeling the contents of energy drinks, and caffeine limits do not stay below the 0.02% caffeine that U.S. Food and Drug Administration (FDA) guidelines require. Some energy drink producers get by on a loophole created by the 1994 Dietary Supplement Health and Education Act, but not all are worse than the cup of coffee many are accustomed to drinking.

The recommendations for caffeine use are that caffeine not be given to those under the age of 12 years, no more than 100-200 mg should be ingested in a 3 or 4 hour period, it should not be used as a remedy for sleepiness, and use should be discontinued if an irregular heartbeat is experienced. Despite these recommendations and warnings, which are present on over the counter no-doze tablets that contain 100 mg caffeine, many energy drinks contain 2 to 5 times the recommended dose (up to 500 mg caffeine) and do not contain these warnings. An average cup of brewed coffee contains 12.8 mg/oz caffeine for a total intake of 77 mg in a 6 oz cup, a regular soft drink (e.g., Coca-Cola) contains 2.9 mg/oz for a total intake of 34.5 mg in a 12 oz can.

Even habitual coffee drinkers have been found to suffer adverse effects from energy drinks, with toxicity and overdose mimicking mental disorders. Caffeine intoxication includes anxiety, nervousness, insomnia, gastrointestinal problems, tremors (being jittery), and irregular heartbeat. Addiction to caffeine can result in withdrawal symptoms, including headache, dizziness, muscle stiffness, depression, and fatigue, when the substance is not ingested. Caffeine withdrawal has been described in the medical literature for a century.

Two or three cups of coffee is considered moderate caffeine intake, but a single energy drink can provide many times this amount of caffeine and in a shorter time span. Caffeine acts directly on the central nervous system, with peak stimulation reached in approximately 30 minutes, but the effect is short-term, leading many who rely on caffeine for increased attention or awareness to continuously seek out more caffeine, in the form of coffee or the high dose energy drinks - a clear sign of dependence.

For more information see:

Marion Howard. Is caffeine addictive? Bryn Mawr College, 1999.

Treating lung cancer: Selenium doesn't work

Many hope that antioxidants may be the key to avoiding the cell damage that can lead to cancerous changes. One such antioxidant is selenium, which researchers have been evaluating for nearly 15 years in the prevention of lung cancer, specifically non-small cell carcinoma.

Selenium is naturally found in trace amounts in plant foods, including Brazil nuts, walnuts, and grains (rice, oats, bread, enriched noodles), and animals that graze or eat on plants and grains containing selenium: beef, turkey, dairy products (cheese), eggs, cod and tuna (if canned in oil), and chicken. Selenium has low dietary requirements: daily recommended intake of 55-70 micrograms for individuals over 14 years of age, 15 to 40 micrograms for children, even less in infants. The average intake in the U.S. is >100 mcg.

Regions of Russia and China suffer from selenium deficiency, which has been associated with heart problems, hypothyroidism, a weakened immune system, and cancer, specifically prostate and lung. A 1996 study found that supplementation reduced these two cancers by 30%, but other studies have had contradictory results. In 2008 the National Cancer Institute found that taking selenium and vitamin E does not reduce prostate cancer risk, and evaluating toenail clippings from cancer patients for selenium intake found no correlation with cancer incidence. Yet other studies have shown slowed tumor growth.

A Texas study on lung cancer presented at the June 5, 2010 meeting of the American Society of Clinical Oncology followed 1500 patients with non-small cell lung carcinoma found that those receiving a 200 microgram Selenium regimen did not fare better than those receiving placebo after tumor removal. They halted the trial early in case the supplementation was worsening the patients' condition.

All patients should discuss supplementation with their doctors and treatment professionals. But overall it appears that selenium does not work to reduce or help lung cancer.

FDA troubles for Diet Coke Plus

The beverage Diet Coke Plus may have to be renamed and claims about vitamin and mineral content retracted due to FDA regulations about labeling. The Coca-Cola Company is being officially reprimanded by the Federal agency.

According to HealthDay, a healthier living news agency, Coca-Cola Co. has received a letter from the Food and Drug Administration admonishing them for fortifying a carbonated beverage, which is considered a snack item. Snack items are generally less healthy and fortifying them may lead consumers to believe they are healthy, when in fact no negative attributes have been removed.

The vitamins and minerals in Diet Coke Plus include magnesium and B-12, which benefit the immune system. The agency claims that this is not enough to warrant the company’s claims for the product.

The FDA has asked that the claim “plus” be removed from the label, but the company has stated that they have followed all regulations. A reply and appeal to the FDA is pending.

Read the FDA warning letter issued on Dec 10, 2008.

Turkey Is Nutritious!

You don't have to break your diet to enjoy Thanksgiving. Just watch your portions. 2-3 ounces of turkey is a healthy source of necessary vitamins and minerals, as well as protein.

Roast turkey. CC2.0 license. Source

Turkey, like other types of meat, contains protein, which is a necessary component of a balanced diet, along with fats, carbohydrates, vitamins, and minerals. Turkey also contains fats, vitamins, and minerals recommended for daily dietary intake. Like most things, though, moderation is key. For calorie conscious eaters, the skinless breast is the least worrisome of all the bird’s parts.

Vitamins and minerals in turkey

A single serving of turkey is considered to be 2 to 3 ounces, and 2 to 3 servings of meat is recommended per day. In this portion is iron, zinc, phosphorous, potassium, and B vitamins. Iron is important for the transport of oxygen by red blood cells. A deficiency of iron can result in anemia. Zinc is important for immune function, reproductive function, and is a component of many cellular proteins. Phosphorous is important for cellular metabolism and energy use. Potassium is important for blood pressure regulation. B vitamins are important for the immune system and have roles in cellular metabolism.

The caloric composition of turkey

The portions of the turkey with the least amount of calories are the breast and the dark meat without skin. Protein, fat (both saturated and unsaturated), and carbohydrates (or sugars) make up the caloric, or energy producing, composition of a food. Each gram of fat is 9 cal, protein is 4 cal, and carbohydrates is 3 cal. There are no carbohydrates in unprocessed turkey based on several sources, including the USDA Nutrient Data Laboratory. Turkey contains more protein than the same size serving of chicken or beefsteak.

A single serving of turkey breast without skin contains approximately 160 calories from 30 grams of protein and 4 grams of fat; very little of this is saturated fat (less than a half gram). Breast with skin has about 30 more calories because there is less protein and twice as much fat. Dark meat without skin is similar to breast with skin. Fresh roasted turkey is also relatively low in sodium, containing less than 50 mg per 3 ounce serving.

A healthy Thanksgiving meal

It is known that many people gorge during the holidays, putting their diets and shame aside. This can lead to guilt, self-anger, and even sleepiness. The simple act of having a traditional turkey does not have to result in bad habits or feelings. When eaten with sensible side dishes, or moderate portions of once-a-year favorites, the Thanksgiving turkey can be enjoyable and not ruin your diet.

Does tryptophan make you sleepy?

Thanksgiving dinner. Ms Jones, CC2.0 license

The tryptophan in turkey is often thought to cause post-holiday drowsiness. This is not true, though the meal does have something to do with it.

Turkey, like many other foods, contains protein. When protein is eaten, the body breaks it down into its components, called amino acids. Tryptophan is one of the amino acids in turkey. One of twenty amino acids, tryptophan is an essential amino acid meaning it is only taken in from the diet and not made by the body. L-tryptophan, the variation of the amino acid which is ingested, is used by the human body to produce the B-vitamin niacin. Niacin, in turn, is used to produce serotonin, a brain chemical that calms a person into sleep.

The myth about tryptophan

It is a common misconception that the tryptophan in turkey makes everyone sleepy after the Thanksgiving meal. Although tryptophan may play a chemical role in helping one nod off, it has this effect more prominently on an empty stomach when there are no other amino acids with which to compete. In truth, only a portion of the tryptophan from the turkey makes it to the brain to produce serotonin. Also, it takes larger quantities of tryptophan than what is present in the average serving of turkey to induce serotonin production to an extent as to cause sleep.

Tryptophan is also found in dairy products, fish, tofu, eggs, some seeds, nuts, and peanut butter. It would be reasonable to assume that eating a meal with any of these would make one sleepy just as turkey supposedly does, but they don't. Often dairy products and eggs are eaten for breakfast, a time when a person does not want to sleep. One more example disproving that turkey is what causes relatives to neglect the dishes in the sink on Thanksgiving.

The truth about the post-meal nap

Large quantities of food, particularly foods high in simple sugars and starches such as those found in a typical Thanksgiving meal, cause the drowsiness associated with holiday napping. The increase in blood sugar causes the body to release insulin. As the body quickly removes the sugar and the level in the blood drops, the body exhibits hypoglycemic symptoms such as drowsiness. This peak and fall is common with simple sugars and they are therefore avoided by runners or athletes the morning of a race or match. Pulling blood away from the brain to aid in digestion induces drowsiness also.

Alcohol consumption has its own sedative effect. This in combination with the bread, stuffing, turkey, potatoes, whipped cream, pie, carrots, or cranberries can make a nap seem like a good idea. It has been estimated that the typical Thanksgiving meal has 3000 calories.

Alternatives to avoid drowsiness

The best advice for avoiding an after meal doze on Thursday is to not pig out. Eat a little bit of everything, but not a lot of it all. To stop your blood sugar from plummeting, eat incrementally, a couple of little snacking meals rather than one large one. Another thing you can do is to have a cup of coffee or tea, caffeine helps offset the sedative affect. Also, limit alcohol and dessert consumption. Most importantly, a person could eat a balanced meal with steamed or fresh vegetables and lean protein; or just schedule in a nap.

New male osteoporosis screening guidelines

The American College of Physicians has issued new guidelines for the screening of osteoporosis in men. Osteoporosis is a loss of bone mass, which is normal as we age. However, severe decreases can lead to fractures and other complications - basically a fragile skeletal frame. There is some debate as to how important screening is and to what extent this qualifies as a disease. Regardless...

The new guidelines recommend that clinicians assess risk factors for osteoporosis in older men and that clinicians obtain a dual-energy x-ray absorptiometry (DXA) scan for men at increased risk for osteoporosis who are candidates for drug therapy.

...

Based on this meta-analysis, risk factors for low BMD–related fracture in men and women were age (> 70 years), body mass index (BMI) less than 20 to 25 kg/m², weight loss of more than 10%, physical inactivity or sedentary lifestyle, previous osteoporotic fractures not resulting from significant trauma, prolonged or ongoing use of certain drugs (eg, prednisone or other corticosteroids), and low-calcium diet.

In men, androgen deprivation therapy and spinal cord injury were also associated with the risk for osteoporosis.

The report was described at Medscape, but originally found in the May 6 issue of Annals of Internal Medicine.