Does Your Shape Matter More Than the Number on the Scale?

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For individuals struggling with overweight and obesity, focusing on body mass index (BMI) or the number of the scale may be the wrong health indicators.

An emerging body of literature suggests that an older measurement, the waist-to-hip ratio may be more valuable when assessing the impact of weight on health.

A new study published in the journal Obesity found that participants with a high waste-to-hip ratio had a higher risk of heart attack.

People with a high waist-to-hip ratio are often described as being “apple” shaped. Apple shaped individuals hold fat around their important vital organs. This type of fat leeches into the bloodstream easily and causes a negative effect on cholesterol and other blood fats.

The World Health Organization states that a healthy waist-to-hip ratio is less than 0.9 for men and less than 0.85 for women. It is important to note that there are no particular exercises you can do to reduce fat in one particular area of your body. “Spot reducing” does not work; rather, cardiovascular and strength building exercises can help convert fat to muscle and lower overall body fatness. For tips on calculating your own waist-to-hip ratio, click here.

High Fructose Corn Syrup and the Obesity Epidemic

December 10, 2013 by  
Filed under Carbohydrates

In 1970, sucrose was the main food and beverage sweetener used in the U.S. Sucrose, or “table sugar”, is composed of one glucose molecule linked to a molecule of fructose.  In 1970, ~15% of America were obese. Today, obesity rates are around 35% and high fructose corn syrup (HFCS) has replaced sucrose in many foods and drinks. The question that has caught the attention of many over the past several years then is: What is the association between this dramatic increase in the consumption of HFCS and the skyrocketing obesity rates in the U.S. Let’s take a closer look at this issue and see what the peer-reviewed scientific literature has to say.

Why has HFCS replaced sucrose in many foods and drinks? That’s an interesting question, but first lets’ consider the source of HFCS. It is made by extracting starch from corn, and then treating the starch to release the glucose, followed by a procedure which converts about half of the glucose to fructose. HFCS is cheaper and more stable during storage than sucrose, explaining why food manufacturers prefer to use it as a sweetener.

Studies performed in the past decade suggested that there was a direct link between increased HFCS intake and obesity. This made sense since fructose is more easily converted to fat than glucose and it may alter hormonal signals that control feeding behavior differently from glucose. Again, interesting facts, but how is the sugar content of HFCS really different from sucrose? The answer is not very different, in fact, very similar. Sucrose is 50% glucose and 50% fructose, while HFCS contains either 55% fructose/42% glucose (in sodas) or 42% fructose/ 53% glucose (used in baked goods). So as you can see, the composition of HCFS and sucrose is very similar. Why then would HFCS lead to different health consequences as compared to consumption of sucrose? The answer is that it probably does not.

A survey of the scientific literature identifies several very recent papers that conclude that from a nutritional or health-related perspective, consuming sucrose versus HFCS is not different. One recent study found that HFCS and sucrose do not differentially affect levels of “energy-regulating hormones” in humans ( Nutr. Res., 2013). Another paper in the International Journal of Obesity concluded that there was a lack of evidence to link HFCS consumption with the current obesity epidemic (Int. J. Obes., 2013). It was also noted that there was inconclusive evidence to link HFCS to childhood obesity (Ped. Obes., 2013). The consensus on this issue thus seems to be shifting.

Nutrition science tells us that greater energy in than energy out leads to weight gain over time. Not only has HFCS intake increased over the past few decades, but total energy intake has as well. Perhaps the culprit is not HFCS, but rather a change in the typical American’s lifestyle towards more food intake and less activity. Future studies will undoubtedly address this important issue further, but in the meantime, will you avoid food and beverages sweetened with HFCS? How do you think it could positively influence your health if you switched to sucrose sweetened foods and drinks? Or maybe the best approach is to decrease intake of ALL sugar sweetened foods and decrease overall energy intake in that way. What will be your approach?

Health at Every Size?

November 27, 2013 by  
Filed under Fat

Being overweight or obese is often identified as the primary cause of heart disease, diabetes, cancer, and, ultimately, premature death. As a result, Americans are waging a war on fat (we have been for years). Diet books, pills, programs, and fitness fads abound… But is fat really at fault? Meaning, is an excess amount of body fat in and of itself responsible for the increased rates of death and disease? Or are other factors like unhealthy lifestyles, lack of cardiovascular fitness, and/or fat prejudice to blame?

Consider the concept of Health at Every Size (HAES). HAES is a relatively new “movement” focused on body acceptance and healthy lifestyles instead weight loss. From the HAES website: “Fighting fat hasn’t made the fat go away. And being thinner, even if we knew how to successfully accomplish it, will not necessarily make us healthier or happier… Health at Every Size is the new peace movement. Very simply, it acknowledges that good health can best be realized independent from considerations of size. It supports people—of all sizes—in addressing health directly by adopting healthy behaviors.”

It all sounds well and good, but is there any scientific support for HAES? Indeed, there is. A 2005 study published in the Journal of Academy of Nutrition and Dietetics compared the effectiveness of a traditional diet approach and a HAES approach in a group of obese women (the approaches were randomly assigned). It’s important to note that “effectiveness” in this study was not limited to body weight; outcome measures also included metabolic fitness (blood pressure, blood lipids), energy expenditure, eating behaviors (restraint, eating disorder pathology), and psychology (self-esteem, depression, body image).

The results? The attrition rate at six months was high in the diet group (41%) compared to the HAES group (8%). The diet group lost weight and showed initial improvement in many variables at 1 year, but the weight was regained and little improvement was sustained at two years. The HAES group, on the other hand, maintained weight, improved all other outcome variables, and sustained the improvements for at least two years.

Food for thought

Do you think people can be fat and healthy at the same time? How about fat and fit? Also, do you think the stigma and fear associated with being fat in the United States contributes to the current “obesity epidemic”?

Diet Sodas and Obesity: Is there a Connection?

November 26, 2013 by  
Filed under Carbohydrates, Consumer awareness

You may have seen recent headlines that heralded studies indicating that diet soda consumption was related to weight gain. A USA Today headline from a July 10, 2013 article read, “Study: Diet soda doesn’t help you lose weight” (Diet Soda Article).  Another on the Reader’s Digest web site asks, “Is Diet Soda Making You Fat?” (Reader’s Digest Article). Furthermore, WebMD reports that searching “diet soda” and “weight” using a popular browser found that 49 of the top 50 hits were for stories that warned readers of the link between diet soda and weight gain (WebMD Article).  Why has this issue been in the news in recent months? It turns out that a few scientific studies were published over the past several months, purporting this idea that diet soda consumption may actually lead to weight gain, rather than what most people would expect, weigh loss.  Let’s have a closer look at those studies and also consider this issue in light of a larger body of scientific research on this topic.

It turns that the recent attention to this issue results from studies with laboratory rats and from observational studies in humans. In the rat studies, published by Drs. Swithers and Davidson at Purdue University (Swithers S and Davidson T – PubMed – NCBI), the researchers noted an association between non-nutritive sweetner consumption (e.g. saccharin) and weight gain. The researchers suggested that rats consuming saccharin, as opposed to rats ingesting table sugar, took in more calories and gained more weigh over time. But, will this finding hold true in humans?

Other recent epidemiological studies, consisting of large numbers of people, reported that those who drank more diet sodas gained more weight over time. One study tracked more than 5000 adults in the San Antonio Heart Study. The second (the Framingham analysis) reported an association between intake of both sugar-sweetened sodas and diet sodas and development of metabolic syndrome, which is cluster of symptoms linked to obesity. However, since both of these studies were observational, it is not possible to say with certainty whether consumption of diet sodas has a direct effect on body weight.

These studies were rapidly popularized by the media and online bloggers, and soon this message was out for all to see. Interestingly, not everyone agrees with these findings and many past studies have not identified such an association. A recent review of past studies on this topic, published in the American Journal of Nutrition (AJCN Article), came to different conclusions, namely that the purported mechanisms by which non-nutritive sweetners promote energy intake and contribute to weight gain are not supported by the current available evidence. The authors do however recommend that this possibility should be further considered in long-term, randomized controlled clinical trials.

The jury is thus still out on this issue, despite all the recent negative press regarding consumption of artificial sweetners. Importantly two respected scientific organizations support the use of no calorie sweetners to restrict calorie and sugar intake (the American diabetes Association and the American Dietetic Association). This thus leaves us as individuals with a sort of dilemma. Should we restrict intake of artificial sweetners? Which studies are correct? The best advice may be to consume these food additives in moderation and await more definitive research which will undoubtedly be undertaken very soon.

Fiber failure

October 25, 2013 by  
Filed under Carbohydrates

Did you see the headlines today? Americans are not consuming enough fiber!… Hmmm, this really isn’t news. We’ve known for years that, as a nation, we don’t consume enough whole grains, fresh fruits, or vegetables. A recent study published in the December issue of The American Journal of Medicine (AMJ), confirms that this lack of fiber is at least partly responsible for an increased risk of metabolic syndrome, cardiovascular disease, and obesity.

How much fiber do we need?

The Institute of Medicine recommends that adults aged 19-50 years consume 25 grams of fiber per day (women) to 38 grams of fiber day (men). That may sound like a lot, but it’s surprisingly easy to meet the recommendations if you put in a little effort. It will likely require a few simple substitutions, and perhaps a couple of healthy additions.

For instance, instead of eating a highly processed breakfast cereal first thing in the morning, choose one made with whole grains (5 grams of fiber per cup). Instead of eating a sandwich for lunch made with bread from refined flour, choose bread made with whole grains (5 grams of fiber per two slices). Instead of eating refined pasta for dinner, choose whole grain pasta (5 grams of fiber per cup). And don’t forget to enjoy fruits and vegetables throughout the day as snacks –a cup of fresh fruit or vegetables is worth another 5 grams of fiber, as is half a cup of beans.

You can see that, if you focus on WHOLE GRAINS,  it’s quite possible to meet the recommendations for daily fiber intake. Unfortunately, according to the recent AMJ study, Americans consume an average of just 16 grams per day! That’s roughly half of the recommendation.

Food for thought

Why do you think that most Americans do not consume enough fiber? How much fiber do you consume on a daily basis? What sorts of substitutions or additions to your diet could you make to consume more fiber?

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“Dietary Fiber Intake and Cardiometabolic Risks Among US Adults, NHANES 1999-2010” by Kya N. Grooms, BA; Mark J. Ommerborn, MPH; Do Quyen Pham, MPH; Luc Djousse, MD, ScD, MPH; Cheryl R. Clark, MD, ScD. The American Journal of Medicine, Volume 126, Issue 12, December 2013.