Even for consumers who know better, highly processed and adulterated grain can be challenging to avoid. Cereal and milk is the number one breakfast served at many schools. LAUSD offers a range of breakfast choices each day, but cereal and milk remains the most popular option, with many kids skipping the milk and opting to eat the cereal as a snack. The same holds true for other school breakfast initiatives, such as Breakfast after the Bell.
How often do you wonder about the best strategies to lose weight? A recently published study looks at the role of exercising in a fasted or fed state and aims to answer the question, “Do you lose more fat weight if you exercise in a fasting state (before you eat) or in a fed state after you eat?” In the end, the researchers say it doesn’t make any difference, but there are details that deserve discussion.
Researchers studied 20 non obese young active women attending a university. Some were off season track athletes, so the researchers matched the two groups based on weight and body composition, making sure the two groups included a comparable number of athletes. For four weeks the study participants were provided individualized meal plans with a 500 calorie deficit from their expected calorie needs using a standardized equation. In the meantime, the participants exercised for one hour three times a week at 70% VO2 max, which is typically considered a moderate level of exercise. Both groups lost weight and both groups lost fat with no significant difference between the two. So what deserves discussion?
WHAT DOES BODY WEIGHT AND BODY FAT MEASURES TELL US ABOUT METABOLIC HEALTH?
Researchers used body weight and body composition measures to match the participants in the two groups, but these measures aren’t sensitive enough to address fitness and metabolic status. We don’t really know anything about the participant’s relative metabolic health, just that they did not have any overt evidence of disease and they were not pregnant during the six months prior to the experiment.
The women reportedly consumed less than 1300 calories a day on average, but didn’t lose as much fat weight as the researchers expected. The authors speculated that possibly participants underestimated their food intake. I’m thinking there might be other explanations
13oo calories is achingly close to or could actually be considered semi-starvation for young active women, especially athletes. Many women chronically restrict calories without necessarily being diagnosed with an eating disorder. We call it “restrained eating”. Chronic calorie restriction leads to a reduced metabolic rate, sometimes measured by assessing one’s resting energy expenditure (REE). The researchers would have needed to assess each participant’s REE to know. Despite screening for healthy participants, it is possible that the energy expenditure equation used to determine calorie intake actually over-estimated the participant’s actual calorie needs. (And it is possible that everyone under reported their food intake as the researchers suggested.)
As I read this study I could already hear the soundbites for individuals who are looking to lose fat weight. Yet, data from some of the subjects could have skewed the results, making these findings less applicable to the rest of us. The off season track and field athletes involved in the study were known to have body composition levels at 11-13% body fat, basically at or below the essential body fat levels for women, and much lower than what many would consider fit or healthy. These women are already exquisitely lean. How does their participation in the study influence the data?
The researchers were careful to include athletes in both groups in order to avoid bias, which makes me curious about the range of weight and fat loss within each group. How did those athletes compare with everyone else in their respective groups? The average results reported don’t tell us nearly enough about the experience of all the different participants. I wrote to two of the authors, and both wrote back without answering my questions. So I guess we don’t get to know for now. With so little body fat to lose, the athletes could have diminished the average results seen with more typical young women seeking weight loss.
WHAT ABOUT THE ACTIVITY
All the participants exercised at 70% VO2 max, but that doesn’t mean all the participants exerted the same effort to accomplish this task. I am curious if the athletes experienced a different level of perceived exertion–and a different metabolism of fat and carbohydrate while exercising at the same intensity. In addition I would like to know if that activity exerted any impact on the participants sense of hunger and satiety during the rest of the day. Too often researchers are preoccupied with collecting data and forget to ask the participants about their experience throughout the research protocol.
WHAT ABOUT THE FOOD
The participants of both groups consumed close to 50% of calories from carbohydrate and the rest of the calories split between protein and fat. But the beverage given to the fed participants before exercise measured 25o calories with 40 grams of carbohydrate–about 65% of the calories from carbohydrate. Some people burn fat better when they eat less carbohydrate. I wonder if the experience would have been different for the fed group–or any individuals in the fed group–with a pre-workout beverage yielding a protein-carbohydrate-fat ratio closer to the average intake.
The bigger question remains, would a more individualized approach to diet be more effective for each individual and the group results. Researchers continue to seek the holy grail of diets: which one works best. That’s the wrong question. We need to be looking for ways to determine what diet works best for any one person.
MOVING TOWARDS PERSONALIZED NUTRITION PRESCRIPTION
Despite trying to answer a singular question, this study mostly triggers more questions: What was the experience of each participant? What does the range of measured change tell us about the range of possibilities within the study group?
Years ago when I worked much more frequently with athletes, I soon adopted a “personalized” approach to nutrition counseling. The unique needs, training and demands of athletes at different ages, in different sports and more critically with different genetic and environmental factors influencing metabolism basically taught me to individualize everything. Research continues to rely on randomized study protocols that assess average results in order to achieve statistical significance. This framework often misses important differences between subjects and leads to broad recommendations based on averages. Most studies, including this one, fail to report or explore the range of outcomes measured by the different participants exposed to a specific dietary and exercise protocol. I’m left wondering if studies like this could offer much greater perspective by reporting all the outcomes, not just the averages.
In December of 2013 the FDA announced a momentous baby step. The agency finally proposed a voluntary limit on use of antibiotics as growth enhancers in animals raised for food. I am hopeful, but waiting to see how this proposal plays out. Proponents of a vegan diet didn’t wait at all. Just two days later the LA Times published a letter to the editor from a staffer for the PETA foundation chastising us meat eaters for not seeing the light. There would be no problem if only the rest of us ate a delicious and nutritionally superior vegan diet.
If only. For forty years the public health and medical community presumed a single dietary approach was best for everyone, and they were flat out wrong. In the early 1990’s I ventured to add more protein and fat to my diet, telling no one. The higher carbohydrate diet recommended for all Americans and especially for athletes failed me. Ornish’s and Pritikin’s vegan and almost vegan protocols didn’t help. I readily gained weight, felt awful, and struggled with food. I rarely felt satisfied. I ventured to try a higher fat and higher protein diet.
A BETTER DIET
With more protein and fat I felt less bloated and lost body fat. I thought more clearly. I enjoyed greater energy and stamina. Over time I stopped feeling like I would pass out any time I got over hungry. I felt more content and less preoccupied with food. My immune system improved and even my nails grew stronger. Clearly this was a better way for me to eat. A high carbohydrate, low fat diet just didn’t work.
After years of research and personal experience, I have worked with many clients who are also insulin resistance. They don’t handle high carbohydrate diets, no matter how “healthy”. I came out in 1995 with my first paper regarding insulin resistance and today continue to work with many individuals who learn how to thrive when they eat primarily protein and produce. The Paleo craze only reinforces my observations, despite the fact that they suffer from the same myopia as other fads. There is no one right way to eat, and even folks who don’t handle carbohydrates are not always insulin resistant to the same degree. There is a wide range of tolerance and the challenge is to figure out an approach to food that works for any one individual.
Ironically I stepped directly into the food fray just days after the LA Times article hit the press when a girlfriend invited me to join her for lunch. Craving a specific dish, she suggesting Real Food Daily in Santa Monica. I demurred, thinking maybe RFD was vegetarian. If they served eggs and dairy I would be fine. I stopped short at the door: RFD Vegan Cafe. I debated going inside, but Marlene was already at the front desk. When she asked what I thought I schrunched my face and pondered whether to stay. The RFD staff eagerly stepped into the void. One server quickly told me that everything was delicious. I wouldn’t even notice there was no animal meat. The hostess chimed in that they served “complete protein.” When I balked, they continued to talk at me. So annoying.
As the debate ensued I realized here was an opportunity to experiment. I handle carbohydrate better today than ever, and require less protein than I used to. Insulin resistance is fluid that way. I relented so we sat down and ordered. I chose the Three Amigos garbanzo bean and cauliflower fritters and a side salad topped with tofu. I know how to complement proteins, but the meal was still mostly carbohydrate. The food was tasty, even though I found it less than satisfying. I could feel the impact as I ate. When I am not satisfied I don’t feel grounded.
Obviously people who thrive eating a vegan diet have no idea. It doesn’t matter that the protein is “complete”. I can complement amino acids in food all day, but if my meal doesn’t contain adequate protein and fat I don’t feel my best. If only the food evangelists of the world would consider that what works for them won’t necessarily work for everyone else.
I could tell I would need something else before we finished paying for our $25 lunch. I grabbed a latte down the street and finally started to feel content.
The largest manufacturers of antibiotics are reported on board with the FDA proposal despite the potential loss of revenue. Currently 80% of all antibiotics are used with animals. But there is time for public comments and that should be interesting. Already the hedging begins, with some stakeholders claiming that the antibiotics they use don’t compromise the antibiotics used in humans. I am left wondering how this will all turn out, considering that the over use of antibiotics is only one of many problems with conventional Confined Agricultural Feeding Operation (CAFO) practices.
Gluten is certainly getting more than it’s share of fame these days, with a sharp increase in the number of people claiming sensitivity to the protein found in wheat and other grains. True believers claim cutting out wheat (and more specifically gluten) is responsible for everything from losing belly fat to quieting a full range of gastrointestinal distress. The FDA finally established standards for labeling products “gluten free” while sales continue to explode. Comics are enjoying all the commotion, especially as consumers become increasingly more paranoid about their food. Scientists claim it can’t be the wheat, but I am not so sure.
I already blame the USDA farm policy for distorting the cost of food, a prime factor contributing to economic based obesity. Calorie for calorie, the cheapest food in our current food supply is refined starch, sugar, and fat. No surprise that these are the exact food ingredients that make it easy for too many people to preferentially store fat instead of burning it for fuel. Wheat subsidies are second only to feed grains in the current USDA budget. I am increasingly worried that our distorted and adulterated food supply is driving increasing food intolerance, allergies, and other disease.
THE DOSE MAKES THE POISON
Food sensitivities are mostly dose related, and Americans consume a very high dose of wheat. Many products are produced from wheat and other grains that contain gluten. Breads, crackers, pasta, pastries and other desserts are often wheat based. Wheat flour and other derivatives are used to make sauces, marinades, salad dressings and other seasonings. Wheat is our food staple and Americans have celebrated the bread basket for decades.
I appreciate that a food scientist at the USDA may say, it’s not the wheat. He may be too close to the chemistry to pull back and think about the food supply. Cultivars continue to be produced that yield a higher protein content because those grains demand a higher price on the commodity market. There are no commercially available GMO grains, but plant breeders have been successful deriving a higher protein content by more traditional methods. In addition, conventional farming adds plenty of NPK fertilizers to their depleted fields. All that extra nitrogen contributes to a higher protein yield, too.
ADDED GLUTEN EVERYWHERE
USDA actively promotes efforts to “maximize wheat utilization, with one document I found dating back to 1969. Food technologists (and the corporations that employ them) will continue to take advantage of the unique properties of wheat protein for one basic reason. It’s cheap. USDA farm policy continues to subsidize wheat, creating an incentive for food processors and manufacturers everywhere opportunistically use them and save a few pennies. The USDA reports that 300 pounds of gluten is extracted from 2 billion tons of wheat each year and used as a additive in everything from food coatings and films to animal feed.
HAS FOOD TECHNOLOGY REACHED A TIPPING POINT?
I figured out that I don’t handle excessive carbohydrate in my diet years ago. Even though I don’t tolerate much carbohydrate in my diet, I know I metabolize most beans, legumes, tubers and some grains better than others. It is only wheat based products that cause my esophagus to swell and my chest to hurt–but not every product. I recently started experimenting with baking gluten free products myself, like the biscuits I made just yesterday morning. Ok texture, but taste and fragrance less inviting. My son said his biscuit smelled like cornmeal crusted fried trout. I could almost smell it, too. Still, not a bad product and I bet it is absolutely delicious for many who doesn’t tolerate gluten at all.
Comics and trolls can make all the fun they want of what they see as a rich person’s manufactured epidemic–but the joke may be on them. Dose always makes the poison. Food technology wields a double edge sword. All the inventive ways food manufacturers have figured out to maximize wheat utilization may be have reached a tipping point. I wonder if gluten intolerance is a manufactured epidemic of food technology’s own making.
I notice when I eat bread I start to hiccup. So strange, but it’s been going on for years. I figured out the role of insulin resistance over twenty years ago and I eat mostly low glycemic starches. I grew up on pasta and bread, and learned in my 30’s that a high carbohydrate diet was packing on the pounds. I eat even less bread and fewer grains today, but I wonder if I can’t even handle that.
Monday I was feeling hungrier than usual, and knew I needed a bit more carbohydrate to be satisfied. I grabbed a few pretzels after a delicious Greek salad and headed out the door. I immediately started to hiccup. Ok, this is familiar. Then I started to burp and my belly felt tight and hard, like it was bloated. Yes, that happens sometimes, too. Minutes later my gut started churning. Soon I was hunched over in the car with a gripping kind of cramp. Nothing more, but I endured the distress for over an hour. What is happening?
There is evidence that since 1980 food sensitivities and food allergies are increasing. According to the Asthma and Allergy Foundation of America (AAFA) website 20% of all Americans today suffer from allergies and asthma:
- Approximately 6% of allergy sufferers have food/drug allergies as their primary allergy.
- Food allergy is more common among children than adults.
- 90% of all food allergy reactions are cause by 8 foods: milk, soy, eggs, wheat, peanuts, tree nuts, fish and shellfish.
WHAT IS CAUSING MORE FOOD ALLERGIES?
The AAFA website doesn’t address what may be causing the increasing incidence of food allergies. The Allergy Kids Foundation suggest environmental chemical contaminants could be to blame. This hypothesis is increasingly provocative when you realize that industry spews tens of thousands of chemicals into our environment. The compounds infiltrate the air, soil and water and eventually end up in the food supply. These compounds also bio-accumulate throughout the food chain. Those of us at the top bio-accumulate the most. We track only about 200 of these agents, and study even fewer. Who knows the role they play?
There is also much speculation regarding the role of genetically modified and engineered foods. There is no genetically modified wheat used commercially in the US, so I can rule that out in my case. Still, the jury is out on the role of genetically modified foods in the role of food allergies. In a 2007 review, the author concludes the paper by asking, “Where is the scientific evidence showing that GM plants/food are toxicologically safe, as assumed by the biotechnology companies involved in commercial GM foods?”
WHAT HAS HAPPENED TO WHEAT
Most of my symptoms surface when I eat wheat. The wheat we eat today is very different than the wheat families consumed decades ago. Today wheat doesn’t grow as tall and can easily be harvested with mechanical equipment. A recent USDA publication asserts that changes in wheat protein concentration are not significant, not likely the cause of increasing incidence of celiac disease, and suggests maybe it’s the imported wheat gluten. I’m not convinced.
In the NY Times best seller, Wheat Belly, Dr William Davis states two different protein fractions are probably causing harm, both gluten and gliadin. Both quantity of wheat and wheat protein content increased during the 21st century. The protein content of wheat allows bread to rise–a desirable quality. It is not much of a stretch to think farmers figured this out. In addition, the use of artificial fertilizers (which has been the norm especially since the 1950’s) is known to increase the protein content of wheat. What is behind the drive for greater protein content in wheat? In a word, profits.
A 2012 study of active duty US military showed a 400% increase in celiac disease ( a severe form of gluten intolerance) between 1999 and 2008. No one really knows what causes celiac disease, but it indicates that your gut experiences a dramatic inflammatory response to gluten that results in a damaged GI tract. The solution is to eliminate food sources of gluten. Of note, the greatest increases were seen in people in their 40’s and 50’s. Could this be happening to me?
Yesterday I purchased a bag of gluten free pretzels and a few other items. After a few handfuls, no hiccups, no burping, and no bloating or cramps. This should be interesting.