Based on the comments, it looks like not everyone is convinced that alpha lipoic acid "locking in" the benefits of calorie restriction is a good idea for long-term weight control. Of course, there is an alternative for those who want to eat big and never have to worry about gaining weight. How does this sound for an eating plan:

Breakfast: Three fried-egg sandwiches loaded with cheese, lettuce, tomatoes, fried onions and mayonnaise. Two cups of coffee. One five-egg omelet. One bowl of grits. Three slices of French toast topped with powdered sugar. Three chocolate-chip pancakes.

Lunch: One pound of enriched pasta. Two large ham and cheese sandwiches with mayo on white bread. Energy drinks packing 1,000 calories.

Dinner: One pound of pasta. An entire pizza. More energy drinks.

No magic diet pills required. All you have to do is swim six hours a day! Seems like a pretty good trade off.

Posted by Phil Bowermaster at 05:41 PM | Permalink | Comments (2)

But, hey, it might be worth a shot.

First, let me say that I have nothing but admiration for those who have adopted a restricted calorie diet in the hopes of realizing some of the health and life extension benefits that have been demonstrated repeatedly in the lab with animals (mostly mice) following similar diets. The only reason I haven't personally tried to adopt the CR lifestyle is fear of failure.

I think I could manage it for six months, maybe a year at most, and then I expect would fall seriously off the wagon. Even following a much more modest program over the course of a couple of years, my weight has been gradually creeping back up -- probably through a combination of metabolic changes and not sticking with the program as carefully as I might have.

A few months ago, I wrote about an emerging critique of diet and exercise as a cure for obesity:

In study after study over the course of the past century, the number of clinical trial subjects who have kept more than 40 pounds off for a period of five or more years is vanishingly rare. The number that's thrown around on Dean's World is 0.1%, although I haven't seen where Dean specifically raised this number, only where people arguing with him have. So if we can name people who have met the criteria -- Jared comes to mind -- we have only found an example of that 0.1% of the population for whom diet and exercise is an effective long-term obesity cure. Likewise, the participants in the National Weight Control Registry (NWCR) study were asked to participate if they had already achieved a certain level of long-term weight loss -- it's just another example of this same selection bias.

It's like "proving" that the lottery is a smart bet because somebody won!

So diet and exercise become a real double-bind for the obese. Typically, it doesn't work out; but it's the only "cure" out there, so people try again and again, and you get the dreaded yo-yo effect. People who want to argue that diet and exercise are an ineffective cure only because fat people are lazy or undisciplined or lack self-esteem aren't really contributing much to the discussion, other than venting. Show me an effective way to combine diet and exercise with acquiring discipline or self-esteem -- and by effective, I mean one that has been demonstrated to work with a significant population of obese people, not more anecdotes about Jared or your aunt -- or shut up.

And if the normal, moderate diet-and-exercise cure proves too difficult for most people, how much progress can we expect from the much more ambitious calorie restriction lifestyle?

Continue reading "Sounds Too Good to Be True" »

Posted by Phil Bowermaster at 06:50 AM | Permalink | Comments (23)

Dean's World has hosted a spontaneous blogwave over the past few days on the subject of whether the traditional recommended course of diet and exercise is an effective long-term cure for obesity. Like Battlestar Galactica and the question of whether "bible-thumpers" should be considered "true Protestants," this is one of those topics that comes up from time to time on DW: obviously a subject of interest to host Dean Esmay. In arguing that diet and exercise have not been shown to constitute an effective long-term cure for obesity, Dean is challenging mainstream thinking (something that regular readers of his blog know that he likes to do.) Whether I agree with him or not, anyone willing to take on the overwhelming consensus opinion in the face of a large body of established research gets a few points from me for chutzpah if for nothing else.

But here's the rub: in this case, the overwhelming consensus opinion and the body of established research are at odds with one another. Or as Dean likes to put it:

No study has ever shown that human beings can drop more than 5-40 pounds or so of excess weight through diet and exercise alone. Not long-term anyway. Those who can do so are so rare they barely qualify as statistical anomalies.

I added italics to the third sentence because it is an integral part of the argument. If you read the first two sentences on their own, you might take Dean to be saying that it is impossible for an obese person to lose more than 40 pounds of excess weight and keep it off for more than five years, or that no one has ever done so. And, in fact, several commenters and at least one of the co-bloggers at DW have read it that way, and have responded by linking to research that tracks the progress of obese people who have demonstrated that "impossible" level of success.

But Dean isn't arguing that it's impossible. Rather, after reading over the literature, he has found that -- in study after study over the course of the past century -- the number of clinical trial subjects who have kept more than 40 pounds off for a period of five or more years is vanishingly rare. The number that's thrown around on DW is 0.1%, although I haven't seen where Dean specifically raised this number, only where people arguing with him have. So if we can name people who have met the criteria -- Jared comes to mind -- we have only found an example of that 0.1% of the population for whom diet and exercise is an effective long-term obesity cure. Likewise, the participants in the National Weight Control Registry (NWCR) study (linked above) asked to participate if they had already achieved a certain level of long-term weight loss, is just another example of this same selection bias.

It's like "proving" that the lottery is a smart bet because somebody won!

But let's say that the 0.1% number is off by a factor of 10. Could be. In fact, let's say it's off by a factor of 100. I doubt that Dean has misread the literature that severely, but even if he has, diet and exercise has only been shown to be an effective long-term cure for obesity for about 10% of the population -- assuming that dozens of trials performed over many years have produced results representative of the population as a whole.

Just for a moment, set aside the question of why this approach doesn't work. Can we all agree that, for any other condition, a treatment with a 10% success rate would be considered a pretty crappy excuse for a cure?

Continue reading "The Future Is Thin" »

Posted by Phil Bowermaster at 07:38 AM | Permalink | Comments (9)

Randall Parker says that it could be as easy as ABC...D:

60% Cancer Drop From Vitamin D Supplements

As regular readers know, I've been after you for years to raise your body vitamin D levels. If you haven't gotten off your duff yet to do anything about it how about this as something to get you going? A study coming out in June will report a more than halving of the incidence of cancer by taking vitamin D supplements.

The linked article goes on to describe the study which has yielded these astounding results in greater detail, noting that a drop of 60% indicates twice the impact on cancer of smoking. However, Randall urges caution about mega-doing on vitamin D:

I would suggest refraining from doses above 2000 IU, at least for now. Vitamin D research has become such a hot topic that we should expect more clarification on the risks and benefits of higher doses. But my guess from what I've read so far is that a 2000 IU dose daily is enough to provide the vast majority of the benefit.

Of course, the other way to get vitamin D is through exposure to the sun, but then that raises the risk of cancer. So we have a lot to learn. Still, this is potentially a huge development. And I don't think it's out of line at this stage to suggest that we should all at least be getting our RDA of vitamin D.

Posted by Phil Bowermaster at 07:02 AM | Permalink | Comments (0)

Sure, we all know that yummy granulated white sugar is bad and and brown sugar is better but it's still bad and saccharine causes cancer if you eat approximately two oil tankers of it a year and aspartame is not quite as nutra-sweet as we once thought it was, but come on.

This is just too much:

Fructose fruit sugar is not a harmless substitute for glucose.

University of Florida researchers have identified one possible reason for rising obesity rates, and it all starts with fructose, found in fruit, honey, table sugar and other sweeteners, and in many processed foods.

Fructose may trick you into thinking you are hungrier than you should be, say the scientists, whose studies in animals have revealed its role in a biochemical chain reaction that triggers weight gain and other features of metabolic syndrome - the main precursor to type 2 diabetes. In related research, they also prevented rats from packing on the pounds by interrupting the way their bodies processed this simple sugar, even when the animals continued to consume it.

The findings, reported in the December issue of Nature Clinical Practice Nephrology and in this month's online edition of the American Journal of Physiology-Renal Physiology, add to growing evidence implicating fructose in the obesity epidemic and could influence future dietary guidelines. UF researchers are now studying whether the same mechanism is involved in people.

If you read the whole thing you will learn that it may be more of a fructose + uric acid problem than it is a straight-up fructose problem. FuturePundit concludes with a call for help:

So how can one keep uric acid levels down? Anyone know?

Ah, criminy, so now I have to keep track of my uric acid levels and do something to keep them in check? Don't I have enough to worry about? It's enough to make me consider doing something really desperate and extreme...like give up sweets altogether.

No, wait. What am I saying? That's just crazy talk.

UPDATE

El Jefe (a.k.a. Michael Sargent) adds some interesting thoughts:

Uric acid is the primary culprit in gout (something I’m familiar with due to my father’s affliction with same.)

Thus, a diet low in purines (the metabolic precursor of uric acid) might also offset this new-found hazard of fructose.

High purine foods include:

sweetbreads, kidneys, liver, brains, or other offal meats

sardines

anchovies

scallops

alcohol, especially beer because brewer's yeasts are very rich in purine. (Alcohol is not itself high in purines, but acts as a solvent)

meat extracts, consommés, and gravies

(List from wikipedia.)

This is also beginning to look like “all things in moderation” might be the best advice.

Posted by Phil Bowermaster at 08:20 AM | Permalink | Comments (1)