Stephan Guyenet, PhD, a neurobiologist, believes that the increase in obesity in Western society coincides with increasing use of antibiotics. Contrary to Rob Knight’s experience, antibiotics are fed to chicken and cattle to fatten them up. Nobody has considered the possible effects on human populations?

Diabetes researchers Roger Unger and Philipp Scherer, both at the University of Texas Southwestern Medical Center in Dallas, have studied the role of fat storage and metabolism. Conclusion – fat cells protect us from the effects of overeating.

Their research holds the potential to answer some of the mysteries surrounding obesity and metabolic syndrome. Ever wonder why some fat people are fairly healthy and others suffer from a laundry list of health problems?

In 2008, a study found that half of overweight and a third of obese Americans had healthy metabolic profiles, whereas a quarter of “lean” people had signs of metabolic syndrome (Archives of Internal Medicine, vol 168, p 1617).

Which statistic is more surprising – that 30% of obese people in the study were healthy or that 25% of normal weight people showed signs of metabolic syndrome (insulin resistance, high blood cholesterol, increased risk of diabetes, heart disease and stroke)?

Unger and Scherer suspect that fat cells explain the paradox. As long as fat cells are doing their job, metabolic syndrome does not manifest itself. Like jiggly water balloons, fat cells hold the byproducts of excess fat and sugar (triglycerides).

Only when the body’s fat cells, or adipocytes, are crammed to capacity do the problems of metabolic syndrome begin. The fully engorged adipocytes begin to die and leak their contents into the bloodstream, including saturated fatty acids such as palmitic acid. Such fats then accumulate in tissues such as the liver, pancreas and heart, where they may prompt the symptoms of metabolic syndrome.

Research like this will someday lead to effective treatments for obesity and metabolic syndrome.

Will Truman, the blogger, addresses the problem of well meaning experts who feel compelled to kick dirt on any an idea that does not fit into their perfect vision of the universe.

“One of the problems I have with the medical establishment in general is that they often have the perfect tendency to make the perfect the enemy of the good. I tell my phys ed coach that I’m drinking orange juice, and I’m warned about the sugar. People get excited by new games and game systems like DDR and the Wii that encourage exercise and they go out of their way to say that the exercise isn’t as good as the exercise you might get on the treadmill. I half-expect them to complain that the treadmill isn’t as good as jogging, which isn’t as good as carrying logs, which isn’t as good as pushing boulders in persuit (sic) of building a cave.”

That’s a great line. He nails it in the next paragraph.

“The problem I have with this is that for most people, the alternative to natural orange juice is not prune juice, it’s Sunny Delight or Mountain Dew Livewire.”

So many overweight people are intimidated by conflicting information about diets – fat is evil, red meat will kill you, wait a minute, carbs are bad, no sugar, no potatoes, no bread. It is enough to make a person give up on the idea of even trying to improve their diet.

Will says that his typical diet consists of 3-4 sodas a day, fast food about once a day, and eating pretty much whatever he wants. This guy is not bragging about his junk food addiction or encouraging everybody to eat more Chef Boyardee. The healthiest part of his diet is the bowl of FiberOne that he eats every morning.

Then Slate magazine comes along and tells him that FiberOne is fake fiber and (implies) that he might as well go back to eating Egg McMuffins. The perfect is the enemy of the good.

Maybe you are not ready to commit to that “perfect” diet – it’s too intimidating, it’s too complicated, and experts can’t even agree among themselves about the best way to lose weight. So pick something small. Make one positive change in your eating habits. Stick to it. After a while, add something else and see how that works for you.

And ignore the Nutrition Nazis who try to kick dirt on your idea.

No surprise – smoking has greatest impact on mortality. Even with massive public health campaigns, smoking and its associated diseases still cause 1 in 5 deaths.

Since the CDC conducted their first Risk Factor survey in 1993, obesity has increased by 85%. That means that there are nearly twice as many clinically obese people in this country than there were 25 years ago. The CDC says that obesity contributes to 1 in 10 deaths (behind smoking and high blood pressure).

While obesity is only the 3rd leading cause of preventable death, it is the worst in terms of reducing overall “quality of life”. In other words, obesity may not kill you but it will make you wish that you were dead.

Nobody really knows why it happens but there are some theories. At the top of the list is the “starvation response”. When the human body is deprived of food, metabolism slows down to preserve energy. The thyroid gland seems to be a key player in this process. Leptin levels not only affect appetite but also energy metabolism.

A common misconception about the starvation response is that you stop losing weight. Weight loss slows down but, if you are still in a deficit (taking in fewer calories than you burn) then you will continue to lose. The body’s attempt to preserve energy does not stop deaths from malnutrition in third world countries or prevent anorexics from slowly starving themselves into the grave.

Another reason that diets mysteriously stop working is non-compliance. During the first few weeks, you are logging every calorie, weighing every gram. Then somebody in the family has a birthday. A co-worker invites you to go to lunch. Donuts in the breakroom. A 1200 calorie diet becomes 1500 (or maybe 1800?). It’s not that the diet stopped working – you stopped dieting.

I came across a study that compared the results of various types of diets. Basically, researchers found that they are all pretty much the same (Atkins participants lost slightly more). Very interesting to look at the pattern of weight loss. The study lasted for a full year but most weight was dropped during first two months. In fact, after the 6th month, there was an overall gain for ALL the diets.

The study was intentionally structured to measure “real world” dieting. Participants kept food diaries and received periodic checkups but were responsible for preparing their own food.

At the end of the year, Atkins dieters had lost the most – 10 whole pounds. Less than a pound a month. For a 200 lb woman, that’s not even a whole dress size.

Seems like the pendulum of conventional wisdom has swung back and forth between low fat and low carb diets. When I started my first real diet back in the late 70′s, it was very much like a 1200 calorie version of Atkins. Rice and potatoes were forbidden. Don’t remember pork rinds on the menu but there were lots of eggs.

The eighties ushered in the era of fat phobia. Snack food companies proudly proclaimed that their products were low or reduced fat. During the same period, there were diets that emphasized “intuitive eating” or psychological approaches to weight management. These diets denounce calorie counting and advocate a more naturalistic attitude towards food (eat when you are hungry, stop when you are full).

Like everything else that enters our marketing driven media, the most simplistic message prevailed: Fat makes you fat. Eat as much as you want as long as you limit fat grams. This was a gold mine for food conglomerates. Cheap, sugary carbs such as Cheerios could be promoted as health food.

Despite the widespread acceptance of diets based on USDA food pyramid, Americans kept getting fatter and increasingly frustrated with physician approved weight loss programs. Low fat diets do a poor job of managing the one thing that drives obesity – APPETITE. Weight loss with low fat diets is SLOW and unforgiving. A single over indulgence on Saturday night can wipe out that whole half pound that you lost the previous week.

Little wonder that Atkins gained popularity in the late 90′s. Here was a program that worked. Weight dropped off quickly. Diabetics who were unable to lose a pound on conventional diets were able to normalize blood sugar and see some progress on the bathroom scales. Seemed like everybody was on Atkins.

Unfortunately, most people who lost weight on Atkins gained it back. And then some. Atkins became just another failed diet fad. Atkins Nutritionals Inc. declared bankruptcy in 2005.

Between the two extremes of low carb and low fat, diets like The Mediterranean Diet and South Beach limit processed carbohydrates, encourage lean proteins, and healthy fats. Richards takes a similar approach with the Leptin Diet. Jillian Michaels is perhaps the most famous fitness gal in the country thanks to NBC’s Biggest Loser and uses a very similar diet in her books – lean protein, non-starchy vegetables and fruit, healthy fats.

I have had great results with ketogenic programs but someday THE DIET WILL END. Since I already eat mostly lean protein and fresh vegetables, the only change will be more complex carbs (maybe steel cut oats for breakfast) and more fruit.

This is the last blog in series on Five Rules. Next topic: Cheat Days

Carbonated beverages are unhealthy even without the added calories. The acid literally dissolves the enamel off your teeth. Secondly, that’s not “real sugar” in your Coca Cola. It is high fructose corn syrup (HFCS).

Unlike rat studies with saccharin, in which the poor creatures were fed massive amounts of Sweet n Low til they developed cancer, the research regarding HFCS clearly shows negative response in human beings. A study at UT Southwestern found that fructose is processed very quickly and stored as fat. One researcher compared it to “sneaking into the rock concert through the fence”. That can of regular soda is stored as body fat before you can say “high fructose corn syrup”.

Research at Johns Hopkins suggests that HFCS bypasses mechanisms that regulate appetite. Glucose (another type of sugar) sends a signal to your brain that you have eaten a calorie dense food. Fructose, especially HFCS, is like crack. Your brain never gets the message that it is time to stop eating.

This article describes how HFCS is processed. High fructose corn syrup is just as artificial as aspartame or saccharin. A study by the USDA compared the development of rats fed either glucose or fructose. Males in the fructose group were most effected – “the little bodies of the rats just fell apart”. It is interesting that rats who were fed glucose had no adverse reaction to a high sugar diet.

While the public has repeatedly heard about the dangers of artificial low calorie sweeteners, HFCS seems to have missed our attention. Maybe it’s the name – high fructose corn syrup doesn’t sound as scary as benzoic sulfinide (saccharin) or phenylalanine (aspartame).

How can corn syrup be bad for you? It’s not the corn syrup but the chemical processing transforms a natural sweetener into a Frankenfood.

UPDATE: Fructose makes you stupid, too. Results of recent study at Georgia State.

Thanks to the big food conglomerates, Americans think that the “ideal breakfast” is cereal (processed grain covered in fructose), milk (fortified – that means that they take OUT all nutrients then add in cheap supplements), and fruit (token fiber – drives up blood sugar even more).

This 7AM carb load is guaranteed to lead to energy crash and hunger cravings within a few hours. Remember, your body prefers to burn simple sugars like cereal, milk, and fruit. After the cheap thrill is gone, your glucose addicted metabolism needs another hit. The continual bursts of glucose train your body to expect an ever diminishing reward. Is anybody surprised that we have a nation of type II diabetics (even kids, unbelievable).

“Healthy grains” are so highly processed that they are scarcely an improvement. Don’t even bother with instant oatmeal – seems to require massive amount of sugar to make it palatable.

On a ketogenic diet, about half of the protein that you consume is converted to glucose. This process is called gluconeogenesis. That’s why people on Atkins-type diets aren’t dropping dead in the streets from low blood sugar. Sufficient dietary protein (minimum 1 gram per kg body weight) can maintain low, healthy levels of blood glucose.

While we are on the subject of gluconeogenesis, let’s talk about metabolic advantage. Atkins popularized the ideal that low carb diets cause the body to burn calories at a higher rate. The theory is this: gluconeogenesis requires more energy to convert protein to glucose (multi-step process) therefore it takes more calories to metabolize protein than carbohydrate.

Research seems to indicate that there is no such thing as metabolic advantage when comparing low carb to higher carb diets containing the same amount of protein. Bottom line – a calorie is a calorie. Lyle McDonald gives an indepth explanation here.

Even without the fantasy of metabolic advantage, protein at breakfast is a good idea. Protein is broken down at a slower rate, does not cause spikes in insulin, and delivers amino acids for cell growth and repair.

Bacon and eggs. Yum…

This rule seems self-evident. If you are following typical 1200-1500 calorie a day diet, you are not going to take in high volume at any one meal.

These rules are intended to form the basis of a new way of eating for life. You can tackle them all at the same time or learn new habits one at a time. We live in a society that has become out of touch with our own internal systems and addicted to tasty, mass produced Franken-foods.

There is nothing earth shattering in the five rules. No promises of overnight weight loss. Nothing here that you haven’t heard from other sources over the years. We need to get back to a simpler view of eating.

I confess that I enjoy The Food Network as much as anyone but elaborate meals are not part of my lifestyle. Typical dinner consists of lean protein and a salad (using bagged lettuce – too much trouble to wash the leaves). If I am really hungry, I add more vegetables usually broccolli or cauliflower. Baby carrots are a little higher carb-wise but nobody gets fat eating raw carrots.

Keep healthy fats on hand, like olive oil or coconut oil. You can whip up a single serving of viniagrette dressing while your meat is cooking. One tablespoon oil, one tablespoon vinegar, a little mustard or whatever seasoning mix is at the back of the cupboard. Mix in small bowl or just sprinkle ingredients directly over your salad and toss together.

Eat real foods. Prepared simply. Not too much.

Mini-meals have become a hot topic among weight loss gurus. The theory is this – digestion stimulates metabolism and causes release of insulin. Amount of insulin (in non-diabetics) is generally proportional to food intake. The idea is that smaller, more frequent meals both encourage metabolic activity and promote stable blood sugar.

The theory sounds fine for people with normal metabolism. However, obesity is the result of a dysfunctional system. In fact the whole issue of “slow metabolism” may be misguided. Obese people take in large amounts of food. The digestive system becomes accustomed to processing a high volume of fat, carbohydrate, and protein. Metabolism of the average obese person may actually be higher than that of a normal weight person. When it comes to insulin levels, type II diabetics do not respond appropriately to blood glucose.

For a 1200 calorie a day diet, a mini-meal is about 200 cal. Not much food. If you have a habit of snacking thoughout the day, it is hard to stop at 200 calories.

Richards believes that frequent snacking contributes to disordered leptin signals. Triglyercides in the blood (little globs of fat also known as free fatty acids) inhibit receptors. Your body is not getting the “stop eating” message from leptin. Five-six hour intervals between meals allow time for break down of triglycerides.

“Yes, you are supposed to get a snack between meals – but it is supposed to come from your liver. This is how your body naturally clears triglycerides from your blood.” Richards

Mini-meals have entered the mantra of conventional wisdom for dieting. Given the failure of most weight reduction plans (mini-meal or otherwise), I can’t see how frequent exposure to food can help someone who is already dealing with addictive behaviour.