bite my words

Dispelling nutrition myths, ranting, and occasionally, raving


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Are apples the key to curing obesity?

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A few weeks ago the media was reporting that apples may provide the cure for obesity. I was a little more sceptical. I mean, how many overweight and obese people do you know who eat apples? Probably lots. If apples were capable of curing obesity everyone would be thin.

My first concern was that this research was conducted on mice. That means that it may (likely) is not translatable to humans. A couple of things to consider: these mice were fattened up by being fed a very specific high-fat diet. Obesity is a complex condition with myriad factors. Unless the reason for people being overweight is due to consuming a similar diet to these lab mice, it’s quite likely that they will not respond to this weight loss treatment in the same manner as the mice. I also wondered how much apple the mice were fed. How much apple would humans need to consume to see similar results? Here’s where it gets crazy: the mice did not eat the apples. Yep, that’s right. We have no idea how much apple would be beneficial to humans as we don’t know how much would be beneficial to mice. Rather than feeding the apples to the mice, the researchers made a slurry of apple compounds and mouse faeces. They found increased levels of certain bacteria that are commonly found in the faeces of slim mice in the cultured faeces of obese mice. Their results were not statistically significant. They showed a trend toward increased levels of some bacteria and butyric acid, and decreased levels of other bacteria in the faeces-apple slurries of obese mice but none of the changes (save the decreased bacteria) were large enough to be statistically significant.

It’s impossible to say whether or not eating apples (how many, how frequently) would have similar effects on the fecal microbiomes of mice or humans. We also don’t know if these microbial changes do occur if they would result in weight loss. Without knowing this, it’s a ridiculously huge leap to suggest that consuming apples could be a treatment for obesity. This didn’t stop the authors from concluding that:

These results suggest that dietary fibre and phenolic compounds remaining in apples after IVD might help to prevent metabolic disorders driven by an altered microbiota in obesity, and potentially protect from an obesity-disturbed balance of microbiota.

It also didn’t stop the media from publishing articles with headlines like: “An apple a day could keep obesity away: Granny Smiths promote friendly bacteria helping us feel fuller for longer” and “Granny Smith apples can help prevent the damage of obesity“.

I do think that research into our microbiomes is going to provide insight into many illnesses and conditions. However, our individuals microbiomes are extremely variable. Suggesting that this research using mice will translate to obesity treatments for humans. It’s also extremely unlikely that consuming one healthy food will negate the effects of an overall unhealthy diet. That being said, apples are nutritious and it’s certainly not going to hurt you to have an apple a day.


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The cure for diabetes

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I was recently informed that there is a cure for type 2 diabetes. Apparently researchers in Newcastle have found a way to reverse type 2 diabetes. According to their website:

Our work has shown that type 2 diabetes is not inevitably progressive and life-long. We have demonstrated that in people who have had type 2 diabetes for 4 years or less, major weight loss returns insulin secretion to normal.

Obviously, we dietitians have been recommending weight loss, diet, and lifestyle changes for many years. However, these changes rarely result in a complete reversal of the condition. The best case scenario is usually that the patient is able to manage their diabetes without the need for medications. More often though, it means that the progress of type 2 diabetes is slowed and less medication is needed to keep blood sugars reasonably stable. Despite this research having been conducted back in 2008 this was the first that I had heard of it.

For those interested, the complete study Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol is available here. To summarize, they looked at eleven people whom had been diagnosed with type 2 diabetes within the previous four years. Yes, that’s correct, eleven people. That’s a pretty small sample size. That means that no matter how astounding the results, it’s impossible to say if they will be applicable to the majority of people with type 2 diabetes.

The results of the study were quite good. All of the participants saw dramatic improvements in both fasting blood sugar and plasma insulin levels after only one week. In fact, after only one week of the eight week program, these levels were indistinguishable from a non-diabetic control group. Because normalization of beta cell function and insulin levels were seen in the participants, they were deemed “cured” of type 2 diabetes upon completion of the study.

What exactly did the researchers do to “cure” these people? They placed them on strict 600 kcal a day diets. Now, I don’t know about you, but that number shocked me. 600 kcal a day is extremely low. Most medically supervised low-calorie liquid diets for obese patients still have them consuming 800 kcal a day. Most weight management programs recommend patients consume at least 1, 200 kcal a day. For most people, 600 kcal is one meal (for many people, it’s less than one meal). In this study, participants consumed 510 kcal worth of Optifast shakes per day and were encouraged to supplement with non-starchy vegetables and drink at least two litres of water (and other calorie-free beverages) each day.

Because there was no follow-up with participants upon completion of the eight week study, there is no way to know for certain if they were actually cured of their diabetes or if it returned after they completed the program. Even supposing the diet is a cure for type 2 diabetes I can’t help but wonder how many people would be able to adhere to 600 kcal a day for eight weeks. As with any medicine, it doesn’t do any good if patients won’t take it. I suspect that the majority of people would forego the cure of such a strict diet.

All issues with this being touted as a “cure” for type 2 diabetes aside, I would like to see further research in this area. Larger, longer studies would be interesting. I’d also like to see a variety of levels of caloric restriction used as well as different sources of nutrition (not just shakes).


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Follow Friday: All of the low-carb diet blogs

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When the news about the new “low-carb diet is the best long-term weight loss diet” came out I fleetingly considered writing about it. In the moment that I took to think about it, pretty much everyone else had covered it. So… Rather than reinvent the wheel. Here are some links to posts that say pretty much everything I would have said (and then some):

James Fell on Six Pack Abs: New Study: What is low carb good for

Karmal Patel on Examine.com: Is low-carb really the best weight loss diet?

Yoni Freedhoff on Weighty Matters: What I actually learned by reading that low-carb is best study

Julia Belluz on Vox: The one thing you need to know about weight loss and diet studies

There’s more, but that’s probably more than enough reading for now. I’m off to The Canteen for a sandwich. See you Monday!

 


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No big fat surprise that butter is being touted as the next Superfood

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Why, oh why must we take everything to the extreme? Is it because simple healthy eating is boring? We have to have “clean eating”, “superfoods”, “low-fat”, “low-carb”, “cleanses”, “high-protein”, yada yada. The latest mantra to irk me “slather on the butter”. I know, I know, I said it first “real dietitians eat butter”. But this doesn’t mean that we have to eat it to excess. What am I on about now? An article in the Daily Mail that I came across on the weekend: Can eating fatty meat, whole milk and lashings of butter help you LOSE weight?

Okay, most of us in the nutrition world have accepted that low-fat was a grievous error. Taking anything to the extreme is a nutritional error. Just because something is not “bad” for you, or even good for you, doesn’t mean that you should consume more of it. The logic seems to go: apples are delicious and nutritious; therefore, an entire bag of them must be even better. In this case, we’re not even referring to foods that we know to be healthy when consumed regularly. We’re referring to foods that were unfairly demonized but have not been shown to lead to good health when consumed daily.

Perhaps, the article in the Daily Mail does not accurately portray Nina Teicholz’s book The Big Fat Surprise. I haven’t read the book, so I can only comment on the news article. Encouraging people to eat more cream, high-fat red meat, butter, and other foods high in saturated fat is not the solution to the obesity epidemic that the Daily Mail would have you believe. Yes, you can lose weight eating anything; remember the Twinkie Doctor? This doesn’t mean that you’re healthier (especially in the long-term).

Apparently Teicholz claims that removing the fat from milk means adding more carbohydrates. No. When you remove fat, you are not adding anything. Yes, an equivalent quantity of skim milk will be higher in carbohydrate (not sugar though) than whole milk. That’s simply a result of what’s left behind when you remove the fat. It’s also higher in protein, minerals, and vitamins. We wrongly vilified saturated fat, let’s blame carbs.

Health and the battle against obesity should not be a nutrient blame-game. How about we stop demonizing and glorifying foods and nutrients and accept that there is a place for bread and a place for butter in a healthy diet.


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Jennifer Aniston weight loss secret?

Is it just me, or are the facebook spam ads getting more insidious? As much as I loathe FB it does prove useful for blog fodder at times. Has anyone else seen this ad in their feed?

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Note that the link at the top says “Shape.com”. Make you think that it’s an article in Shape Magazine, doesn’t it? Well, it’s not. If you take the bait, it brings you to Shape.com-11.tv… and an “article” about How to Lose 7 lbs of Stomach Fat EVERY Week with Just 2 Diet Tips. Jennifer Aniston uses this simple trick to melt fat off her legs! The website looks like a cheap reproduction of the true Shape website. If you didn’t know better, and didn’t check the URL, you might actually believe that you were reading an article in Shape.

However, the “article” is yet another thinly veiled advert for (have you guessed yet?) garcinia cambogia. It’s pretty much the same idea as the green coffee bean ads masquerading as news articles I’ve blogged about before. Is there any merit to the use of garcinia cambogia for weight loss? In a nutshell, nope. If you want more than a nutshell, I recommend this write-up by Gemma Critchley, a fellow dietitian in the UK.

The notion that Jennifer Aniston ever had 32.5 pounds to lose is pretty ludicrous in and of itself. I’m pretty sure that at any recent weight, if she were to lose 32.5 pounds she would be hospitalized. However, I can see how the allure of quick, easy weight loss paired with the notion of having a body worthy of celeb could make people want to believe in the validity of garcinia cambogia. Sorry guys, bad news. Jennifer Aniston has a body like that because it’s her job. She puts a LOT of time, money, and effort into being super slim. Instead of wasting money on expensive, useless supplements, we should all get off facebook, get outside, and learn to love the bodies we have.