Saturday, February 28, 2009

the obese only have themselves to blame?

Suppose a cancer patient walks into to the doctor and/or oncologist or hospital and before they treat her or maybe instead of treating her, they all say "but you only have yourself to blame!"? Never would happen, right? Even though the American Cancer Society has stated that cancer is 85 percent lifestyle caused!

However with obesity, Dr Rudy Leibel has stated that it is only 40-60 percent lifestyle caused and yet, the obese person going for medical treatment hears it all the time that they "only have themselves to blame".

One of the most ignorant articles I have read in a while (and that's saying something considering how ignorant the media is) was written by someone in the UK named Amanda Platell.

(Photo caption - "self delusion is an obese person's greatest problem" says Amanda)

She writes:

But my mother cooked simple, cheap food for us every night, packed our lunches (sandwiches, a carrot and an apple... is that too hard?) and none of her three children ever had an ounce of fat on them.We swam, ran, climbed trees, played football. We ate healthily and lived healthily.

Well, excuuuuse me Amanda but MY mother cooked healthy, packed our lunches with no sweets and we swam, rode bicycles, climbed trees and played sports and we still were fat, all of us!

And according to the unpublished Russell Williams study, in which he asked 6 catering services which had catered both the NAAFA conventions as well as many other conventions, which group had consumed more food, the answers would have surprised Amanda and others. Three of the caterers said that the fat folks in NAAFA consumed exactly the same amount of food as those of the general population and three of the caterers stated that the folks in NAAFA consumed less food than consumed by other conventions.

It's time for those of us with genes which tend to render us fat, stop taking the nonsense and ignorance from such as Amanda and for that matter, consider stopping taking their advice to disable our digestive tracts also. Instead, we need to embrace our beautiful bodies whatever size they are, live on a healthy program like HAES (read Dr Bacon's book "HEALTH AT EVERY SIZE" if you have not yet read it) and educate the general public about genetics and size and obesity.


Because if we do not tell society the truth, no one else will and articles like Amanda's will continue to misinform the public. The Amanda's of our society never hesitate to speak out, as we can see.

Monday, February 23, 2009

Review- Stress Eater Diet book

I have been asked to take part in a "blog tour" reviewing the book, the Stress Eater Diet by Robert Posner, MD and Linda Hlivka, MBA, C.N. Since I tend to be a stress puppy myself, I was intrigued when approached to review this book.

Robert Posner, co author of the book, is an internist who has apparently run a Weight Loss Clinic in the Washington D.C. area for the last 20 years. Having a theory that weight gain in some people could be caused by an imbalance of serotonin in the brain, he and Linda Hlivka, a nutritionist-chemist, developed a Supplement called Serotonin-Plus. This supplement's ingredients read like a multivitamin but it does have "green tea extract" in it which has been touted in some circles to raise metabolism, and also contains 50 mg of caffeine in each pill (and that has been proven to 'raise metabolism' but is not necessarily a healthy way of doing it). Dr Posner wrote a book published in 2002, advocating this supplement but since then, some groups have de-bunked the green tea theory including consumer group, Center for Science in the public Interest (CSPI). A government document detailing a suit questioning weight loss claims about a drink called Enviga containing green tea extract and caffeine, includes the following:

CSPI's scientists have concluded that "Enviga is just a highly caffeinated and overpriced diet soda, and is exactly the kind of faddy, phony diet aid it claims not to be." [Watchdog group sues Coke, Nestlé for bogus "Enviga claims." CSPI news release, Feb 2007] Meanwhile, Connecticut Attorney General Richard Blumenthal has asked the marketers for copies of all scientific studies, clinical trials, tests, and/or papers that support the calorie-burning claims-and information about any group that may have sponsored the studies. [Attorney General demands that Coca-Cola, Nestle prove claims of 'calorie-burning' beverage. Connecticut Attorney General press release, Feb 5, 2007]

To Dr Posner's credit, he does not include a plug for this supplement in "THE STRESS EATER DIET". In fact, it's not mentioned at all except in the bio of Linda Hlivka which names her as the chemist involved in developing "Serotonin-Plus".

One of my personal frustrations with the book which, by the way, IS a good read with plenty of worthwhile information in it which can help us all to be less stressed, was that for some reason, Dr Posner and Ms Hlivka chose to not include their cites and sources as footnotes in the traditional manner, so although many studies were mentioned, one has no way of knowing when, where or how these studies were done. In the section called "References" at the end of the book, it mentions that cites and references can be found at however that page returns a "not found" error. The few studies listed in the references section are ones we all know about and not the studies supporting the book's theories about Serotonin and weight control.

So I had my work cut out for me. The book is a collection of tips about weight loss i.e. log your food, exercise, reduce stress using yoga and deep breathing etc, eat slowly and more - things which will cause weight loss on any program, but I wanted to check out some of the claims new to me which were as follows:

1. That eating foods high in tryptophan would cause the brain to produce more serotonin and that this is a good thing and one which would aid in weight control

2. That tryptophan is the precursor to serotonin

3. That although carbs are high in tryptophan, they only produce a momentary relief and thus are not as effective as foods like turkey etc i.e. low carb foods.

With reference to number 1, I did find a few articles (not any studies though) that suggest that eating tryptophan rich foods would cause the brain to produce more serotonin and some opinions that this does aid in weight control. Of most interest in that area was an article sent down a listserve for medical providers by a P.A. The article was not from a medical journal but still is interesting because it opined by mixing substances rich in tryptophan and taking anti depressant drugs which are serotonin re-uptake inhibitors (SSRI's) could cause a syndrome called "serotonin syndrome" which according to the article could result in:

  • Cognitive-behavioral symptoms like confusion, disorientation, agitation, irritability, unresponsiveness and anxiety.

  • Neuromuscular symptoms like muscle spasms, exaggerated reflexes, muscular rigidity, tremors, loss of coordination and shivering.

  • Autonomic nervous system symptoms like fever, profuse sweating, rapid heart rate, raised blood pressure and dilated pupils.

Source:February 27, 2007 - PERSONAL HEALTH - A Mix of Medicines That Can Be Lethal

While this is obviously extreme and not necessarily a risk with eating a lot of turkey, the article did contain the statement that:

"Although serotonin poisoning can be caused by an antidepressant overdose, it more often results from a combination of an S.S.R.I. or MAOI with another serotonin-raising substance."

And this causes one to wonder whether it's a good idea to fool around with Mother Nature when it comes to brain chemicals at all... even with food sources, a question asked in the book, "PROZAC BACKLASH" by Joseph Glenmullen, MD. Glenmullen opined from his research and working with many patients over a long time span that messing with the serotonin balance in the brain could cause problems such as Parkinsonism.

As for my question of whether Tryptophan IS really the precursor of serotonin, my research suggested that it is generally theorized that, yes, it is at least ONE of the precursors. Again I didn't find any studies but many educated opinions on this.

And finally with reference to question 3, eschewing carbs in favor of low carb meats, I found that the jury is still out on this with at least one very respected researcher at MIT disagreeing with the authors' low carb suggestions.

Dr Judith Wurtman has apparently done a lot of research on carbs and serotonin and in an article carried on the MIT site, Wurtman stated that carbs were essential for good health and that a low carb diet could result in some serious cravings (due to the body's need for carbs). Wurtman feels that stopping carbohydrates could not only affect the brain's serotonin levels but also affect your mood: (Note apparently Wurtman's remarks are based on her years of studies which are available in peer reviewed journals.)

"Wurtman, director of the Program in Women's Health at the MIT Clinical Research Center, and colleagues have found that when you stop eating carbohydrates, your brain stops regulating serotonin, a chemical that elevates mood and suppresses appetite. And only carbohydrate consumption naturally stimulates production of serotonin.

In "The Stress Eater Diet" Dr Posner and Ms Hlivka are not clear as to whether one should go low carb for life because they say you slowly add carbs back after the first week of "induction" (of a 4 week program). However, comments like the following suggest to the reader that carbs in general are not well thought of by the authors:

"pasta has little nutritional value" (page 122)

However, this conflicts with what I have often read and that is that Pasta is rich in B complex vitamins for one, a vitamin which Dr Posner stated he feels is a direct stress reducer, a statement accepted by mainstream medicine.

(And it's well known that one gets much more of the vitamin out of food than out of supplements).

Dr Posner and Ms Hlivka are also very much opposed to eating sugar which is OK but as substitute, they recommend, by brand name, sweeteners like aspartame and splenda which is somewhat controversial now that many studies have shed suspicion on the safety of these chemicals. Even the CSPI, once on the "no sugar" bandwagon i.e. do aspartame instead of sugar, has recanted on this position after the well respected Ramazzini Institute studies which found a link between leukemia and aspartame consumption.

The program in "THE STRESS EATER DIET" recommends cardio exercise which, as folks know, I greatly agree with, and the chapter on exercise is excellent, as is the chapter on stress. Perhaps we have heard some of the suggestions given before but somehow having it all in one place, reminds us that we need to do some of these things to reduce stress in our lives.

I hope that in a future edition of the book, the authors _do_ consider including the cites in a footnoted manner because I think today, most of us being bombarded on a daily basis with all kinds of claims, do question uncited material.

For example, one of the statements I would like to see cited is the authors' claim that 90 percent of those diagnosed with type II diabetes are overweight. The percentages I have read have been that 33 percent of type II diabetics have never been overweight and this has been my own observation also.

All in all, I liked the book - it is readable, well written and interesting, and provides a lot of useful suggestions and some things I did not know even with my having read so many diet books.

And most of all, it is one of the only books which gives us real world practical suggestions on reducing stress which I, in agreeing with the authors, feel is a major factor in many of the ailments we suffer.

As a weight loss program, well, if you do the things they suggest such as, log your food daily, count your calories, measure your portions, substitute low cal food for fast food etc and exercise at least 20 minutes - 30 minutes a day, yes you will lose weight whether you eat foods high in trypophan or not. Unfortunately, studies have suggested only about 5 percent of the public are able to be this vigilant on a long term basis. But even if you don't use "The Stress Eater Diet" as a diet book, I feel reading it can be helpful in getting more healthy and reducing stress.

Would this book make a good addition to your library? I would say, probably so. I know I found it rather enlightening.

Where you get it: The Stress Eater Diet Website

Other blogs participating in the "blog tour" can be found here!

Thursday, February 05, 2009

re-visit - diabetes and weight loss surgery

If you listen to the TV, you will hear that weight loss surgery (either gastric bypass or lap band) "cures" diabetes. You will see happy patients less than 2 years post op dramatically throwing out their medication.

Remember TV is NOT the truth. Not even close.

We have two studies available which looked at diabetes and weight loss surgery.

The first was the Swedish Obesity Study. It compared weight loss surgery patients to people trying to diet. It was NOT randomized and as a matter of fact, those chosen to be in the NON patient group had MORE diabetes and MORE heart disease. The surgeries used in this study were gastric bypass and gastric banding.

At the two year point, they recorded a 73 percent remission in those patients with diabetes.

But at the 10 year point, only 36 percent of the patients remained "diabetes free". That means for most of them, the diabetes had returned. We have no longer term results than this.

Also this study did NOT look at the number of gastric bypass patients who got reactive hypoglycemia which is less treatable than diabetes (caused by the death of the islet cells of the pancreas). One 13 year post op recently remarked that "most gastric bypass patients eventually get this problem."

Finally the Swedish Obesity study found that at the 10 year point the "average" BMI among the weight loss surgery patients was 35. Still clinically obese.

SOURCE: New England Journal of Medicine: Volume 351:2683-2693 December 23, 2004 Number 26 Lifestyle, Diabetes, and Cardiovascular Risk Factors 10 Years after Bariatric Surgery Lars Sjostrom, M.D., Ph.D et al

graph showing percentage of patients in remission from diabetes at the 2 and 10 year points

The second study was the "Monash Study". This study was randomized sort of. It did not take any diabetics who were diagnosed more than 2 years before surgery. (and we all know that moderate lifestyle changes without weight loss can bring A1C back to "normal" in the first few years after diagnosis).

It did not study patients any more than two years post op. They found at the 2 year post op point, 73 percent of patients were in remission (and the researchers used remission and not cure!) which is the same that the Swedish Obesity study found.

Monash Melbourne study link

The TV ran with it. The Monash Study used adjustable lap band patients. And the word "remission". The TV said they were gastric bypass and used the word "cure".

I have heard some Weight Loss surgery surgeons use the word "cure" also and the ASBS is now trying to recommend gastric bypass for overweight patients with diabetes (i.e. BMI 30 or more). Those patients tend to fare badly post op. Somehow their bodies do not adapt as well as heavier patients.

Speaking of Weight Loss retention: The third study we should look at is the Utah study which found that 34 percent of patients whose start BMI was over 50, regained all or most of their weight within 10 years.

SOURCE: Annals of Surgery. 244(5):734-740, November 2006. Christou, Nicolas V. MD, PhD; Look, Didier MD; MacLean, Lloyd D. MD, PhD

Bottom line, weight loss surgery is not effective unless you diet, count calories and exercise (which will keep weight off without surgery) and it does NOT cure diabetes - no study ever found that and the only place reporting a diabetes "cure" is TV which is selling the surgery or some surgeons who are also selling the surgery.