Weight Maven

The May issue of The Atlantic includes a lengthy article by Marc Ambinder, Beating Obesity, that is part policy discussion, part personal story.

The policy discussion is pessimistic; the personal story is perhaps more optimistic. Ambinder had weight loss surgery a year ago, and has lost 85 pounds, becoming what a colleague refers to as “a ghost of my former self.”

But I say perhaps more optimistic for a number of reasons. First, Ambinder notes that his insurance didn’t cover his $30K surgery. I don’t know (he doesn’t say), but I’m guessing it is because he wasn’t heavy enough. Doing a reverse calculation for a BMI of 34 and a weight of 235 puts Ambinder at just under 5′ 10″ tall.

Is 235 too much for that height? Clearly. Is it the kind of excess weight you normally associate with weight loss surgery? I don’t; my understanding is that typically patients need to be morbidly obese with at least 100 pounds to lose.

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Have you heard about the Ancestral Health Symposium scheduled for summer 2011?

The Ancestral Health Symposium fosters collaboration among scientists, healthcare professionals & laypersons who study & communicate about health from an evolutionary perspective to develop solutions to our health challenges.

I like that Loren Cordain is calling it the Woodstock of evolutionary medicine :).

Sign up and the organizers will send you regular email updates on the event!

I’ve posted before why I think BMI is problematic. Now there’s a new reason: using BMI may lead to a “massive underdiagnosis” of obesity:

A retrospective analysis of 1,234 Americans indicated a substantial underdiagnosis of obesity when Body Mass Index (BMI) was used compared to the Dual Engergy X-ray Absorptiometry (DEXA) scan.

The details will be released later in April, but overall, this is another set of data whose subjects might be considered normal weight obese.

One question is how do people get to be this way? I don’t know for sure, but I’d bet money on dieting being a likely cause. Another question is whether this phenomenon is related to the idea of weight loss and mortality risk, but that’s for another time.

For me, this is just another good reason to focus less on BMI or weight and more on what we eat — especially since I think the evidence is mounting that it’s what we eat and not our weight that leads to the majority of problems attributed to obesity.

I know there are very mixed opinions about Jamie Oliver’s Food Revolution, but I think he made a very good point on Oprah yesterday (emphasis mine):

But you’ve got to remember I’m not doing a diet show, … This is about real food. This is about health. … There are just as many unhealthy skinny people. We can’t just label it as obesity.

Exactly. This is the point I hope someone makes to MeMe Roth the next time she’s on my tee-vee!

A week ago, I mentioned a paper that hypothesized that:

obesity protects the body from the effects of overeating by providing somewhere safe to deposit the dietary deluge of fat and sugar, which in excess is toxic to many body tissues.

Today on Obesity Panacea, Travis explains how being able to store fat subcutaneously rather than viscerally might delay metabolic syndrome.

And now there’s this study,

While obesity puts people at risk for a whole host of chronic illnesses, including heart disease, there’s a least one situation in which extra pounds appear to provide a health advantage.

Oddly, once someone has already had a heart attack, obesity seems to confer protection against further heart problems, a new study suggests.

The results show that among 1,231 heart failure patients (those who have already had a heart attack), underweight, normal weight and overweight (but not obese) individuals had a 76 percent increase in risk of sudden cardiac death compared with obese patients.

Now, I’m only a lay person, but as far as I know, heart failure is a condition on its own and doesn’t describe “those who have already had a heart attack,” but whether these people have heart failure or previously had a heart attack, these researchers have found that, in this population, obese patients are at a reduced risk of sudden cardiac death.

Could these two be related? As one of the researchers from the second study mentions:

Obese patients are hard on their bodies; many don’t eat right, don’t exercise, and many smoke … If their bodies are surviving this bad treatment then perhaps they are better equipped, from a genetic standpoint, to live with heart failure.

Or maybe they did less damage to critical organs because the problematic elements of their diet (sugars including fructose? omega 6s?) were being shuttled off into accommodating fat cells.

And then there’s this, from Travis’ colleague Peter:

this recent study showed that weight loss of 15% or more was associated with an increased risk of death from all causes among overweight men and among overweight and obese women

Now, I think there could be lots of explanations for this latter finding, as Peter notes as well. Flawed study, effects of yo-yo dieting, weight loss thru crash dieting or without change to healthful diet, etc.

But is it a total stretch to think that maybe there’s another reason our bodies try to hold onto that fat? Well, I can’t imagine that’s the case. Just seems a curious few pieces of a puzzle!

I think I have a new rule: never, ever change your diet or lifestyle based on the reports (especially the abstract) of a single study.

Yesterday, Dr. Davis of Heart Scan Blog posted a study that he claimed supported his contention that butter had an “insulin-triggering effect, doubling or tripling insulin responses” and that “butter makes you fat.”

One of the study’s graphs showed a much greater AUC (area under the curve) for both insulin and triglycerides after the test subjects consumed a meal with butter compared to other fats.

Now that may not be scary for you if you’re following the anti-saturated fat guidelines, but for folks like me who are into Weston Price, real food, paleo/primal, or low-carb, butter is probably a staple.

Slightly concerned, I followed the link to the actual study and found out that the study subjects ate nearly six tablespoons of butter in their test meal of 800 calories to get that response. Does that sound like one of your meals? Sure doesn’t sound like mine!

Later that day, one of my regular reads responded to Dr. Davis’ post. Turns out that it’s even more complicated than I understood; the response shown by the study may suggest that the butter allowed for more fat loss!

Anyways, just goes to show you. You absolutely must take scientific research with a huge grain of salt. For more on this subject, check Jenny’s All Purpose Technique for Debunking Worthless Studies.

Well, in the spirit of better late than never, Steve Parker’s recent post about updating his blogroll got me thinking I needed to launch a new blogroll to go with the new blog (former blogroll was pretty much all politics and user experience design).

I did a count, and I’m following about 150 blogs on topics including obesity & weight loss, health & fitness, real food, paleo & lowcarb eating, and more.

Out of those 150, I’ve highlighted a top 25 that are blogs I strongly recommend. In general, most are science-oriented, published regularly (if not frequently), have great readers (which means the comments can be just as interesting as the posts), and have a very good info to marketing ratio (no one hides the good stuff behind a pay wall).

I don’t necessarily agree with each of them all the time, but I do read them all religiously. Your mileage may vary!

There’s a recently published paper that’s going around the tubes that you may have heard about. It’s controversial (more about that later), but it suggests that obesity may be the body’s attempt to protect itself from the excesses in our diet.

Diabetes researchers Roger Unger and Philipp Scherer (both from the University of Texas Southwestern Medical Center) looked at recent studies involving fat in both mice and humans and concluded:

that obesity protects the body from the effects of overeating by providing somewhere safe to deposit the dietary deluge of fat and sugar, which in excess is toxic to many body tissues.

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Meant to make a note of this a while back. Over at PaNu, Kurt Harris was commenting on the similarities between Doug McGruff’s Body by Science’s nutrition approach and Dr. Harris’ PaNu approach.

Check out the whole post; it’s interesting. But one specific item stuck out for me. Dr. McGruff has put out a DVD, and in his post, Dr. Harris shared that at:

one point in the lecture, [Doug McGruff] hints that he does not believe in doing a lot of testing. He says, “if the number is bad, eat healthy, and if the number is good, eat healthy”. What do you need the number for?

Dr. Harris then added this sidebar:

This is profound, actually and I have been meaning to blog on this for a while. I think he is using a heuristic that could, when coupled with having the consumers of health care actually be the ones paying for it, slash our health care costs nationally by more than half, even if everyone kept eating the SAD.

For me, this is less about the policy issue (although the implications are pretty staggering), but it strikes a chord on the wellness/healing front.

No matter the number, eat healthy? Works for me.

Seeing this post from Dr. Parker today got me interested in finding out more about the study he mentioned recommending seven color groups for fruits and vegetables.

I found Dr. Heber’s original study, but also found a plain language version via CBS News. According to the article, Dr. Heber says that:

counting servings may not be adequate if you are missing out on one or more major color categories. Not all members of the fruit and vegetable group are alike.

They have unique properties that provide combinations of substances with unique effects on human biology. Therefore, simply eating five servings a day of fruits and vegetables will not guarantee that you are eating enough of the different substances needed to stimulate the metabolic pathways of genes in the different organs where fruits and vegetables have their beneficial effects.

So, the idea behind Dr. Heber’s What Color is Your Diet? is to make sure you eat from each group every day. Like Dr. Parker, I suspect this may be a challenge for many, and others (like the zero-carbers) may not agree with this approach philosophically.

Note too that fruits & veggies aren’t the only source of these nutrients. For example, eggs are a great source of lutein. Also, keep in mind that you may benefit from (or require) fat in the diet to increase your ability to use some of these (like lycopene). Finally, there are other issues that can affect whether or not we can use these nutrients; e.g., some people require preformed vitamin A because they can’t make it from carotenes.

Me, I think it makes sense to eat veggies year-round and fruits in season. I like the idea of the color groups, so I whipped up a graphic to keep on hand for reference. Click on the image or this link for a larger version. Hope you like it!