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Archive for December, 2009

Happy Holidays!

Christmas 2008

I’m off to enjoy Christmas with my family at Grandpa Bob & Grandma Jane’s house. Hope you all have a very happy holiday season, no matter your tradition!

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How much omega 3?

Boy, I guess it’s a bit like Vitamin D supplementation, but could ranges for omega 3 be further apart? I’ve seen estimates from about 1g a day to this from Robb Wolf:

My rough recommendation on fish oil supplementation is 0.5-1.0 g/10lbs Body Weight/day of EPA/DHA. The top end is for sick/fat people, the lower end is for most other folks.

That’s a lot of fish oil! Works out to be about 7g for a health 150lb person to 25g for someone at 250.

Should someone in Biggest Loser shape be taking 30 or more g of fish oil, especially since there may be some side effects from taking so much?
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Utopia and obesity

Curious news out of Forbes today. On the one hand, we have Americans getting spanked for “ignoring the basic rules for preventing” heart disease and related issues. No big surprise there.

On the other, they report that a recent public health study has found snack food for sale in 41 percent of “retail outlets that did not sell food as their primary merchandise.” 1 in 5 furniture stores sell snacks? Really?!

More's UtopiaThis brings to mind a line from Thomas More’s Utopia:

[If] you suffer your people to be ill-educated, and their manners to be corrupted from their infancy, and then punish them for those crimes to which their first education disposed them, what else is to be concluded from this but that you first make thieves and then punish them?

(Disclosure: I’m not that well read; I first heard this line in the movie Ever After!)

I find this somewhat compelling when considering obesity.

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Obesity is an elephant

Blind men and elephant

I’m often struck by how much obesity reminds me of the six blind men and the elephant.

Pharma folks think it’s all about drugs. Fitness folks think it’s all about exercise. Dieticians think it’s all about cutting out fat or maybe eating multiple smaller meals. Psych folk think it’s about therapy or intuitive eating or 12-step programs. Public health folks think it’s about taxing soda or banning ads. Et cetera, et cetera.

I’m sure all of these have their place in the solution. But just a hint. If you think you have “the answer” to solving the obesity problem, you’re probably looking at just one part of the elephant.

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For a number of reasons, I’m not a fan of the BMI. But my argument hasn’t been that a higher BMI is a neutral or positive measure; it’s that the BMI is really fuzzy math and adds little value compared to height and weight (which is what the BMI is after all — a measure of height and weight). But I get that researchers like it as a shorthand for studying overweight and obesity.

Over the last week, a couple of studies have been published highlighting higher mortality risk with a higher BMI. The first study showed that people with a higher BMI had a higher risk of mortality even if they didn’t show the traditional risk factors associated with metabolic syndrome.

The second study shows that women with a higher BMI have a poorer prognosis and higher risk of death due to breast cancer.

Yesterday, Peter at Obesity Panacea posted an interview with one of the researchers from the first study. The entire interview is well worth a read, but this particularly caught my attention in light of what I’d read in the second study.

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How low is low carb?

Jimmy Moore has a great post defining different levels of low-carb diets. This is something that has bothered me for a while: when someone says “low carb” you don’t necessarily know what they mean. I’ve seen research studies refer to diets with 45% carbs as low carb! That may well be low compared to the standard American diet, but it’s a lot more carbs than on Atkins, etc.

Last year, a number of researchers discussed carb restriction as an approach to treating diabetes and metabolic syndrome, and as part of that discussion, laid out the following definitions:

The ADA designates low carbohydrate diets as less than 130 g/d or 26% of a nominal 2000 kcal diet and we consider this a reasonable cutoff for the definition of a low-carbohydrate diet. Carbohydrate consumption before the epidemic of obesity averaged 43%, and we suggest 26% to 45% as the range for moderate-carbohydrate diets. The intake of less than 30 g/d, as noted above should be referred to as a very low carbohydrate ketogenic diet (VLCKD).

In the December 2008 issue of Clinical Nutrition Insight, a subset of the study authors added the low-carb ketogenic diet to acknowledge the difference between the LCKD and the VLCKD diet; the latter is generally a therapeutic approach for epilepsy.

Thus we have:

  • Very low-carb ketogenic diet (VLCKD): < 30g carbs/day
  • Low-carb ketogenic diet (LCKD): < 50g carbs/day
  • Low-carb diet (LCD): 50-130g carbs/day
  • Moderate-carb diet (MCD): 130-225g carbs/day

For the average person eating 2000 cals/day, this represents 6%, 10%, 10-25% and 26-45% of the diet, respectively.

BTW, I agree entirely with Jimmy on this:

The bottom line for you and me is to find out at what level carbohydrate-restriction is necessary for managing your weight and health. Some may be able to eat a MCD while others like me need to stay on a LCKD. Discover what works for you, follow it exactly and then stick to it for life!

And for some, that might even include a high carb or maybe even zero carb diet! See Jimmy’s post for lots more interesting info.

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A Friday inspiration

Don’t ask yourself what the world needs. Ask yourself what makes you come alive and then go do that. Because what the world needs is people who have come alive. — Howard Thurman

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