Overweight: The Stress Connection Unraveled

In the course of the last year, we've learned and shared a lot with you.  We've uncovered the basics of less than meets the eye.
metabolism and energy consumption.  We've looked at scams and myths and into the tendency of people to overstate the virtue of a food, nutrient, or ingredient simply to sell their product.  We even looked into the relationship between genetics and obesity.  Often, once we peeled back the layers, we found there was a whole lot

But today's topic is not one of those.  Stress is a big deal and is a very real player in the health of an individual.  And that makes it worth talking about. 

Cortisol

It's become conventional wisdom that cortisol is "bad".  (Ugh - I really hate these kinds of binary labels).  But how does cortisol work on the body?  Understanding this mechanism is the first step in grasping the impact of stress.

Cortisol is produced in the adrenal gland in response to stimulation messages from the hypothalamus. The adrenal gland's better-known function is to produce the hormone adrenaline which kicks off that critical-to-survival "fight or flight" response.  This is the ultimate stress response.  Think of cortisol as adrenaline's annoying little brother.  Not quite as cool, not quite as strong, but always around.  In fact, cortisol follows a natural circadian rhythym - naturally highest in the morning and gradually decreasing throughout the day, hitting a low point at bedtime.  This has some interesting implications for night-shift workers, but that's probably another post.

Just like adrenaline creates an all-out response of the body's key survival functions, cortisol signals the body to go into a form of "preservation mode".  Essentially it's a metabolic depressant.  The release of cortisol reduces your body's conumption of blood glucose, desensitizing insulin receptors, and signals the release of enzymes to release potential energy from alternate sources, like muscle tissue.  It signals your body, saying "we don't know what's happening here, or how long it's going to go on, but we're ready for the long haul."  If you've read some of our other posts about metabolic syndrome, improving your metabolism, or even carbohydrates in general, you start to see where cortisol levels can wreak havoc on a person's weight loss goals.  

And, like adrenaline, cortisol levels are spiked in response to external stimulus.  But instead of a survival threat, cortisol release is triggered by a broad and murky mix of stimuli we lump together under the title "stress".  And, like just about everything else in the human body, stress can be a positive motivator or a chronic debilitator.  So, how do you tell the difference?

Unravelling Stress

Stress is one of those wonderful words that everyone understands, but just about everyone defines differently.  This points to the fact that people perceive specific stressors quite differently.  And, if stress is in the eye of the beholder, how can we possibly hope to classify "good" stress as opposed to "bad" stress?  Science, it turns out, has been working hard on this very question.

According to a meta-analysis of 208 different studies on cortisol responses in humans and animals, there are two key factors that determine whether a situation is stressful or not: uncontrollability and social/evaluative threat.  Let's look at each separately. 

Clearly  nobody is in control here.

Uncontrollability:  This aspect of stress describes whether or not a behavioral change will have any impact on the outcome of an event.  In animal trials, mice who had control over a negative sound response (the buzzer rings when I decide to take the food) had much lower stress responses than those who had no control (the buzzer rings whether I take the food or not).  These same results were reflected in numerous human trials; if the subject perceived they could do something to change the outcome, their stress responses were much lower than those who didn't.

Social/evaluative threat:  As we said before, adrenaline is a survival response.  But a person's social survival (i.e. preservation of one's perception/status in a group) is no less important.  In the studies, tasks that presented a significant "threat" of being regarded or evaluated negatively by others, particularly in an aspect where the person held particular importance or the stakes were personal well-being, the stress response spiked significantly.  Interestingly, in studies of social primates, the submissive members of the clan consistently showed higher levels of cortisol than the dominant leaders.

What's more, stressors that exhibited both uncontrollability and a social/evaluative threat compounded the stress response and the stress response lasted longer than either stressor alone.  Now, I don't know about you, but I can't imagine anything that fits the bill better than a person who has tried and struggled with their weight each and every time they walk out their front door.

Some things that turn out to not significantly predict stressfulness in terms of cortisol response:

• Duration of stressor.  People were either "stressed" or "not stressed" and for how long didn't relate to the level of stress response.
• Type of task.  This is a tricky one.  Some tasks are inherently uncontrollable or present a social/evaluative threat (public speaking, for instance), so it can appear that a task, in and of itself, might produce a more significant response.  But when the studies controlled for these elements, the type of task was not predictive.  I'm one of those weird people who actually enjoys public speaking.  But hook up a camera or have my boss unexpectedly show up, and it's a whole different ball game.

The Stress Response

So, given the idea that uncontrollability and social/evaluative threats are the key elements of  negative stressors that elicit the strongest stress response, how do you tell when you're experiencing (or likely to experience) a negative stressor?  This is where I depart from the science and travel out on the limb of my own experience.  Thinking back on these kinds of events in my own life, the signs were clear: worry, over-thinking, heightened response (loud, over-expressive, quick to conclusions), and then there's the physical part.  My hands sweat.  Another thing that I seem to do is anticipate conflict and then start planning to argue.  Basically I start having emotional reactions to logical problems.  

Physiologically, if cortisol spiking signals the body to slow the processing of nutrients and be ready to borrow essential energy from muscle tissue, then "stress eating" (guilty, by the way) is about the worst thing you could do for your body.  This is a prime condition for fat storage.  Studies show that the effects of cortisol last less than an hour, so if you can hold off your urges for that long, your metabolic balance will be back to normal.

The point is, learn to recognize your own stress responses and realize where they are coming from.  Do you feel out of control?  Is your social (including professional) status threatened?  What are the warning signs and are there ways you can re-position the situation to put yourself back in your "happy place"?

Tackling Stress in Your Life

So far, we've established that elevated cortisol levels will suppress your natural metabolism.  Chronically elevated stress is definitely not healthy for your body and will ultimately derail weight loss goals.  Uncontrolled situations and the threat to a person's social status are the kinds of stressors that produce a strong cortisol response.  

I have long been a proponent of a simple life and believe in the principle that "less is more".  But it was only in the last couple of years that I took a determined look at my own life and did a "cost/benefit analysis" of each and every one of my commitments and obligations.  For me, the simple act of actively deciding what to keep and what to let go in my daily life was a tremendous relief.  We wrap ourselves up in so many things that many of us lose all perspective on what it is we actually "have" to do. 

There's really no way around it: if it doesn't involve feeding, sheltering, or clothing yourself or your family, you don't necessarily have to do it.

Once you've gone through the exercise of deliberately evaluating all the stuff you have in your life, you're on your way to seriously reducing the impact of uncontrollability.  Even if there are things that you choose to keep doing which are unpleasant, it's your choice and you're reminded of the reasons for your choice.  That puts you back in the driver's seat.  

I can hear you now through the interwebz, "Michael, that's all fine and good, but it's just not realistic.  There's no way you can eliminate all stressors."  And, gentle reader, you'd be right.  Some things are just plain unavoidable.  But, when those stressors come, I do believe there are a couple of important things you can do to deal with them.

Redefine "control".  This is serenity prayer stuff, right?  What factors can you control in a stressful situation?  If you can't control it, will that factor cause you physical or material harm?  Can you decide that factor is irrelevant to you in the bigger picture?  And, of course, "the wisdom to know the difference."

Be mindful about who's opinion/evaluation you value.  Often, we give others a great deal of power over our self-esteem without even knowing it.  Take that power back.  The circle of people whose assessments of me affect my self-worth is alarmingly small.  And, even then, the context is pretty specific.

"Let the air out."  What are the real stakes in your stressful situation?  Are you going to lose your livelihood?  Will you be harmed?  Will you be impeded in goals that are truly important to you?  Or is it simply unpleasant?  

Finally, when it comes to weight loss in particular, get informed.  The more you know about nutrition, the science behind different kinds of training, the more tools you have at your disposal to achieve your goals.  You'll be in control of your body again - to make it whatever you want it to be.  And realize that things take time.  We didn't get in the shape we are in overnight and our bodies are going to take time to remake.  You are in control - but you have to obey the laws of physics and the basics of human biology.  

Obesity's Perfect Storm

There's something going on in the Western World.  And, despite so much attention being focused on it, it's still getting worse.  The average westerner has lost touch with the innate ability to feed and, thereby, care for ourselves.  People are getting heavier and sicker by the day.  We're more educated, have a higher living standard, and medical science is more advanced than ever before.  How are we not getting the message?

It must be something bigger.

I'm not a conspiracy theorist.  But I do believe in complexity.  And the more I learn, the more I see a "perfect storm" of factors that have come together to, quite literally, shape our society.  To peel it all back, let's take each factor one at a time.

Storm front #1: Flawed Science

It really all starts here.  Whether you agree with his "carbs are the real problem" stance or not, in his book, Good Calories, Bad Calories, Gary Taubes paints a fairly dismal picture of the evolution of medical science with respect to weight and health management.  The foundational focuses are decades old and were based on the limitations of what was known and what could be measured at the time.  These foundations have endured over time and, like a crooked wall, veer ever farther from the original premise.

Scientific studies can do as much harm as good.  This is no critique (necessarily) of the researchers themselves, but more of the instant-gratification, dumb-it-down media to immediately take things out of context and beyond the scope of the study.

These days, the focus is on "curing" obesity.  It was even recently designated a disease.  Open the door for "there's a pill for everything" medicine.  Family practitioners are not up to speed on nutritional science breatkthroughs, and are also less likely to explore lifestyle treatment, like meaningful physical exercise.  The lifestyle mantras are quoted chapter and verse by doctors across the world: get 30 minutes of cardio, 2-3 times a week and eat less fat.  But there is little expectation that patients will follow this advice, so very little emphasis is put on the importance of lifestyle and health.

Specialization also takes a toll here.  Diabetologists and endocrinologists are on the front lines of the impacts of obesity.  But those specialists come into the picture after things are well out of control, and "downward" communication to your family doctor isn't happening the way it should.  Instead, the entire focus has been put on calories in vs calories out, rather than on how to nourish and power our bodies.

Storm front #2: "Big Fitness"

The fitness industry, from big box gyms to "as seen on TV" wonder DVDs and gadgets, to the purveyors of miracle supplements and shakes, is a mult-billion dollar industry.  And its customer base is growing.  There is no incentive for the fitness industry to actually get you into shape.  In fact, they'd rather make you dependent on their products and keep you coming back as a return customer.   If you buy a gym membership and never go, the gym still gets your money and the equipment you would be using remains vacant for yet another member.  It's a win/win for the fitness center.  And nothing you buy from TV is ever going to deliver the results promised.  They even tell you that, right on the screen: "results not typical".

Storm front #3: "Lifestyle Marketing"

Can I have a side of Diabetes with that?

I'm in the marketing industry myself.  Everybody is looking for that fundamental emotional connection to make with their customer.  Lifestyle marketing is when you tie your product to a way of life, a feeling of prosperity, happiness, and success.  The tactics are incredibly successful.  Now think about the last restaurant commercial you saw.  Was it really about the food?  Or were there images of attractive people having a great time while eating food?  If you want to have a good time with friends, what is the first thing that comes to mind?  A meal out somewhere?  Where did that come from?

Now think about the advertising for "convenience foods" that pepper the television.  What are the underlying messages there?  Cooking is hard and you don't have time.  Your family will love you for serving this dish.  Plus: hey! added fiber / reduced fat / naturally sweetened - you name it.  Bottom line: this is better than what you could possibly pull off on your own.  Nonsense, I know.  But we, as a society, are completely in the thrall of the convenience food message.  

Storm front #4: "Addictive Flavors"

On the first three points, we are talking about information that is widely available and completely up to the reader to make an informed decision.  Let the buyer beware, right?  But, when it comes to addictive flavors, this is the one topic where I will point a finger at a malignant source.  

Food companies consult with flavor labs to create the perfect balance between a distinctive flavor and a very limited finish.  When the food is in your mouth, the texture and flavor are extremely pleasing, but, in these engineered flavors, the moment you swallow, you need a "boost" to get the flavor back.  It literally keeps you coming back for more.  

We haven't been eating clean for that long: just over a year.  I still remember foods that I loved.  They were my go-tos week after week.  We recently drove across the country and hit some pretty austere territory in the process.  Our choices were limited.  I literally had McDonalds for the first time in 13 months.  It tasted like - nothing.  Nothing at all.  Place after place we stopped, it was the same story.  Safe to say, we were sort of stunned.  When you're used to real food.  The stuff you used to think of as craveable is just a pale shadow of flavor.  And that's the way they design it.  

Storm front #5: "Pop Media"

Have you noticed that when you flip through five different news broadcasts, they're all on the same stories?  That's because they all take their information off the same news wire.  We are obsessed with the sound bite and the news feeds us exactly what we want.  When a study that took five years to conduct and comes with four hundred pages of findings is reduced to a two-minute blurb read by a talking head from a teleprompter, it's fairly safe to say that you aren't getting the nuances.  

Take the recent story on Omega-3 fatty acids.  The study took participants who had prostate cancer and examined their blood chemistry to see if there were any trends.  They found that some of these participants had elevated levels of Omega-3 DHA.  There was a correlation between these participants, all of whom had cancer, and blood levels of this fatty acid.  Of course, people at risk for prostate cancer (men over 50) have been bombarded with messages about supplements that will reduce their risk or the severity of the cancer.  Did they have elevated levels because they were fighting cancer, or was the cancer a result of the Omega-3?  Or... was some other element of body chemistry out of whack that contributed to both the cancer and the blood lipid levels?  The study confessed not to know.  But the news story said "Taking fish oil is associated with an increased risk of prostate cancer."  Period.  

Beyond the news, you run into an endless stream of "talk" shows that are, at best, the blind leading the blind, and at worst, a serious conflict of interest.  People who profit from the endorsement of a product on their forum should be regarded with skepticism, especially when it comes to your health.

Storm front #6: "Urban Myths"

The Internet is a fabulous thing, isn't it?  I mean, you're enjoying our fabulous content right now thanks to the "information superhighway".  But the Internet is a peculiar paradox.  On one hand, it has nutured our craving for instant gratification.  There is always something new to grab your attention.  On the other, it is a vast repository of things that just won't die.  In my military life, when you got a new regulation or new set of orders, they would always tell you that the previous version was obsolete and you should get rid of it.  That was nice.  It was clean and simple.  The new guidance is the only guidance.  

Not so in our modern world.  Everything gets mixed up.  This will save you, that will kill you.  Then tomorrow the whole thing is reversed.  The result is that people hold on to whatever piece of information struck them first or resonated the most, with a healthy dose of skepticism for anything that conflicts with what they perceive to be the truth.  And, with the Internet, they can perpetuate it through a host of different channels, continually re-muddying the waters.  

People mean well.  They believe that their information is the right information.  But there is very little to help you, the reader, from separating established fact from outdated convention from plain ol' poppycock.  

Superstorm: Obesity

By themselves, none of these "storm fronts" would do much damage.  But the way they've coalesced into a combined power, it has colored our perception in a profound way.  Look at how these look when they're strung together into one set of attitudes about food and fitness:

     "I'm overweight, and I know I need cardio exercise three times a week to burn fat, plus I have to watch my fats and cholesterol.  Fiber's great though, so I should eat more grain.  Plus, I drink green tea every day, since it's a fat-burner.  I have a membership at a great gym; they have all these cool classes and tons of treadmills and elliptical machines, plus I bought that "Turbo Jam" DVD, so I can tone and shape my muscles.  It really makes me sweat."  

     "I eat pretty healthy; I only buy low-fat and low-calorie foods. Except on weekends, because that's when I go out with my friends.  Dinner, drinks and dessert are such a great way to unwind and I deserve a little reward.  I'll just work out twice as long on Monday.  When I'm hungry, I usually have an extra bowl of Special K, because it's heart healthy and "they" say the studies show women who eat this weigh less.  Besides, it's delicious! I could eat a whole box of that stuff every day."  

     "I'm not sure why I'm not losing weight.  I don't eat eggs, cheese, or meat hardly ever; I only drink diet soda now, and I've been taking Hydroxycut for months.  I only eat 1200 calories a day (when I don't cheat).  I'm just so tired all the time.  I have no time or energy to go to the gym, let alone cook a lot of crazy food.  I feel bad, because I've paid for the membership, but I'll get back in there soon.  Guess I'll microwave dinner; it's Healthy Choice at least."

Do these sound like anybody you know?  Do you see the subtle influences of the six "storm fronts" across them all?  

How about this one?

     "I love food!  It seems like I'm eating all the time.  Steak, cheese, and full-fat Caesar dressing?  Bring It!  I can't remember the last time I had a bowl of cereal.  I have a vague idea of how many calories I'm eating, but I don't count and don't really care.  I  never jog or hit the elliptical.  The best thing is all the great flavors I get to eat: Mexican, Greek, Chinese, and Italian.  Besides, I save a ton of money by eating at home."

This person is obviously unconcerned about his or her health.  A walking time-bomb, right?  Well, the truth is, this is a declaration that Michelle and I have both made more than once.  In fact, though it is only part of the story, it is a big part of our attitude toward nutrition now.  It flies in the face of everything you know about eating healthy, right?  How could we possibly lose weight with such a bizarre approach to nutrition?  

I'll repeat what I said at the beginning: something is wrong - something bigger than "eat less, move more".  We believe that we have found a winning approach to nutrition and fitness.  I won't say "right" because your goals may be different.  But if you want to lose fat, be stronger, have more energy, and feel great about how you feel and look, then you've come to the right place.  You've got to shed the conventional wisdom, choose a nutrition plan (not a diet) and a training plan (not exercise) that will deliver the results you want.  

Can You Really Improve Your Metabolism?

My last 45 was Men at Work.

One aphorism that seems to accompany aging is that, after 40, we start "slowing down".  It seems to be an inevitability; we can't eat as much, do as much, or muster that seemingly endless reserve of energy we had in our 20s to power through a crunch period.  And we've all said it: "My metabolism ain't what it used to be."

Metabolism may well be one of the most blamed (and least understood) villains of weight loss.  Claims all over the news and Internet extoll the virtues of one product, food, or detox smoothie, saying it will "increase your metabolism" to aid in weight loss, though little change actually ever results from these wonder cure scams.

So, what is it?  How does it work?  Can you actually increase your metabolism?  Does it even matter?  In today's post, we'll try and put it as simply and completely as possible, so you can put it to work in your daily life.

Metabolism Defined:  

In the simplest terms, metabolism is the ability to get nutrients into your body, process and deliver them to the systems that require them, and expel unneeded waste from the body. The systems involved include, of course, your digestive system, your liver, kidneys, thyroid, pancreas, and the circulatory system.  Really, there are infinite reactions and activities that could be included, but these are the heavy hitters.  

Understand that your body, much like the starship: Enterprise, is a set of counter-balances and back-up processes.  When threatened, we can pull resources for a short burst of "better than 100%" energy.  When power or resources are damaged in one area, the body diverts alternative sources of energy to other systems.  When things are truly dire, we divert all of our bodily resources to "life support".  I won't ask whether you're a James Kirk or Jean Luc Picard supporter; some things are just too controversial for this forum. 

In many discussions about human metabolism and weight loss, it is reduced to the concept of calorie burning.  You can look at it in that context.  But, since different nutrients (and, therefore their potential caloric energy) are taken up by different systems, if you're thinking purely in that sense, you'll miss out on some very important distinctions.  Our approach to nutrition veers away from calorie-centric and focuses more on macronutrient management.

If sweating was the key, every guy in the sauna would be RIPPED!

Metabolism is NOT: 

• Your heart rate
• Sweating
• Breathing heavy
• Body heat
• Perceived "energy level"  

These are by-products of activity.  Products that are billed as "energy boosters" are not metabolism-enhancing.  They are stimulants that increase your heart rate and/or give you the sensation of alertness.  Don't be fooled.  

Can we Really Affect Metabolism?

The short answer is: yes!  Scientific studies consistently show that we can manipulate the mechanisms  that take in, absorb, and process nutrients, both independently and as a whole system. If we break it down into four components, we can easily examine ways that will make a difference.  

In addition, we have to examine our approach to metabolic repair in three phases: 

1.    Stop inflicting more damage
2.    Repair existing damage
3.    Optimize performance for the future

*** SAFETY DISCLAIMER: If you have any condition and especially if you're on meds for things like thyroid levels, cholesterol control, or blood sugar management, make sure you make any changes in your diet/lifestyle in partnership with your doctor.  Even "good" effects of dietary changes can be risky if you mess with the balance established by your medication.

So, let's dig in.

Component 1: Intake.

For our discussion, we'll consider "intake" everything from your mouth to your intestines.  Once it passes through the intestine wall, we'll call that processing.  Intake metabolism involves: quality, digestibility, and timing of food consumed and your digestive tract's ability to break it down into a consumable form.

The human body uses a multi-stage system to get food into a usable form.  Chewing and the stomach handle the mechanical breakdown to pieces that are small enough to act on.  The stomach sanitizes the food particles with acid, killing off bacteria.  Different enzymes specifically target proteins, fats, and carbohydrates and attach to them for transport through the intestinal wall.  Vitamins and minerals are either fat soluable or water soluable, depending on the type. 

What you can do:

     1. Stop inflicting damage.  Since our bodies are designed to take in nutrients as fats, proteins, and carbohydrates as well as micronutrient vitamins and minerals, choose foods that are rich in these substances and limited in non-nutrient additives.  These elements may not be caloric (because they can't be digested), but they represent extra work for your system to do.  Choose foods that are more bioavailable, naturally taking the strain out of your system.  

Manage your portions.  The stomach is involved in mechanical breakdown of food, like a food processor.  What happens if you overload a food processor?  You get uneven breakdown because movement is restricted.  The same thing when you overload your stomach; you get bloated, uncomfortable, and your digestion is hindered. This can lead to a vicious cycle as over-filling your stomach often leads to heartburn, for which you take antacid (even though it's not the acid's fault) which makes your food harder to digest, which perpetuates the backlog.  It's a good case for eating more, smaller meals for many people.

When is the right time to eat?  We are a proponent of sticking to a schedule so that we don't get too low and we don't overeat at any given time.  But, eat when you're hungry.  The time of day may determine what kinds of foods you choose, but the whole "no food after 7pm" thing is a non-issue, metabolically.   

     2. Repair existing damage.  Learn whether you have sensitivities to particular foods.  Most food allergies are specifically related to a particular protein.  Only about 1% of people have Celiac's disease, but at least 6% have gluten sensitivity, which can really negatively impact the digestive surfaces of the intestines, leading to malabsorbtion of the nutrients you need.  If you feel particularly uncomfortable after eating a particular food (dairy, nuts, etc.) it may be an indication of sensitivity.  Eliminate only one element at a time and stick with it for at least a week to see whether and how it affects you.

     3. Optimize your system.  Get plenty of water!  A shocking number of people walk around partially dehydrated all day long.  Water is an essential component of the digestive process.  Some sources recommend limiting water intake during meals, as it dilutes the stomach acid that breaks your food down.  Also, make sure you're getting some healthy fats in your diet to aid with the digestion of fat-soluable vitamans and minerals.  

Component 2: Processing.

As we discussed earlier, "processing" begins at the intestine wall and describes the mechanisms used to prepare nutrients for distribution.  The line here between processing and distribution is a little fuzzy, but, we're just doing this for ease of discussion, so we'll accept the arbitrary split.

Once macronutrients, vitamins, and minerals have made it through the intestine wall, these components pass through your liver and circulatory system.  They're spurred along by hormones, which are the "traffic cops" of the digestive process.  

What you can do:

     1. Stop inflicting damage.  The liver is a beast of a filtration system.  It's also grand central station for the nutrition process.  In addition to the recommendations in "Intake," limit alcohol use.  Limit fructose in your diet (e.g. sugar-sweetened drinks and foods with high-fructose corn syrup).  These both put additional strain on your liver in return for NO real nutritional benefit.  Refined carbohydrates and non-refined simple carbs in excess continually spike insulin levels, which will make your muscles insulin resistant and may eventually exhaust your pancreas entirely.

**Note - there is still controversy in the nutritional community about the relative cost/benefit of fats (particularly saturated fats) compared to carbohydrates.  Here's our take:  Fat consumption, as a nation, has gone down over the last 30 years, yet obesity and related conditions continue to increase. This demonstrates that the relationship between fat consumption and these conditions is not as strong as once thought.  Refined carbohydrates (sugars, flour), meanwhile, continue to play an ever-increasing role in our daily intake because they are inexpensive, last forever, and are tasty.  You're probably eating them in places you never expected, like low-fat dressing.  These ingredients, in contrast to fats, offer nothing nutritionally beyond energy.  So, whether you could cut fat or not, you can always eliminate foods heavy in refined carbs without any risk of malnutrition.  So - fat-haters - we hear you; we still stick with the recommendation to ditch the refined carbs.  

     2. Repair existing damage.  As many as 1/3 of Americans have metabolic syndrome, characterized by fatty liver (the non-alcoholic version of cirrhosis) and insulin resistance.  We're not getting any younger, and the effects of these things are cumulative over time.  Together, fatty liver and insulin resistance lead to inflammation of the joints, increased "bad" LDL cholesterol, decreased "good" HDL cholesterol, and significantly increased risk of heart disease.  You can reverse these conditions by removing the refined carbs, maintaining a healthy level of balanced fat intake, and exercising (even very moderate levels of activity).  The result of which will likely be weight loss - itself an aggrivating condition of metabolic syndrome.  

     3. Optimize your system.  Regular bouts of exercise increase insulin sensitivity.  High-intensity cardio activities, like sprint intervals, as well as strength training are most effective, but steady-state cardio like jogging or aerobics also positively impact insulin sensitivity.  The effects only last for about 24-48 hours post-workout, though, so consistency is key.  

Component 3: Distribution.

Distribution involves actually getting nutrients to the places in the body where they can be used. We're now talking about the cells and tissues that are the end users of what we eat.  People don't often think of the demand side of eating beyond their stomach.  But, trust me, this is where it's at.  

We typically associate aging with changes in skin tone, muscle mass, bone density, and energy levels. These are the "demand" activities we need to stimulate to derail the aging process.  The food and pharmaceutical marketers want you to believe that you need a pill for vitamins, a supplement for digestive health, another pill to fight off the heartburn, a drink for energy, yet another pill for vitality, and Cheerios to be "heart healthy".  That is, if you're not already on statin drugs to fight down the cholesterol.  Do we REALLY believe that the human body is so fundamentally broken that it can't maintain a healthy, functioning system without all this medical intervention at every stage? 

What you can do:

     1. Stop the damage.  Cellular health is maintained by a steady stream of essential fatty acids.  Diets extremely low in fat, or ones that provide only the kind of artificially hydrogenated trans-fats found in fast food and low-grade processed foods do not deliver what the cells need to repair and restore.  Inflammation in the joints can also be positively impacted by ensuring you have sufficient fat in your diet, along with reducing the intake of refined carbs, which promote inflammation.  

     2. Repair existing damage.  Cellular damage is from the process of oxidation.  These damaged cells, if they don't self-destruct properly, become free radicals, which are essentially "baby cancers" waiting to attach to something and create more damaged cells.  Including anti-oxidant-rich foods, such as blueberries, in addition to ensuring you're consuming sufficient amounts of healthy fats, will help reduce this oxidation process.

     3. Optimize your system.  In two words: create demand.  As children and young adults, our bodies were operating on biological imperatives: grow, survive, and reproduce.  These imperatives are accompanied by a flood of hormonal activity that brings renewal.  Those days may be starting to fade into the rear-view mirror, but you can still create stimuli that spark an increase in those hormones and the activities that go with them.  Lifting weights stimulates testosterone, growth hormone, promotes bone density, and, if done correctly a little thing called protein turnover (which we've written about before).  Lifting also creates a unique level of demand for new energy in your muscles, dramatically increasing your glucose uptake.

Another, often overlooked method of increasing your resting metabolism is to gain weight.  I know - everyone is talking and thinking about losing weight.  But body weight is a key factor in the equation of daily energy consumption.  Obviously, the weight we'd like you to gain is muscle and not body fat.  But it can't be ignored: people who weigh more burn more (and the opposite is true as well).

Component 4: Expulsion.

At the end of the day, your body needs to be efficient and effective at eliminating non-digestible and waste material to complete the cycle.  People with damage in this phase of their metabolism are, in fact, at risk for reabsorbtion of toxic materials and bacteria the liver and kidneys selected to eliminate.  "Cleanses" are a popular staple of pop-fitness pseudo-science. But, the fact of the matter is, your body is designed to handle this task as well.

If you are not regular, join the club.  Probiotic foods and supplements as well as fiber supplements are flying off the shelves.  Don't ignore this!  The simplest and most reliable indicator of digestive health is regularity.  My own experience with IBS lasted years, and only ended when I cleaned up my diet and started getting enough sleep.  

What you can do: 

     1. Stop inflicting damage.  As I mentioned in the "intake" portion, our bodies are designed and equiped to digest certain nutrients.  The body can certainly absorb things that don't conform to this list, or medicines wouldn't heal and poisons wouldn't kill when ingested.  But, on the whole, the body considers its list of "foods" to be protein, fat, and carbohydrate, along with essential vitamins and minerals.  Anything else you eat, dyes, colors, preservatives, flavors, and texturizers are in the "not food" list.  This leaves it to your gut to deal with.  In a previous article, I compared the difference between a breast-fed baby's diaper and a formula-fed one.  The difference should make you really think about what you put your gut through every day.  Eat foods that are close to their natural state, things that will go bad in a week if you don't put them in the freezer.  The fewer ingredients on the label (most of what we buy doesn't even have a label) the better.  And, also mentioned previously - hydrate. Sip water consistently throughout the day.  Keep it around you.

Cleanses and diuretics are not the answer.  In many cases, they can be unsafe, because they can alter the PH or water balances in your system.  At best, they will provide temporary symptom relief that will be short-lived.

     2.  Repair existing damage.  If you've already learned about food intolerances and dealt with them, you're well on your way.  As long as there hasn't been any permanent damage done to your digestive tract, the removal of foods to which you're sensitive and a diet of whole, fresh foods should induce your system to "bounce back."  If, after 4-8 weeks of clean eating and good hydration, you haven't noticed real, positive change in this aspect of your life, it's time to see an allergist or internist to figure out what's going on.

     3. Optimize your system.  In addition to hydration, certain minerals figure prominently in this aspect of digestive health, magnesium chief amongh them.  (Look at the ingredients of many laxatives, milk of magnesia, e.g.).  Green vegetables, such as brussel sprouts, are great natural sources of magnesium.  This is actually the only nutritional supplement we take.

Really, that's it? Diet and exercise?  

There's a reason people keep coming back to the same old standbys; you just can't skip the fundamentals.  But, hopefully, reading this, you've got a little new perspective on the precise mechanisms that affect your metabolism and how you can impact them.  I'd like to add that this is really just scratching the surface of a very deep subject.  But, get the fundamentals right and see what happens.  If you're not seeing a significant improvement in a few weeks, it's time to take additional steps, with the assistance of a doctor and nutritionist.

How the Calorie Ruined Nutrition

Okay - that's it - I've had all I can take...

I know we are going to start a storm here, but, day in and day out, we keep seeing the same mythology and misunderstanding being perpetuated around the Internet, the water cooler, and forums across the web.  It's time to try and put it to rest.

The dietary Calorie, a brief history:

The Calorie, in its modern definition, came from  roots in mechanical physics at the time that the steamboat and the steam engine locomotive were the height of technology.  It was, as today, a measure of heat energy to quantify the effects of fuel on a thermal engine.
 In the mid-1800s, this concept became adapted to food consumption, though the measurement was transformed into the more practical Kilo-Calorie (kcal).  The concept was introduced to the public by Atwater in the journal "Century" in a series of articles.  Ironically, even at this early stage, scientists acknowledged that "The potential energy represents only the fuel value of the food, and hence is only an incomplete measure of its whole nutritive value".

As a unit of energy, the calorie has long been surpassed by the joule, but the term Calorie has become so embedded in our nutritional awareness, that it has never been replaced.

The method of determining the caloric value of food is the same as it has always been: a calorimeter, which combusts the food in a laboratory and records the heat energy generated.  Which is great, if you're a pot-bellied stove.

What's wrong with the Calorie?

This obsession with food = calories = energy = balance to be maintained and manipulated is baffling.  Somewhere along the way, we forgot about the difference between energy and matter.  Energy that exists solely as energy can be found in all kinds of places: light, heat, radiation, house music... well, maybe not house music.  Matter, on the other hand, has mass and takes up physical space in the universe.  Which category do you think your chicken breast falls into?

The whole calorie theory rests its ponderous bulk on the First Law of Thermodynamics, that energy cannot be created or destroyed, only transferred or converted.  Fine and good, except that, as matter, the things we eat as food also have the laws of physics surrounding them.  As finite quantities of molecules, you can't burn them and build with the same piece.  You have to choose.  

YES, okay, the chicken breast can potentially be used as energy.  And some of it certainly will be.  But some of it, depending on your age, metabolic health, training routine, and other factors, possibly most of it will be applied to replacing worn out tissues and building new ones.  

Think of a steak.  When it is on your plate, you look at it as "X" calories per serving.  But, in the cow, it wasn't energy; it was muscle tissue.  Stored protein that did work and burned energy.  Yes, if the cow were starving, that muscle tissue would eventually be catabolized into energy to keep the cow alive.  But then the cow wouldn't have the muscle anymore.  You can't burn it and build with it.  You have to choose.

Somewhere along the way, we took a wrong turn...

Something happened in our advanced society.  Somewhere we lost the ability to think and reason for ourselves.  Worse, some pompous scientists started bashing anybody that disputed the immutable laws of physics when it came to food - completely ignoring the fact that they had skipped a chapter along the way.  I'm not a pot-bellied stove.  The stove isn't going to take any of the wood you throw in it and use it to reinforce the iron base, or replace the stovepipe molecules that have degraded in the heat.  Nope, it's just going to burn stuff.  I'm not a pot-bellied stove.
ourselves.  Grandma used to say "eat your meat and vegetables; they'll make you grow up big and strong."  We used to think of food as nutrients, as building blocks.  In short: matter.  But some knucklehead started slapping the caloric value of every piece of food on a label and we lost our minds.  Calories became everything.

If food is just a collection of calories and calories are interchangeable, then why do some people get fat and some get muscular?  Why is there any variation in body composition between two people that eat the same thing?  Why can some people lose weight on 1800 kCal a day and others feel the need to plummet to 1000?  

And it gets even more ridiculous!

Since people abandoned their own experience for the wisdom of a food label, they have gone to unbelievable lengths to create the "perfect equation" of energy balance.  From measuring calories in, to Basal Metabolic Rate, to calories burned in exercise, we have heaps of calculators and tools to show us how to strike the magical energy balance.  And none of them, no matter how complex, are right.  

Futility, Part 1 - Calories in.

Calorie counters read those labels religiously. They add them all up, weigh, measure, and portion so exactly right.  But - there is so much variation between those labels and the actual content of food, sometimes as much as 50% above or below, that, from the outset you're doomed to arrive at any meaningful number.  Add to that the variation in cooking techniques and, well, you get the idea.  

What's more (and I'm going out a scientific limb here) many of the so-called "foods" we eat in a modern society are either barely digestible at all or so refined the body sucks it up at alarming rates.  The best documented example of this is baby formula.  Scientific studies have conclusively proven that much less of the processed and artificial nutrients used to simulate breast milk are not absorbed into the body, but passed straight into the stool.  Their solution, multiply these ingredients by the inefficiency of absorption to "force" sufficient nutrient into the baby's system.  But what happens to the rest of it?  How does it impact the digestive tract?  Anybody who has changed diapers of both breast-fed and formula babies will tell you.  

Paleo practitioners, on this score, have it right.  Though the specifics of "what" are still in dispute, there is no doubt our body was constructed and equipped to digest and process certain molecules better than others.

Futility, Part 2 - Basal Metabolic Rate (BMR). 

Apparently there is an app for that...

The next piece in the calorie-counting nightmare is calculating BMR.  There are all sorts of Theory of Relativity-rivaling calculators out there that estimate your activity level, adjust for the Thermic Effect of Food, and factor in other components like age and gender.  These calculators are supposed to spit out the amount of energy you burn just existing.  

But again, every person is unique in their combination of body composition, metabolic health, hormone levels, perceived level of activity, and even the efficiency (conditioning) with which their body operates.  Conditions such as stress, fatigue, and even the weather add further variables to your actual daily energy expenditure.  

So we start with a calculator based on estimates and subjective factors, leave out individuality and variation, and yet, somehow, spit out a number that we are supposed to consider "valid".

Futility, Part 3 - Calories Out. 

C'mon, would he lie to you?

This part may be the least controversial assertion I make, but still people cling to it.  "Calories burned" calculators are models that estimate the amount of energy you converted in your body through oxygen consumption.  Oxygen consumption is estimated by measuring your heart rate.  Most calculators include a body weight factor and some an age factor as well.  These factors are supposed to increase or decrease the base number built into the heart rate model.  

Once again, these factors entirely leave out individuality.  Conditioning, training style, and body composition all drastically effect the level of effort you put forth in any activity.  Furthermore, your body is the ultimate master of efficiency and adaptation.  That means, as you improve your conditioning in a specific activity, you will expend less energy as you continue to perform it over time.  Yet the calculator will read out the same number again and again.  

And no calculator effectively measures the expenditure of energy through anaerobic activity, such as lifting weights.  Yet every single contraction of a muscle consumes sugar, generates heat, and stimulates hormonal reactions that stimulate energy-burning growth.  And, as with aerobic activity, our body's become more efficient at performing the same workload over time, so you burn less energy each time you repeat the same activity at the same load.  

So, once again, we start with estimates, toss in generic factors, and leave out the actuals, while completely ignoring an entire class of activity.

Futility, a recap. 

So - you cannot count on the precision of the calories you're taking in, you have little hope of producing a realistic number of your BMR, and calorie monitors for exercise are next to worthless.  So why are you still doing it?

Why is the Calorie still around?

Calorie zombies? We may be onto something...

Here's the deal.  The Calorie is a well-established scientific measure, defended by the medical and scientific community for over 150 years.  And there is a very strong statistical relationship (in real food) between caloric content and nutritional density.  So strong, in fact, that at times, it's truly difficult to tell the difference.  No matter how strong the relationship is, you simply can't get around the fact that this is correlation and not causality.  

Note: It is precisely because of this strong correlation that calorie counting can prove useful to practitioners who understand and adjust for all the variability and use the relationship to achieve weight loss.  

But, in the age of ultra-processed ingredients, we have stripped away nutrition, leaving only the energy (in refined carbohydrates) behind.  To counter this, we stripped away even more of the original ingredients (like fat) and replaced them with lower-calorie substitutes like sugars and gluten.  This has created a bizarre imbalance in our perception of healthy food.  

But food isn't just energy.  And you are not a pot-bellied stove. You need to rebuild and replace your body every single day with amino acids and fatty acids.  You need to fuel your activity with glucose from quality carbohydrates.  You need to put things into your body that it was designed and equipped to consume to perform these functions.  Nutrition is about incorporating the right amounts of the right components to continue these activities.  Grams of protein, grams of fat, grams of carbohydrate, all with the essential vitamins and minerals they provide.  Anything else is malnutrition, pure and simple.  

Now, eat your meat and vegetables so you can grow up big and strong!

What does hunger have in common with breathing?

I love analogies and metaphors.  Sometimes they don't work out so well, but often I find them the best way to make a (seemingly) complex point simple to understand.I've been trying to find a clean and concise way to explain the concepts the underpin our approach to nutrition for some time now.  And, let's face it, the biology lessons get a little - well - dry.  I mean, who wants to muddle through this:

Clear as mud, right?

But recently, it occurred to me that we can learn a lot about hunger and nutrition from another set of organs frequently focused on in training and exercise: the lungs.  

Everybody knows that exertion causes us to breathe more deeply and heavily.  So much so, that being out of breath is often associated with a "good workout".  But why, really, do we breathe hard during activity that crosses the aerobic threshold?

Soldier, do you even HIIT?

Extended exertion relies on the body's ability to get oxygen to working cells and transport away the CO2 generated in the process.  Oxygen is free-flowing through your arteries at all times (remember red arteries and blue veins from middle school biology?)  But, when the existing stream isn't enough, your cells are "starved" for the needed oxygen to continue the energy-supplying reaction.  Like the AT&T commercial, "you want more, you want more!"  The call goes out.

The central nervous system signals "more oxygen please" and, in response, your breathing rate and depth increases.  In short, you don't breathe harder because your lungs are empty, or even because your lungs asked for more; you breathe harder because your cells demand it and put the call out to your brain.  The lungs are the supplier in the system - not the driver.

Now your breathing is an autonomic reaction.  You can't very well stop it.  And nobody accuses you of poor willpower because you can't choose to reduce your oxygen intake.  

With me so far?  Let's look at how this relates to nutrition.

The same kind of processes go on with regards to replenishing your body with nutrition.  Cells need amino acids, fatty acids, and energy to continue their daily activity, and even more if you're stressing them through strenuous activity.  Instead of the lungs, our digestive system is the supplier for nutrients and energy the body demands.  When things get low, the brain signals "more nutrients please" and you get hungry - biologically, truly hungry.

The problem with us as humans is, we've convinced ourselves that the stomach is the driver of hunger, that "full" and "empty" are simply based on the contents of our gut.  We've stopped listening to our brain about when more is needed.  Obviously, the act of eating is voluntary, in contrast to breathing, and that gets us into trouble.

Another parallel: people perform "cardio" exercise in order to improve the capacity and efficiency of their oxygen processing system.  But how many of us work to "optimize our gut efficiency"?  We wouldn't consider breathing "junk air", because it just wouldn't give our body what it needs.  But food?  Nutritional density, quality, availability, and efficiency just aren't given a thought.  We know a growing number of people have sensitivities involving gluten - especially in excess.  And the skyrocketing popularity of probiotics would seem to indicate that gut problems are fairly wide-spread.  Our go-to foods contain preservatives and chemicals, foods so refined that they last a year on the shelf.  What do they do to our digestive process?  

Okay, so now what?

If you've hung around this long, you might be saying "I see your point, Mike, but what am I supposed to do about it?  Well, we need to change our relationship with food.  Our culture is so centered on food for everything but nutrition.  Whether it's for celebration, rewards, or commiseration, the messages around food are powerfully ingrained from childhood, marketing, and peer pressure.  We all have to wrestle with that in our own way.  But at the end of the day, food is fuel: building material and energy.  To have a healthy relationship with food, you have to put that thought at the forefront.

Next, try to figure out what your real hunger signals are.  For Michelle and I, we slow down a bit, our minds don't work quite as fast, and - if allowed to go on too long - we get shaky and "hangry" (a compound word of our own design, combining hungry & angry).  The problem is, these signs come on very gradually and aren't always easy to notice.  They are also signs of the fact that you're already at a deficit.  To me, this is probably the best case for, like breathing, eating a small, steady stream throughout the day.  You don't get especially hungry at any point, you don't get especially full either.  You're basically doing "healthy grazing".  From pre-workout through dinner, our meals are, at most, three hours apart.  

Finally, make sure that the food you have available and choose to provide your body is of high nutritional quality.  It's simpler, more satisfying, tastes better, and not that expensive, if you plan right.  

So, if you're struggling with your nutrition, dealing with hunger and cravings, just remember: it's as easy as breathing.

Book Review: Good Calories, Bad Calories

When I first planned to write this review, I have to admit I took it too lightly.  I thought that it would be a simple matter of "liked this; didn't like that" and that would be it.  As it turns out, there's a lot more to consider.

About the author: 

First, let's get to the elephant in the room: the author.  Gary Taubes is a controversial name in nutrition.  Some go so far as to say "utterly discredited".  But why?  There are all kinds of flat-out crazy assertions in diet and nutrition books out there and they don't carry the kind of stigma that Mr. Taubes does.  It would seem that he fell victim to his own enthusiasm (Gary, I can sympathize).

Set the way-back machine to July 2002 and Gary Taubes wrote an 8,000 word editorial titled "What if it was all a big fat lie?" in the New York Times.  Clever play on words, as his assertion was that long-demonized dietary fat may not be at the heart of the obesity epidemic or the threat to heart health that it was made out to be.  The problem is, he cited some experts he interviewed about his premise, but "curtailed" their quotes in a way that supported his theme, but not their actual feelings on the matter.  The result was a thorough blasting that eclipsed the substance of his argument.

This book, published in 2007, appears to be his way of redeeming himself from the aftermath of "... Big Fat Lie."  It is a tome, nearly 700 pages, loaded with research, citations, and footnotes.  It's probably the single most complete compilation of the story of how our thinking has evolved surrounding nutrition over the last 100+ years.  This alone makes the book, in my opinion, essential to anyone studying nutrition and weight loss.  Taubes actually published a "Reader's Digest Version" of this work, titled "Why we Get Fat".  The shorter read promotes the same thesis, but in a much more condensed format.

About the book:

Taubes is unabashed in promoting his theory (one which I generally share) that refined carbohydrates in excess are a significant factor in today's obesity epidemic and seemingly spiraling growth of Type II Diabetes.  By contrast, he asserts how dietary fat has been wrongly accused of being the culprit.  On that score, this is a mixed bag for the inquisitive reader.  It's great that you know exactly what Taubes' point of view is, but it is far from a balanced presentation of the merits of both arguments.

But that's not what makes this book interesting or unique.  Regardless of whether you agree with Taubes or not, this book is a must-read. Read it because it is, in fact, a three-way cautionary tale.  Through his tireless pursuit of historical data and anecdotes to make his case, you see clearly how confirmation bias, cults of personality, and even a little class warfare have shaped the message and, therefore the attitudes of pretty much the entire Western World.  Moreover, he shows clearly the risks involved when public policy makers dispense sweeping medical advice (something we have come to accept and expect, thanks to groups like the American Heart Association and others), that ought to be left to physicians and their individual patients.

Finally - Taubes clearly exposes the danger of taking studies and their findings at face value, particularly when you don't understand the mechanics and controls behind the study.  In many ways, these scientific studies have taken the place of our own observations of reality, much the same way over-relying on a GPS seems to rob people of their ability to navigate on their own.  Think of this: it's a statistical fact that obesity is on the rise.  It's generally accepted across the board that 80-95% of "diets" fail to produce any meaningful weight loss.  Yet we are still devoted to the same methods that have been failing for the last 30-40 years. Definition of insanity, anyone?

Taubes shows how, too often, researchers have relied on data of convenience, rather than those data points that are most meaningful, to support their pre-existing assertion.  This is, in part, because a truly meaningful nutrition / weight loss trial is virtually impossible unless you govern every single aspect of their behavior and measure it meticulously and with precision.  Any variation in intake or expenditure can cast the results in complete doubt.  It is also in part due to the duration required to really determine whether an approach "worked," "initially worked," "looked like it worked, but turned out later not to," or just plain "didn't work".  Trials like that take years.  And people tend to prefer not to have every single meal and activity governed for such a duration.  

And what is "worked?" exactly?  Most of the dietary trials were trying to assess whether manipulating a single variable, fat, for instance, would measurably improve a person's incidence of heart disease and, ultimately, death from it.  This sort of trial is the methodology employed by the field of epidemiology to prevent the spread of infectious disease.  The trials' ultimate finding is not about whether a treatment is 100% effective or 100% ineffective, but rather how many people need to be treated in order for one person to be positively affected.  Think: flu shots here.  We know it isn't going to work for everybody, and the majority aren't at risk to begin with, but the "relative harm" is considered negligible for the "relative benefit."  So - flu shots, issued as broadly as possible, are considered an effective epidemiological practice.  Since no one at the time was looking at Diabetes, but instead at heart disease, the "relative harm" of trading benign carbohydrates in favor of fat seemed like an altogether simple recommendation.

In these recommendations, obesity was always assumed to be the proximate cause of heart disease and not a related outcome from some other condition, so the results, time and again read: "X makes you fat, which makes you susceptible to heart disease."  And, by and large, it was also accepted that the proximate cause of obesity had to be gluttony.

It was a revelation to me, personally, to realize just how disconnected fields of expertise in health and nutrition have become.  Impacts to inter-related systems, upstream and down, are not necessarily considered if those systems reside outside the specialist's purview.  

About the premise:

As I said, Taubes' argument is that refined carbohydrates, consumed in excess, are both uniquely fattening and uniquely harmful to the human body.  He presents a series of arguments, both against the "fat hypothesis" and for the "carbohydrate hypothesis".  

The most compelling support for his position is, in fact, the oldest.  He spends a good amount of time walking us through how missionary doctors in very remote populations never had to deal with "western diseases" such as diabetes and cancer. How it was only after introducing highly refined carbohydrates into their newly-westernized diets (they had to be highly refined in order to survive the long transport), that these populations began to exhibit these conditions.  He provides numerous examples of this pattern across the world.  Since we, in the western world, only recall dealing with Diabetes and heart disease in terms of increasing or reducing their occurrence, we've never had the luxury of considering the posibility of their absence.  These missionary doctors had the unique opportunity to examine their own "patient zero" at the time the conditions manifested, to and directly observe the changes in environment and lifestyle that may have contributed to or caused them.

And here is where Taubes' assertions differ so drastically from the conventional wisdom of energy balance and the First Law of Thermodynamics.  Taubes treats obesity as an outcome to the metabolic damage caused by constantly elevated insulin levels.  He explains (often in terms you'll have to read through more than once) the biochemical processes from system to system, from intake to storage and consumption, and does something nobody else does: connect the dots.  The energy balance group doesn't have to connect anything, because at the end of the day, all they're looking for is a zero sum, and the rest is fat.  But hormone imbalances, the impact to the liver and pancreas, the mechanics of fat metabolism itself, are all laid bare in the pages of "Good Calories, Bad Calories".

Despite his passion for his position, Taubes does take care to repeatedly state that his evidence is equivocal.  That we still have to infer much of what leads him to the carbohydrate conclusion.  Again,  whether you agree with him or not, one has to admire his commitment: Taubes has long been an active practitioner of the Atkins Method, and he is currently partnered with Dr. Peter Attia, a ketogenic diet proponent and practitioner, in an organization called the Nutritional Science Initiative (NuSI.org).  NuSI is advocating for the best possible nutritional trials and studies to finally deliver some definitive answers to the full picture of human nutrition and how our eating affects the quality and longevity of our lives.

The Bottom Line:

Good Calories, Bad Calories is absolutely worth the read.  For me, it appeals as a student of public policy and history, as an analyst, and as someone who has sought to further my understanding of nutrition, health, and the function of the human body.  Whether your interest is in only one, two, or all of these areas, you will find it enlightening and engaging - if you start it off with an open, but skeptical, mind.  And, with it, you'll have a virtual catalog of studies, pro and con, to further your own understanding.  

Why EVERYBODY Should be Talking About Metabolic Syndrome

Stories about the obesity epidemic flood the news. Practically all of us can quote the statistics: a third of adult Americans are overweight or obese; future generations are looking even more dire. And, hand in hand with obesity, the increasing pervasiveness of Type II Diabetes, a completely lifestyle-induced disease, is becoming so ubiquitous that it seems like a non-event to see someone with a glucose meter at the lunch table.

These problems seem insurmountably huge and irreversible to most of us. According to analyses of various nutritional studies, 95% of standard diets fail to produce results. Diabetes is a disease that seems to be "someone else's problem" -- until the day the doctor tells you it's now yours. How do you hope to make progress against such a tide?

Graphic courtesy of Nature.com

The answer: understanding and addressing metabolic syndrome.

What? You don't know about metabolic syndrome? You've never heard of it? It affects an estimated 25% of Americans right now. That's okay. A year ago, I'd never heard of it either, and my father has had Type II Diabetes for the last 10 years.

What the heck is Metabolic Syndrome?

Put simply, metabolic syndrome is pre-diabetes. It's a set of conditions that set you up for that next step. The central condition is insulin resistance, which is the point where your muscles and other tissues can't effectively process and take up sugars from the blood anymore because insulin levels have been elevated chronically for an extended period of time.

A few quick words on insulin. It's a hormone, produced by the pancreas. Like cholesterol, it has been defamed because it is frequently mentioned in association with conditions like diabetes and Alzheimer's syndrome. But insulin isn't a bad thing at all. Like cholesterol, It has an extremely important job, to regulate energy by distributing glucose from your bloodstream to your brain, muscles, and organs. You want insulin doing its job, and doing it well. Hence, being insulin resistant is a problem for your body. It is a lifestyle-induced hormonal imbalance.

I want to break down the vicious cycle of events:

• Any time you eat, insulin is released to handle the carbohydrate energy. But - your blood sugar is particularly spiked from high glycemic index foods (sugars, refined flour in cereals and bread, rice, potatoes, etc)


• The liver calls for insulin to distribute the sugar from your bloodstream


• Your muscles can't take up the sugar they need. The sugar/insulin combo sort of "bounces off" the cell walls.


• Blood sugar remains high, so more insulin is sent out


• Cells become more resistant to the already elevated levels of insulin, requiring more each time to overcome the barrier


• Insulin is the body's primary signal for fat storage


• So, while your muscles and other tissues are literally starving for energy that can't get through, your body is happily depositing all of that in fat cells instead

Throughout this cycle, your energy levels are on a roller coaster, but you can't seem to get on top of the tasks you need to accomplish. Internally, your pancreas and liver are working on overload to continually respond to the ever-increasing task of producing insulin and regulating blood sugar.

Do this long enough and - yep - you've got Type II Diabetes.

People who consume the Standard American Diet (which most do, that's why it's called standard) normally have cereal products for breakfast, sandwich items for lunch with a side of fries or chips, and pasta, potatoes, and breaded foods are dinner time staples. And that's not including the snacks, sodas, and sweets. Simple refined carbohydrates are built into virtually every bite we take. These foods spike insulin severely, over time leading to the cycle above.

I want to say it again: 25% of Americans have metabolic syndrome. Those same Americans are also struggling with weight. This is everybody's problem.

The good news about metabolic syndrome

There is actually quite a silver lining to this dire picture. First, understanding the preconditions that lead to diabetes and which are so closely linked with the weight epidemic sheds some very interesting light on both (I'll go into detail on that in a moment). Second, unlike full-blown Type II Diabetes, metabolic syndrome has been shown to be entirely reversible.

Two approaches that are regularly used successfully to reverse the insulin resistance syndrome: strength training (getting those muscles to deplete and consume all those sugars), and removing refined carbohydrates (those with the highest glycemic index/load) as much as possible from your diet. This two-pronged approach works from both ends of the cycle to restore the hormonal balance your body needs to effectively regulate insulin, fat, and weight.

Now let's take a moment to examine what metabolic syndrome reveals about obesity. Insulin is the primary signal for fat storage in the body. Fat metabolism, under normal conditions, is in a constant state of storage and release, providing your body the steady stream of slow, efficient energy it needs throughout the day. When insulin is continually released to address the blood sugar spikes from our sugary and starchy diet, the fat storage signal is increased. When we are insulin resistant and blood sugar levels remain high, the insulin redoubles its efforts. The signals increase still more and there is plenty of blood glucose that needs to be stored.

Did you know that diabetics often report a ravenous, insatiable hunger? Think about it. The cells themselves are starving in a sea of energy just out of reach.

The flip side of this metabolic cycle is when, through activity or stress, you need to consume energy at an increased rate for a time. Adrenaline, sex hormones, and growth hormone are the primary signals to call for additional energy. But this call only goes out from the liver when your blood sugar has reached a low threshold. If you're continually supplying your body with that "cheap energy", the liver will delay the need to call for that all-important fat energy to fuel the body.

Let's recap

Even though there is heated debate on the most effective methods and means for weight loss in the medical community, strangely, the processes described above are accepted as gospel. The line of thinking is hard to miss, though. Most Americans eat a certain way. Those eating habits irrefutably result in a strain on the pancreas and liver to handle all the sugar. The body has a limited tolerance for this kind of abuse. Insulin signals fat storage. Metabolic syndrome is insulin regulation run amok. 25% of Americans have metabolic syndrome and almost all of them are overweight or obese.

It's reversible. We know how to treat it. Nutrition and rigorous exercise (particularly strength training) are the key. Strength training also releases adrenaline, sex hormones, and growth hormone, the fat releasing signals. So why aren't we talking about it and what are we waiting for?

Spread the word. Learn about how different nutrients affect and fuel your body. Make your health an immediate priority. Have a glucose test to check for insulin resistance. And get into a strength program. And join us here often for more information and to share your success with us and others.