According to the National Health and Nutrition Examination Surveys (NHANES), conducted by the Centers for Disease Control and Prevention (CDC), nearly two thirds of adult Americans are overweight as defined by body mass index (BMI) greater than 25. That is 130 million people. About one third are obese (BMI greater than 30). That is an astounding 61 million people. From 1960-200, the prevalence of obesity has more than doubled.

Being obese increases the risk of death by 50-100%. This translates to a reduced life expectancy of 8-20 years. In addition, the total cost of annual medical spending due to being overweight and obese is $118 billion, about 9% of all U.S. health expenditures.

Although there have been many different dietary recommendations over the past decades, the rates of obesity have only increased. Data from NHANES shows protein intake to be relatively constant from 1971-2000, with a gradual decline in fat intake proportion of nutrients. Carbohydrate intake has increased during this time.

The Food Pyramid developed by the USDA, outlines several recommendations including emphasis on choosing a diet low in fat. This change in dietary guidance has not been effective as demonstrated by the increases in rates of overweight and obese Americans. It is currently being studied to consider revision.

Is a low fat diet the “natural” state for the human body?

Over several hundred thousands of years, modern humans evolved in stages over a long time. The current foods you are eating were not readily available to these predecessors of current people.They did not have convience stores with 30 varieties of ice cream and whole aisles devoted to cookies. What did they have readily available?

The ancient diet consisted mostly of available vegetation, seasonally limitied amounts of fruits and nuts, and food that ran for its life. Characteristically, foods that are not low in fat. Foods made from grains were not part of the human diet until about 10,000 years ago. The evolutionary history of people goes back 3-4 millions years ago. You are trying to run your body on the wrong fuel for which it was evolutionarily designed.

After eating a meal rich in carbohydrates, your body secretes hormones that cause storage of the extra blood glucose in the liver as a storage material called glycogen. When this reserve gets filled up, the rest starts getting stored as fat. By changing your approach to eating, this process can reverse and cause fat burning.

By reducing, not eliminating the amount of carbohydrates in your diet, you can shift your body into fat burning metabolism. Weight loss follows and reduces the risks of obesity related illness and mortality.

Body Mass Index (BMI) is a measure of body weight adjusted for height. The formula replaces previous weight measures based on distribution tables of large numbers of people to give averages.

BMI = [Weight in Pounds/(Height in inches x Height in inches)] x 703

It does not distinguish between people with different percent body fat. Someone muscular, with a lower percent body fat can have the same BMI as a person of the same height with a higher percent of body fat. It is not clear whether there is a difference in risk factors of a higher BMI in this comparison. This is its limitation.

Normal is designated as 18.5-24.9. Overweight is defined as 25.0-29.9. Obesity begins at 30.0. The CDC (Centers for Disease Control) describes that a higher number is correlated with higher rates of premature death, cardiovascular disease, hypertension, oseoarthritis, some cancers, and diabetes.

BMI was originally calculated by the Belgian mathematician Adolphe Quetelet (1796-1874) in the 19th Century trying to describe the notion of the “average man.”

The BMI is only one type of measure of weight. Others include bioelectrical impedance, computerized topography, skin fold measurement, waist circumference, and waist-to-hip ratio.

Carbohydrates are one of three classes of nutrients in foods (proteins and fats are the other two). They are composed of carbon, hydrogen, and oxygen and are classified on the number of carbon atoms per molecule, the number of units in the chain, the location of a certain bond, and its shape.

The number of sugar units in the chain distinguishes the various types of carbohydrate:
monosaccharides are composed of one unit, disaccharides have two units, oligosaccharides are made of 3-10 units, polysaccharides have more than 10.

Monosaccharides, the one sugar unit type of carbohydrate, are Glucose, Galactose, Mannose, Fructose, Ribose, Ribulose, and Xylulose. These are sweet tasting and dissolve easily in water. Ribose and deoxyribose are part of nucleic acids which go to form DNA.

Disaccharides are two simple sugars joined together by a chemical bond. These are Sucrose (fructose and glucose), Lactose (galactose and glucose), and Maltose (glucose and glucose).

Polysaccharides are long chains of simple sugars (predominantly glucose) joined together as polymers. They can be branched or unbranched chains, and fold upon themselves.

In animals, Glycogen is the main storage form of sugars. It is a polymer which is highly branched and made of glucose molecules. Starch is the storage form in plants. In the unbranched form, it is termed Amylose, and the branched form is Amylopectin. Plant forms of carbohydrates are found in potatoes, wheat, corn, rice, and beans. Cellulose, or plant fiber is another polysaccharide, but it is not digestible.

When starch is eaten, digestion begins an enzyme called amylase, which breaks down the large chains into simple sugars which are absorbed into the bloodstream. From there, these simple sugars are either used as energy, or stored for later use. Storage occurs in the liver and in muscles as glycogen. Extra carbohydrates can also be metabolized and stored as fat.

As cells of the body use simple sugars for energy, oxygen is added and releases carbon dioxide and water as byproducts. Glycogen breakdown occurs when more sugars are needed by the body for energy. After it is used up, the body looks to stored fat for its energy needs.

There’s a common belief that any initial weight loss on a diet plan comes from lost water weight. It is not clear how this inaccuracy originated. In mammals, including humans, there is no water reservoir sac or gland that empties upon beginning a diet. (Even camels, contrary to popular belief, store fat, not water in their humps.) Where does water in the body come from?

There are two sources: intake and byproducts of metabolism.

The first line of nutrient storage in the human body is glycogen. This is basically a water free glucose polymer stored in the liver and to some degree in muscles. The average liver weighs about 2.5-3.0 pounds. Glycogen usually accounts for about 10% of this weight. This equals less than half a pound. Muscles have about twice the amount of glycogen as the liver, so this is less than a pound or two of total glycogen. Even if all the reserve were converted to water, it would account for less than a pound. (Actually, a chemical reaction called phosporylation breaks down glycogen, not hydrolysis as is commonly believed.) The water molecules that are formed account for only a fraction of the weight of broken down glycogen and are later used for new glucose production.

When fat is broken down, it produces fatty acids and glycerol as its first byproducts. Glycerol enters metabolic pathways to produce energy and glucose molecules, which the rest of the body can use for its energy needs. Fatty acids are chemically converted by oxidation and hydration to Acetyl CoA, which is broken down in other energy and amino acid pathways. These other energy pathways actually use water rather than release it. Even if fat break down were to release an equivalent amount of water per pound, what is the difficulty? Fat gets broken down and weight loss occurred.

What about total body water? The human body has about 42 liters of water. There is a lot of body machinery to keep water at a constant equilibrium. This ranges from thirst centers in the brain, to changing absorption in kidney tubules, to a number of regulatory hormones.

The body is made of 60% water (women have water content closer to 50%). Sixty percent of total water is within cells. Forty percent is in between cells and within blood vessels. Interestingly, more lean people have higher water content than those with a higher total body fat. This is because lean tissue has more water content than fat tissue. Thus, as one loses weight, percentage of water content actually goes up.

Where does the notion about water loss come from? It appears to be from misinformation, not biochemistry and physiology.

Contrary to what many dieters may think, choosing one diet plan over another because it allows more of certain favorite foods may be a recipe for another dieting failure according to Psychiatrist, Dr. Anthony J. Burlay, author of The Foundation Diet: Your Body Was Designed to Eat (Zen-Fusion Publishing, 22.95).Differentiating between “wants” and “needs” and learning what your body is designed to eat is the key to weight loss, Dr. Burlay says. “Approaching your search for a diet with the thinking that you can’t give up certain foods- like pasta, chocolate, certain fruits, or whatever your food may be- is a symptom of our society’s trend towards instant gratification and not the way you should be thinking if you want to lose weight.”

Many approaches to dieting rely on restricting “bad foods,” an approach, Dr. Burlay says, that ascribes morality to food choices and feeds the cycle of weight loss and regained pounds that plagues the modern dieter. “A ‘forbidden fruit’ mentality only fuels the feeling that dieting is a time-limited unpleasantness. However, a shift to a permanent change in food choices is the way to sustainable weight loss,” he says. Feeling denied certain flavors or tastes only compounds the problem and hiding foods in cookie jars or pantries does not reduce the risk that they will be eaten. “Even a five year old knows hidden cookies taste the best,” says Dr. Burlay.

Changes in food choices that meet your body’s needs rather then your wants will, in time, lead to a change in those wants. If the plan you chose does not allow your favorite food, there will be some initial discomfort but, Dr. Burlay says these previously favorite foods will take on a different importance as you proceed with your weight loss goals and change your pattern of eating. “It is as though your taste buds evolve to a new plateau of satisfaction. Those foods that previously had such a grip over your decision making may actually cause an adverse response. You will go by the donut or pizza shop with a new found freedom and not give in to the primitive part of your brain linked to emotions and food aroma.”

Once you are eating a diet which is evolutionarily correct you can and should pay attention to your body’s signals to eat, says Dr. Burlay. At that point your body will be telling you what it needs and you will find that your “needs” and “wants” are the same thing.

How do we know what we know? Often, our knowledge comes from through repetition and stories. In childhood, we call them fairy tales or bedtime stories. They amuse or entertain and have with the occasional moral lesson. However, as adults these stories or myths can be harmful when we start making decisions based on their often inaccurate information.

This often happens in food choices, especially when it comes to losing weight. Through repetition, even incorrect information can permeate our thoughts and get in the way of weight loss goals. The problem is, many ideas or stories surround weight loss get repeated so often, they become believable.

Let’s examine the science behind some of this folklore:

Myth #1: Initial weight loss on diet plans comes from a loss of water weight.

There is no water storage gland in the human body that empties upon dieting. The proponents of this fallacy usually argue that the breakdown of glycogen in the liver, a common occurrence in the body of a dieter, causes a release of water. The human liver weighs about 3 pounds and glycogen accounts for only about 10% of this. So, water from the liver could only contribute to less than half a pound loss, and that’s if all of its weight were water.

The fallacy mongers further suggest that the breakdown products of fat metabolism release water. However, for the technically minded, most of these chemical reactions actually use water initially, rather than release it.

Myth #2: Skipping meals is a practical way to lose weight.

When you skip a meal, your body uses stored sugar molecules which have been converted to glycogen. These stores are in the liver and muscle tissue. Once these are gone, your body turns to other nutrient sources for its constant energy needs. After skipping a meal under this circumstance, your body shifts into a “fasting” metabolism which leads to protein breakdown.

If you are eating according to evolutionary guidelines, that is, the right combination of foods for your body’s design, you would actually break down fat, rather than protein, by NOT skipping lunch.

Myth #3: The Food Pyramid is a good way to eat to maintain a healthy weight.

The U.S. Department of Agriculture released the Food Pyramid in 1980 and released an updated version in early 2005. The Pyramid advocates a diet with plenty of breads, cereals, rice, pasta, vegetables, and fruits. However, decisions about food choices are much more complex than following a list of recommended foods. Our food choices are the result of a combination of body signals, cultural influences, habits, events, people, emotions, and beliefs. Since the introduction of The Food Pyramid, obesity has become of pandemic proportion. It seems economically driven agricultural promotion is not serving public health.

Myth #4: Eating a low fat diet is the best way to lose weight.

Low fat diets have been advocated for the last 20 years and the fat content of the American diet has actually decreased slightly during this time, but the obesity rate has more than doubled. Why? Part of the reason is that a low fat diet is not the correct fuel mix for the way the human body was designed. Over millions of years of evolution, our metabolic pathways developed. The original diet consisted mostly of available vegetation, seasonally limited fruits and nuts, and foods rich in protein and fat.

Myth #5: Counting calories is essential to healthy eating and weight loss.

The human body needs about 11-12 calories per pound of weight a day to maintain its current weight. For a 200 pound person, this would be approximately 2400 calories. Approximately 3500 calories are eaten for every pound of body weight. So, to lose 10 pounds, a dieter would have to eat 35,000 less calories. It would follow, that by eating 500 less calories a day, it would take over two months to lose those 10 pounds. However for most people, this significant calorie restriction is uncomfortable, and unsustainable. For anyone who has tried a reduced calorie diet, they are familiar with how difficult this way of life can be. What do you do when, at 5 PM all the day’s calories are gone and you are still hungry?

The body processes various nutrients differently. It is not necessarily the total amount of food eaten that leads to weight loss or gain. It is the proportion of various nutrients and the shift to fat burning metabolism that is important.

Unfortunately, competing interests rely on these “facts” and help perpetuate their existence. To lose weight, you must inform yourself of how your body evolved and your body’s process of metabolism if you want to know how you should eat and how to lose weight. Believing diet myths will only keep you in the cycle of the serial dieter.

You have been on diets before. You probably have lost weight. But sometimes, it’s tough to stay focused and on track. What’s been missing from your efforts? It is possible to lose weight in a consistent way and keep the pounds off.

Perhaps in addition to a solid diet plan, there are some other aspects you have overlooked. It’s important in any of your efforts to have motivation and drive to achieve your goals. Dieting is no different and with a few changes around your excitement for the task, you can get to your target weight.

1. Make it fun
Tired of the same foods on your regimen? Do the meals seem boring and repetitive? Try a new recipe that makes sense with your plan. Spices and herbs don’t interfere with most diet plans and can add a lot of flavor to the same ingredients. If you are cooking just for yourself, don’t settle. Make Tuesday a special occasion. You’re going to be eating for the rest of your life. Make it enjoyable.

2. Have a goal
It’s easy to get lost without a map. You can get easily sidetracked if you have vague weight loss goals. If you tell yourself, “I’m going to lose a few pounds before that event,” you can fall off your plan as quick as a trip to the coffee shop bakery. Don’t settle for losing 10 or 20 pounds if your target weight is 40 or 50 pounds away. If you lost the first few pounds, you can get to your goal by continuing what you’ve been doing.

3. Get help
You can also get lost if you refuse to stop and ask directions. Most tasks are easier if we recruit help. This can be family, friends, or coworkers. Help does not mean everyone in your life will eat the same as you. But asking for support on difficult days is important. Letting the people in your life know what you are doing will give you that extra push when you need it. Getting help can also take the form of enjoying people ask, “Have you lost weight?”

4. Ruin your wardrobe
Part of the excitement of losing weight is finding your clothes get loose?or, finding that last year’s jeans actually fit now. One way to reinforce your efforts is to set aside some funds for every pound you lose. Put away $5, $10, or whatever amount feels right and when you hit that goal, go shopping and replace your ill fitting old clothes.

5. Enjoy the extra energy
As you lose weight, you’ll feel better and likely have more energy. Do something you’ve been putting off. Or, take the energy and become more active as you had been in the past. The increased energy as you lose weight lets you do more and increasing your activity level only moves you closer to your weight loss goals.

Take what you know about your body and turn it into a plan that works for you. Sometimes, it takes a complete direction change to get to your goals. Other times, some fine tuning can turn a good plan into a success.

4 cups napa cabbage, sliced thinly
1 clove garlic, crushed
1 tsp fresh grated ginger
2 tsp fish sauce
1 tsp Splenda®
1/2 tsp red pepper flakes
1 tsp lime juice
1/4 cup peanut oil
Mix all ingredients except cabbage in small bowl. Drizzle over cabbage.
Serves: 2-4
Actual carbs    (entire dish):  15.1
(grams)          (per serving): 3.8-7.6
 

Experiment with different greens and vegetables. They bring in different textures and flavors. Napa cabbage is mild and aromatic.

1 pound medium scallops
1 pound crab claw meat
1 12-13 oz can unsweetened coconut milk
1 clove garlic, crushed
1 tsp chopped fresh ginger
1 large zucchini, diced
1 cup raw spinach
1 tsp green curry paste
1 tbsp canola oil
1 tbsp basil
1 8 oz can bamboo shoots
1 tsp fish sauce
1 packet Splenda® (sucralose)
Heat oil in saucepan over medium high heat.  Sauté garlic and ginger for 2 minutes, stirring.  Add curry paste and coconut milk.  Bring to gentle boil for about 3 minutes, stirring.  Mix in scallops and cook for 3-4 minutes.  Stir in spinach and simmer until wilted.  Add zucchini, bamboo shoots, fish sauce, and Splenda® and cook for 1-2 minutes more. Mix in crab meat. Garnish with fresh or dried basil.
(Green curry paste and fish sauce can be found at most Asian markets.)
Serves: 6-8
Actual carbs    (entire dish):  24.5
  (grams)          (per serving): 3.1-4.1
If you’ve never tried green curry, be warned you will become hooked on the flavor. Scallops and crab are a great combination of flavors that compliment each other and don’t get lost in the spiciness. 

Everyone has heard the expression “cheating on a diet.” It’s part of our vernacular and common language. It’s a “known” phenomenon; something that almost every dieter does. So, why do we purposely deceive ourselves and violate diet rules so deliberately and regularly? And, how can we stop?

Perhaps it is in our nature as human beings. People cheat in games, sports, on exams, in relationships, and on taxes. The claim that “cheaters never prosper,” implies no clear reasonable endpoint to the choice to mislead oneself when it comes to diet rule violations. In dieting, this failed prosperity is measured in pounds and self consternation.

When diet cheating occurs, there may be momentary satisfaction around the choice, but the brief pleasure can be followed by stagnation of weight loss goals, or if often enough, regain of lost pounds, not to mention the mental anguish.

Knowing the consequences of going off our diet plans, why do so many of us keep doing it? There are several areas to consider, common triggers to dietary infidelity, if you will.

Morality
There are often labels attached to foods in terms of “good and bad.” Many foods considered “bad for you,” can be the tastiest. Not all of these “bad” foods will be contrary to diet goals for some diets. However, the notion of forbidden fruit can be a powerful force and run decisions contrary to one’s overall goal. This cycle often leads to feeling bad about the decision and can lead to further choices not congruent with your weight loss goals. Removing the idea that any food is “bad” is a good start to seeing eating from a different perspective then a set of moral choices.

Emotions
It’s very common to eat in response to stress, depression, anxiety, boredom, or low self esteem. These potentially powerful emotions can be a trigger to eating and can lead to choices in foods that are not part of the day’s plan. When strong feelings occur, rational judgments can be influenced or discounted, derailing diet efforts. Often, there is a hope that the act of eating will quiet or change these emotions. Often, these so called “comfort” foods can change body chemistry and do act directly on brain centers to change feelings.

As you change the way you think about food, often you will find another outlet for dealing with emotions. As food becomes less of a focus or obsession, much of your energy can be used to successfully work through emotional issues.

Immediate gratification
In today’s society, there is an increasing perception that every want must turn into immediate action to have satisfaction. Often, that immediate, intense desire will pass in a few minutes. Unfortunately, that few minutes can be all it takes to make food choices not conducive to your diet plan. Designing a strategy ahead of time to deal with these urges is vital to success. With your plan of action in place, you are significantly less likely to give in to those primal urges.

Lack of variety
People will quickly become bored and dissatisfied with a diet that has no variety. Increasing options of food selection makes eating more interesting and sustainable over a lifetime. This contradicts the perception that dieting is a time limited event. Changing this view to accommodate a life long change in direction of food choices requires interesting and flavorful meals. So, try spicing up your meals a bit. Spices can add many different flavors and are in line with acceptable foods for most diet plans.

Snacks and desserts
Any diet that does not provide for snacks and satisfying that “sweet tooth” is less likely to succeed. Physiologically, there are signals to eat during non meal times. It’s important for a dieter to pay attention to these signals. Skipping the gratification your body asks for can lead to a decline in your structure of food choices during weight loss. Providing some variety of dessert options is also vital. Similarly, your “must have foods” must be accounted for during your diet efforts.

Daily weighing
Even though regular weight loss is still occurring, there may be some fluctuation of daily weight. At the end of the week, you may lose a few pounds, but a day to day gain/loss cycle may be discouraging enough to begin to make food choices off of your plan. This discouragement can be a powerful force in rationalization. The sense of non accomplishment in the face of difficult effort can be demoralizing. Shift to weekly weighing if this occurs.

Special occasions
The food availability at holidays, birthdays, parties, and other events can often include dishes not helpful to weight loss, or provide an overwhelming variety that tests resolve. It is important to have a plan of eating before hand and make certain there will be foods available conducive to your goals, even if you have to bring them yourself. The “just this once” thinking of special occasions can quickly become a habit.

Conformity
It is common in groups of people to want to share some degree of sameness. This is the social adhesive groups require. Unfortunately, as two thirds of Americans are now overweight or obese, this new “majority” is not healthy. It is difficult to cross the path of the herd and make choices to lose weight when it will cause you stand out as you succeed.

These are powerful factors in making day to day food choices. They are all amenable to having a directed plan and committed goal in mind. Remove the commonplace notion of “cheating” as a benign entity and realize these are active moment to moment decisions. This change in thinking can go a long way to help you reach your weight loss goals.

Addiction or dependence to a substance is characterized by continued use despite negative consequences, loss of control, and significant distress or impairment due to the use. Dependence is characterized by tolerance and withdrawal. Does the use of “food” as a substance in those defined as overweight or obese meet these definitions? Further, if this is addiction, do current approaches to treatment, that is “diets,” make sense? Commonly, people describe their eating as “out of control.” Certainly, people can use food in a maladaptive way, leading to significant distress, and serious consequences. These consequences can take the form of physical, emotional, and relational. Often, this is experienced as eating more than they intended, or not being able to stop eating certain foods. Some people even claim they cannot “live without” certain foods such as chocolate, french-fries, cake, or other favorites. This sequence of eating foods clearly harmful to the body can cause serious problems and distress and lead to serial dieting attempts.

Obviously, there are negative consequences to being overweight or obese. The distress can be apparent. What about tolerance? This refers to needing larger amounts of a substance in question to achieve the same level of intoxication or desired effect. Although most foods are not intoxicating, they can often be used to change emotions or produce strong feelings. Do most people continue to eat more to produce the same effect? Well, some foods do not seem to turn off the inclination to eat. An empty bag of cookies is evidence enough.

Withdrawal with food is different than with substances. There are no clear withdrawal symptoms if you stop eating candy bars, for example. People will often confuse a craving for withdrawal. However, wanting something that may be harmful is not the same as being dependent upon it. Food decisions are moment to moment choices, influenced by a wide range of factors, including experience, family, relationships, events, fatigue, and hunger.

There are some similarities between addiction and eating behaviors connected to being overweight or obese, but only in a strictly definitional sense. The implications for treatment of obesity are more important. If obesity were indeed an addiction, most models of treatment would argue for abstinence. This is not possible with food. Everyone must eat every day, several times per day.

But what about the notion that some have that they “can’t live without” certain foods? Can people “learn” to eat them in moderation? With a modification of approach to food, there is a shift in the strength of the triggers to harmful eating. For many who are overweight and obese, there is a change in taste and inclination to foods that are not helpful to weight loss and maintenance goals. When restricted, these previously powerful foods change in their ability to derail diet efforts.

Certainly, there are lessons from addiction treatment for dieting. Identifying triggers that lead to choices not helpful to weight loss is one example. Considering situations and people that lead the dieter to stay from their plan is another. But, beyond these ideas, the addiction model falls short when considering weight loss. It is not possible to “give up” the offending agent.

Other psychological and social factors are important to consider for any diet effort to succeed. Adhering to a food list or guide is not sufficient.

How food choices are made is important. As in addiction treatment, education about the effects of certain foods is a start. Identifying strategies for difficult stretches of time, considering the impact of emotions and experiences, and looking at events, people, and situations that lead to harmful food choices can increase the odds of more successful weight loss attempt.

6 Pounds lighter in one week!

That’s what Mary tells us! Congrats Mary and keep it up. We’re all rooting for you. For those interested in hearing about Mary’s progress, check out her blog through the link in our blog roll.

If you would like to tell us about your progress, please email us at: foundationsuccess@foundationdiet.com

The Foundation Diet is happy to announce that Dr. Burlay will be starring in a new cooking show! The pilot episode has been taped and we’ll have more information soon. Stay tuned!

Dr. Buraly’s new cooking show is ready and waiting this year’s pilot season beginning January. We will be sure to keep you updated.