Dr. Jonny Bowden

Category: Weight-Loss

  • Cravings: Why They Strike, How to Curb Them

    This excellent article by Katherine Kam was originally posted on WebMD. It’s reproduced here in its entirety. A big thanks to Ms. Kam and to WebMD for letting us share this with you.

    Almost everyone has hankered after potato chips, ice cream, chocolate, or another beckoning treat. But why? And what do you do when a craving calls your name? Is it OK to give in once in a while? What if your cravings start to run amok and demand satisfaction every day?

    Food Cravings From the Inside Out

    Cornell professor Brian Wansink, PhD, makes it his business to understand food cravings. He’s studied a woman who loved to cuddle up with her favorite snack: a bowl of popcorn mixed with M&Ms. He knows why hearty men crave steaks and pizza, while women usually go for candy or cookies.

    Insight into cravings is important because our environment is loaded with sensory cues that can prompt us to overeat, Wansink says. He directs Cornell University’s Food and Brand Lab, which studies consumers’ relationships with food. (The lab’s motto: “We uncover eating traps and change them.”) He also wrote the book, Mindless Eating: Why We Eat More Than We Think.

    Visual cues — such as seeing enticing foods — are the most frequent environmental triggers. Smells are potent, too. For instance, “You walk by a Cinnabon,” Wansink says, and the rich, sweet aroma can automatically trip a strong desire for the cinnamon rolls.

    Don’t Blame Nutrition

    One popular myth holds that people crave certain foods to fill a nutritional deficiency.

    “The naive view has always been that cravings represent wisdom of the body,” says Marcia Pelchat, PhD, a food researcher at the Monell Chemical Senses Center in Philadelphia.

    But it’s not so. Some of her work has shown that people have cravings even when they’re fed a diet that’s completely adequate in calories and nutrients.

    “People will often say things, like, ‘Gee, I’m craving potato chips. I’d better eat some because I must need the salt,’” Pelchat says. “But really, how many of us — aside from runners in hot weather — are deficient in salt? And then how do you explain cravings for sweets in terms of deficiency?”

    We feel virtuous blaming cravings on nutritional needs, Pelchat says. But “we don’t have such great wisdom of the body,” she says. “Unfortunately, humans rely less on instincts and more on culture to determine what they eat — or on individual experience.” (In her city, for example, a lot of men crave Philly cheese steaks.)

    Culture, Sex, and Cravings

    Wansink agrees that culture and gender play a big role in cravings. In his research, men were more likely to crave pizza, pasta, and soup over cakes and cookies. Why? Besides being tasty and filling, such hot, savory foods reminded them of attention from their mothers or wives.

    In contrast, women liked these foods well enough, but associated them with work, including preparation and cleanup. So instead, women tended to crave hassle-free snack foods, such as candy, cookies, ice cream, and chocolate.

    What about that woman who liked popcorn mixed with M&M’s? Not only was the snack easy to prepare, but it made her feel “cozy and safe,” Wansink says. She and her husband had made it as a “secret snack” when they were dating in college; hence, the positive association turned it into her favorite craving.

    Almost everyone has hankered after potato chips, ice cream, chocolate, or another beckoning treat. But why? And what do you do when a craving calls your name?

    Is it OK to give in once in a while? What if your cravings start to run amok and demand satisfaction every day?

    Good Mood, Bad Mood

    Certain emotions, including stress, sadness, and boredom, can promote cravings, Pelchat says. “That’s another very strong correlate of cravings. A bad mood can become a conditioned cue for eating. Just like walking by the donut shop, being in a bad mood becomes a cue that elicits going over to the refrigerator.”

    Those negative moods get all the press, but Wansink suggests that happy moods might be even more likely to cause cravings. In his survey of about 1,000 Americans, 86% reported that they craved comfort foods when they were happy, and 74% had cravings when they wanted to celebrate or reward themselves. In contrast, 52% had cravings when they were bored and 39% when they were sad or lonely.

    The happy eaters craved food to maintain their upbeat mood, he explains: “I want to do something to extend my happy feeling or my happy experience.” Furthermore, they tended to prefer “more meal-like, healthier foods,” he says. In contrast, people in sad moods were much more likely to seek out ice cream, cookies, or potato chips.

    You also learn to crave certain foods in certain situations. “If you have a cookie every day after school, just walking into the house cues you to have a cookie,” Pelchat says. “If you don’t get that cookie right away, your mind obsesses about it and turns it into a craving.”

    Taming Your Cravings

    So you want to put your cravings back in their place. What should you do?

    Don’t waste your time on bizarre methods. They don’t work for most people. For example, some models deal with cravings for sweets by taking one bite from a candy bar and spitting it out, or carrying a candy wrapper to sniff, Wansink writes in his book.

    Here are some expert tips to try instead:

    Eat the Food You Crave Less Often

    You may have heard that having a little bit of the food you crave is a good way to break the craving. Maybe not.

    “We used to think that eating a small amount of those foods would extinguish a craving. For a long time, we thought that that was the way to deal with cravings, and it just doesn’t seem to work for most people,” Wansink says.

    Rather than quitting the craving, continually eating the food may just strengthen the habit. “The more you eat sweets, the more you reinforce the cravings for sweets,” Pelchat says.

    So should you go cold turkey? No, Wansink says. Feeling deprived of a favorite food often backfires and you end up eating too much. “You can indulge in it, but just do it less frequently,” he says.

    Use Portion Control

    “Allow yourself to have a food, but do it in a portion-controlled way,” Pelchat says. For example, don’t keep tempting foods at home, because it’s too easy to wolf down excessive amounts. Instead, go out for one scoop of ice cream or one slice of pizza.

    Also, know yourself. Portion control doesn’t work for everyone, especially if tempting foods are on hand. Some people can count out and eat only 15 smoked almonds; others routinely barrel their way to the bottom of the can.

    “If you can’t manage portion control, then you want to weaken the link between cues in the environment and eating that food,” Pelchat says. Hide the food in the back of a cupboard; don’t keep it on a kitchen counter or in plain sight. “If you resist, you weaken the link between cues and mindless eating,” she says.

    Substitute a Healthier Food

    “There’s a very fine line between eating an unhealthy food and a healthy food in terms of how it satisfies cravings,” Wansink says. “You may be dying for that chocolate sundae or whatever, but eating something that’s healthier will eliminate that craving almost as effectively.”

    For instance, eating apple slices with peanut butter might satisfy your craving as much as if you really did splurge on ice cream, he says. The sense of satisfaction might not happen immediately or even five minutes later, but it will kick in 15 to 20 minutes later, he says.

    Just make sure to eat an amount equal to the volume of the craved food. Otherwise, “you’re still going to be hungry,” Wansink says — and your craving will still be there, waiting for you to give in.

    Distract Yourself With an Activity Unrelated to Food

    “Substitute something else until the craving goes away. It could be in the form of taking a walk or doing pushups or calling a friend,” Wansink says. Cravings are fleeting, he says. They’ll diminish or go away within an hour, if not sooner.

    Don’t wait out a craving passively. An activity that’s “somewhat absorbing” will help you to resist, Pelchat says. “Even counting to 10 does help,” she adds. “People are less likely to eat the craved food. It gives them more control over it.

    Have a Plan to Combat Chronic Cravings

    “The most dangerous cravings are the ones that are chronic. Those are going to be the most difficult ones to deal with,” Wansink says.

    Let’s say that on most days, around 3 p.m., you crave a sweet or salty food — jelly donuts or a big bag of cheese puffs. “In those cases, it can’t be a piecemeal, day-by-day strategy,” he says. That’s a set-up for failure.

    It’s better to have a steadfast plan. Make sure to have sugarless gum on hand, ready to pop into your mouth when the craving strikes. Or make it routine to take a walk at that time. “Habitually, you replace that craving,” Wansink says.

  • Protein and Weight Gain

    A new study in JAMA adds to the growing body of literature showing that protein is critical for managing weight.  In this study, the researchers wanted to see what effect (if any) different amounts of protein in the diet would have on weight gain.

    They started with the basic premise that anyone who overeats—however “overeating” may be defined for each person— is going to gain weight. OK, so far, so good. If the researchers were to overfeed a bunch of subjects by, say, 1000 calories a day for a couple of weeks, they could reasonably expect all of them to gain some weight.

    The question for the researchers, however, was this: does it matter what we feed them? Specifically, would the amount of protein in the “over-eating” diet make any difference when it comes to weigh-in time?

    So they took 25 healthy men and women and put them on a “weight-stabilizing” diet for 13-25 days. After that, the folks were divided into three groups. For the next eight weeks, each person ate a daily diet containing 1000 more calories than that individual needed to maintain his or her weight, regardless of which group they were in.

    • Group One ate a diet consisting of 5% protein (low protein diet)
    • Group Two’s diet contained 15% protein (average protein diet)
    • Group Three’s diet was 25% protein (high-protein diet)

    The researchers weren’t just interested in whether protein in the diet affected weight gain. They were also interested in whether or not it affected body composition  researchers were also interested in body composition. They wanted to know how much of the expected weight gain was fat and how much was muscle, and whether those results were impacted by the amount of protein eaten.

    Interestingly…

    • The low-protein group gained the least amount of weight (approximately 7 pounds)
    • The “normal” protein group gained 13.3 pounds
    • The “high-protein” group gained more than twice as much as the low-protein group, weighing in at an average of 14.4 pounds heavier than when they started

    However.

    When the researchers looked at body composition, it was a whole different story:

    • The low-protein group lost about 1.5 pounds of muscle (or lean body mass)
    • The medium (“normal”) protein group gained 6.3 pounds of lean body mass.
    • The high-protein group gained about 7 pounds of muscle!

    “The low-protein group stored a higher percentage of calories as fat than the other groups”, lead researcher George Bray told WebMD.  “The low-protein diet was clearly not good in terms of preserving lean body mass”.

    Another great “side-effect” of the higher protein intakes: a boost in metabolism. The researchers found that resting energy expenditure (the amount of calories you burn when laying around on the couch) actually went up for the people in both the “normal” (15%) and “high” (25%) protein groups. For the low-protein group? Not so much. (Not at all, actually.) This is hardly surprising, since the more muscle you have the more calories you burn– one of the many reasons to use weight training for fat loss.

    Years ago, the distinguished past-president of the American Society of Bariatric Physicians Mary Vernon, MD, told me that in her own clinical practice she saw case after case of overweight people putting on muscle even without exercising, just by eating more protein. Obviously, that was an anecdotal story albeit from a very reliable source, but this study seems to confirm the likelihood of that happening.

    This study demonstrates the importance of protein in putting on muscle (and, of course, in preserving lean body mass when losing weight). Remember, most people in America are on the low-end of protein consumption, not the high end!

    People who eat according to my Unleash Your Thin weight loss meal plans usually lose weight while preserving lean body mass because they are eating a large portion of protein at every meal.

  • Are There Any Fattening Vegetables?

    Are some veggies more fattening than others?

    It’s not an unreasonable question.

    As you know, we’re experiencing an epidemic of obesity and diabetes in most of the Western world. (Actually, it’s not just the western world- India and China now lead the US in the number of diabetics, but even adjusted for population the percent of the population that’s diabetic in India is almost twice that of the US. But I digress.)

    And although most people don’t think immediately of vegetables when they think of cutting “fattening” foods from their diet, but some people who are really conscious about carbs have nonetheless asked me about vegetables as they relate to insulin, blood sugar and weight loss.

    There’s a lot of confusion about certain starchy vegetables that have a “high glycemic index”, vegetables that people following lower-carb eating plans have been told to avoid. So the short answer to the question about vegetables being fattening is this:

    If you’re a person for whom blood sugar management is a real issue, yes, some vegetables like potatoes (white and sweet), corn, and parsnips might be worth limiting. But in my opinion, the argument about vegetables and sugar is a little bit of a tempest in a teapot.

    Here’s why. There are two real culprits in the obesity crisis. One is the fast-acting carbs and sugars in breads, cereals, pastas, desserts, cakes, rolls, crackers and fast food. Two is the obscenely large portions of everything else. As my wisecracking pal, the brilliant nutritionist and USDA researcher C. Leigh Broadhurst, PhD, says, “No one ever got fat on peas and carrots!”

    So of course, we always want to keep an eye on how much sugar we’re eating, as well as on the foods that can raise blood sugar (and with it, the fat storing hormone insulin). In that regard, we have nothing to fear from most vegetables.

    There are, however, some exceptions, and it’s not always easy to identify them just from the glycemic index. The glycemic load is a far more telling measure of the impact a food will actually have on your blood sugar in the real world.

    • Some starchy vegetables- peas for example—have a glycemic index of 80 (high!) but a glycemic load of 3 (extremely low) meaning the typical portion won’t do much to your blood sugar.
    • Carrots are another vegetable with a bad rap because of its glycemic index but its glycemic load is also 3.
    • Potatoes have high glycemic load and high glycemic index.
    • Tomatoes, actually a fruit, have the ability to raise your blood sugar as well.

    So eat your vegetables and, unless you’re highly sensitive, don’t worry about sugar or carbs (exceptions being the starchy veggies like corn and potatoes).

    Just to get you started, here’s a list of the vegetables that earned a “STAR” for outstanding performance by a vegetable in my book “The 150 Healthiest Foods on Earth”

    You can’t go wrong with any one of them!

    • Beets
    • Broccoli
    • Brussels Sprouts
    • Cabbage
    • Carrots
    • Dandelion
    • Kale
    • Mushrooms
    • Onions
    • Spinach
    • Swiss Chard
    • Watercress
  • Hormones Drive Weight Regain After Dieting

    Hormones Drive Weight Regain After Dieting

    A study in the New England Journal of Medicine shows that rebound weight gain isn’t just a matter of having no willpower. Hormones play a huge role.

    Let me explain.

    Hormones related to appetite and hunger can be disrupted by dieting and weight loss, and can remain so for at least one year. When these hormones are out of whack, you can experience tremendous hunger and cravings, and even the best intentions can easily be derailed.

    “Maintaining weight loss may be more difficult than losing weight”, said lead researcher Joseph Proietto, PhD, a professor of medicine at the University of Melbourne’s Heidelberg Repatriation Hospital, in Victoria, Australia. “This may be due to biological changes rather than [a] voluntary return to old habits”.

    I’ve said for decades that weight loss is relatively easy—it’s keeping it off that’s the issue for most people. (I’m always reminded of my father’s quip about stopping smoking: “It’s easy to stop smoking”, he’d always say, “I myself have done it 20 times!”)

    Researchers have long known that hormones found in the pancreas (like insulin and glucagon), the gut and the fatty tissues have a huge influence on body weight not to mention hunger, appetite and calorie burning. And when body fat percentage drops, that causes a decrease in certain hormones like leptin  while at the same time causing an increase in hormones like ghrelin.

    Leptin- when working properly– puts the brakes on eating by sending a signal to the brain saying, “Hey! Stomach’s full! Stop shoveling the food in!”. Ghrelin, on the other hand, does the exact opposite, effectively telling the brain, “Don’t listen to leptin! This dude’s starving! Chow down!”

    A decrease in the stop signals (leptin) coupled with an increase in the go signals (ghrelin) is a prescription for disaster when it comes to weight gain.

    The hormone changes that happen during weight loss have been known to scientists for ages. But what wasn’t clear before this new study was how long the hormonal changes actually persist.

    In the study, Proietto and his research team put 50 overweight men and women on a very low-calorie diet for ten weeks and then monitored their hormone levels for a full year.

    During the initial period on the low-cal diet, the average weight loss was 30 pounds, representing about 10% of starting body weight for most of the participants. Blood tests confirmed that levels of the hormones that affect appetite and weight gain (insulin, ghrelin and leptin) had indeed changed as expected. And- not surprisingly—the participants also reported being hungrier.

    After ten weeks on the low-calorie weight loss diet, the participants were told they could resume a “normal” diet, but they were given periodic advice by a dietitian and also strongly encouraged to get a half-hour of exercise on most days of the week. After a year, most of the participants had regained an average of 12 pounds.

    But the blood tests showed that hormone levels hadn’t really stabilized fully. And hunger levels remained a bit elevated as well.

    The moral of this story isn’t that you have to be a victim of your hormones. But it does mean that there are some hidden forces driving appetite and the more you can get them under control the better prepared you are. One of these “powerful forces” is the hormone insulin (also known—for good reason— as the “fat storage hormone”).

    Another of these forces—not discussed in the present study—is brain chemistry. In my weight loss program, New You in 22, we spend a great deal of time addressing the brain chemistry of cravings and appetite, and teaching you how to reprogram your brain so that these cravings don’t rule your life and determine your behavior. Sure, you may still feel a little stirring when you smell a Cinnabon baking, but you won’t be as compelled to do something about it!

    A healthy respect for hormones and brain chemistry is always a good thing, but it’s also good to remember that there’s a lot in our power that can affect these things, and that their power over us can be strongly modified by the actions we take and the choices we make.

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    Ask questions

    Take A Free Assessment!

    Want to know more about how your hormones affect you?  My friend Glen Depke has made his Adrenal Assessment available to the  Jonny Bowden community for free. You can access it by clicking here.

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  • The Best Diet for Maintaining Weight Loss

    The Best Diet for Maintaining Weight Loss

    Researchers in Denmark have found that a high-protein low-GI diet was significantly better than other diets tested at maintaining weight loss in subjects who had already successfully shed pounds.

    My father used to have a favorite saying: “It’s easy to stop smoking. I myself have done it lots of times!” The same could be said about weight loss. Losing weight isn’t all that hard.. keeping it off is where the action is.

    In the current study, researchers enrolled 773 subjects who had lost an average of 24 pounds using a low-calorie diet. They then assigned the subjects to one of four groups for the “weight-maintenance” phase of the study.

    Group one ate a low-protein/ high-GI diet. (Readers of this newsletter will recall that GI stands for Glycemic Index, a way of measuring how quickly food raises blood sugar. High glycemic foods are always carbohydrates, usually processed ones; they’re either high in sugar to begin with (cereals), or they turn into sugar pretty quickly once they hit the stomach, i.e. bread, rice, pasta, potatoes, etc.).

    Typical “low-protein/ high-GI” meals: a little bit of chicken with a big plate of pasta, or a breakfast of cereal, bananas, toast and one egg.

    Group two ate a low-protein/ low-GI diet.

    Group three ate a high-protein/ low-GI diet (typical meal: protein and vegetables), and group four ate a high-protein/ high-GI diet.

    Over the 26 weeks that followed, the subjects eating the low-protein/ high-GI diet actually regained significant weight (even though this was the “weight-maintenance” phase). They were the only group to do so.

    Meanwhile, those eating the high-protein/ low-GI diet (protein and vegetables) actually continued to lose a small amount of weight over the next 26 weeks! Interestingly, these folks were also the least likely to drop out of the study. (Conversely, the folks in the low-protein/ high-GI diet were the most likely to drop out!)

    Families got involved

    What’s really interesting about this study is that the researchers got the whole family involved, not just the overweight adult study participants. The participant’s whole family ate the same diet with no restrictions on the amount of food.

    And get this: In the families who were in the high-protein/ low-GI condition (protein and vegetables), the percentage of overweight/obese kids in those families actually fell over the course of the study!

    Though it’s not crystal clear why this type of eating plan works so well, there are two very likely hypotheses (which are not mutually exclusive).

    One, a high-protein low-GI diet doesn’t knock your blood sugar into the stratosphere, which in turn has a very positive effect on the levels of your fat storing hormone, insulin. (When blood sugar goes up high, insulin goes up with it, and when insulin is high, fat burning is pretty much turned off.) (This is the reason we use a high-protein low-GI diet in both our programs, Diet Boot Camp and the brand new Unleash Your Thin.)

    Two, a high-protein low-GI diet seems to be easier to stay on. Because it doesn’t send blood sugar skyrocketing, you are less likely to experience the crashes and cravings that come with “blood sugar hell”. In an editorial accompanying the current study, Drs. David Ludwig and Cara Ebbeling of Children’s Hospital and Harvard Medical School commented: “A person’s ability to maintain adherence over time may be influenced by the way in which a diet affects hunger and metabolism”.

    In other words, it’s easier to stick with an eating program if you’re not hungry all the time.

    And it’s easier still when you see yourself losing weight, which is much more likely to happen if you can control the levels of your fat-storing hormone, insulin.

    And that, in turn, is easy to do: Just cut back on sugar and carbs, and fill your plate with protein, fat, fiber, vegetables, nuts, berries and other low-glycemic fruit!

  • Whey (Not Soy) Protein Shakes Help You Stay Thin

    Whey (Not Soy) Protein Shakes Help You Stay Thin

    According to a new study from the US Department of Agriculture’s Human Nutrition Research Center, whey protein powder offers an advantage over soy protein powder if you’re trying to drop a few pounds.

    Researchers randomly assigned 90 adults- all overweight or obese- to one of three groups. All three groups consumed their normal diet of approximately 2200 calories, but the first group added a protein drink made with whey, the second group added a protein drink made with soy, and the third group added a drink made with carbohydrates.

    All three drinks had the same number of calories (200) and all had the same number of grams (52 grams of protein for the first two groups, 52 grams of carbs for the third group.)

    At the start of the study, no significant differences existed among the three groups. The average weight of the men was 218 pounds, while the average weight of the women was 190.

    At the end of the 23 week study, those drinking the carbohydrate shake had actually gained about 2 pounds, most of it fat. Those drinking the soy protein shake stayed the same.

    But those drinking the whey protein drink actually lost a little bit of weight and body fat (about 2 pounds worth!) And while both other groups saw essentially no change in their waist size, the whey protein group actually lost about an inch around their middles!

    Interesting, those in the whey protein group actually had significantly lower blood levels of an appetite-stimulating hormone called ghrelin than those in the carb group or the soy group. “(Grehlin) is a hormone that helps regulate food intake”, said David J. Baer, PhD, research physiologist and lead author on the study. “So the higher concentration (of grehlin), the more hungry someone feels. The lower the concentration, the fuller someone feels.”

    Interestingly, though no subjects knew which drink they had been assigned, and were not told to change their basic 2200 calorie diet in any specific way, those drinking the whey protein shake on a daily basis wound up gradually consuming less carbohydrates during the course of the study, even though they were eating the same number of total calories per day.

    This reduction in carbohydrate intake may have been a contributing factor in their weight loss.

    Apparently something about the whey protein powder seemed to make them crave less carbohydrates (a very nice “side” effect!)

  • Can Coconut Oil Help You Lose Inches?

    Can Coconut Oil Help You Lose Inches?

    A study from Brazil suggests that two tablespoons a day of coconut oil can not only help you drop inches, it can also raise protective, HDL (“good”) cholesterol.

    I’ve sung the praises of coconut oil for a long time. The fat in coconut oil- a form of saturated fat known as MCT (medium chain triglycerides)– is among the healthiest fat in the world. It contains fatty acids such as lauric acid and caprylic acid known to be anti-viral and anti-microbal. And medium-chain-triglycerides are more likely to be burned for energy than stored as fat, leading to their popularity in the bodybuilding community.

    But the actual ability of coconut oil to help with weight loss has not been thoroughly investigated.

    In the present study, 40 women aged 20-40 years old with abdominal obesity were given daily dietary supplements of either soybean oil or coconut oil over the course of 12 weeks. All subjects followed a “balanced” diet with the same number of calories and were told to walk for 50 minutes a day.

    By the end of the study, the coconut oil group had significantly higher HDL (“good”) cholesterol and an improved LDL: HDL ratio. While both the soybean oil group and the coconut oil group had similar reductions in BMI, only the coconut oil group saw a reduction in the circumference of their waists. (Meanwhile, for the record, the soybean oil group saw their HDL go down and their cholesterol ratio go up!)

    A very interesting- and unexpected- finding, was that those consuming the coconut oil spontaneously reduced their consumption of carbohydrates and increased their consumption of protein and fiber over the course of the study.

    “Supplementation with coconut oil does not cause dyslipidemia and seems to promote a reduction in abdominal obesity”, write the researchers.

    For my money, the best coconut oil on the market is Barlean’s extra-virgin organic coconut oil. It’s inexpensive, organic, and comes from hand-selected coconuts. I use it for everything, including sautéing vegetables and making eggs.

  • Sodium to Potassium Ratio More Important Than Sodium Alone!

    CHICAGO – A high sodium intake, especially when combined with a low potassium intake, is associated with an increased risk of cardiovascular disease (CVD) and mortality, according to a report in the July 11 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.(1)

    According to background information in the article, previous trials and studies have demonstrated apparent associations between increased blood pressure and high sodium intake or low potassium intake.

    “Recently, several studies suggested that the ratio of sodium to potassium intakes represented a more important risk factor for hypertension and CVD than each factor alone,” write the authors. “Examining the joint effects of sodium and potassium intakes on CVD risk is particularly important because most of the U.S. population consumes more sodium and less potassium daily than recommended.

    Quanhe Yang, Ph.D., from the Centers from Disease Control and Prevention, Atlanta, and colleagues used data from the Third National Health and Nutrition Examination Survey Linked Mortality File. They selected the data from 12,267 participants for analysis based on dietary information, demographic characteristics and health history.

    The data set also included mortality status matched to the participants. The researchers analyzed the data to determine consumption of sodium and potassium, as well as the sodium-potassium ratio, and to further determine the relationship between these variables and the risk of all-cause mortality as well as CVD and ischemic heart disease (IHD) mortality.

    After an average follow-up period of 14.8 years, 2,270 of the participants had died; 825 of the deaths were attributed to CVD and 433 to IHD.

    Researchers found several characteristics associated with a higher sodium-potassium ratio, including male sex, younger age, status as a smoker and ethnic background. After adjusting for other variables, a higher sodium intake was related to increased all-cause mortality, and a higher potassium intake was associated with a lower mortality risk.

    The risk of CVD and IHD was significantly associated with a higher sodium-potassium ratio.

    “In summary, our findings indicate that higher sodium-potassium ratio is associated with significantly increased risk of CVD and all-cause mortality in the general US population,” write the authors. “Public health recommendations should emphasize simultaneous reduction in sodium intake and increase in potassium intake.”

    1) Arch Intern Med 2011: 171 (13): 1183-1191

    Dr. Jonny Comments:

    The relationship of sodium to potassium is somewhat similar to the relationship between omega-6 fatty acids and omega-3’s. Neither is “bad”. Both are necessary. The problem is the balance between the two.

    We do best with a ratio of about 1:1 when it comes to both omega-6: omega-3 and when it comes to sodium: potassium. However in our modern diet, we consume many many times more omega-6’s than omega-3’s and we consume far more sodium than we do potassium. Processed foods, canned foods and prepared foods are absolutely loaded with sodium, while potassium comes primarily from vegetables and fruits.

    While it’s probably prudent to consume less sodium in general, it’s worth noting that a big part of the “sodium” problem is that we’re not getting enough potassium. This study indicates that the ratio is just as important, and suggests that lowering sodium intake is only half the problem- the other is increasing our intake of potassium, one of the most important minerals for heart health.

  • Can Diet Sodas Cause Weight Gain?

    Can Diet Sodas Cause Weight Gain?

    San Diego, CA – The perception that diet sodas are a benign alternative to highly sweetened beverages might be dangerously wrong, according to the results of the San Antonio Longitudinal Study of Aging, which were reported here at the American Diabetes Association (ADA) 2011 Scientific Sessions [1].

    Diet soft drinks have long been thought to be a healthier alternative to their sugary counterparts; however, past reports have linked increased incidence of weight gain, metabolic syndrome, and diabetes to the frequent intake of diet soda.

    In the study presented, Sharon P Fowler (University of Texas Health Science Center at San Antonio) and colleagues examined the effect of the long-term consumption of diet sodas by a population of individuals 65 to 74 years of age (n=474).

    At baseline, measures of height, weight, and waist circumference were recorded, as was diet-soft-drink intake. Three additional exams of the study subjects were conducted over an average follow-up of just over 3.5 years (the study was conducted over a nine-year period).

    When the results of these observations were compared with those from subjects who did not drink diet soda, the differences were striking. Overall, consumers of diet soda drinks experienced a 70% greater increase in waist circumference than nonconsumers. Further, among elderly drinkers of two or more diet soda per day, mean increases in waist circumference were five times greater than those recorded for nonconsumers.

    “These results suggest that—amid the national drive to reduce consumption of sugar-sweetened drinks—policies that promote the consumption of diet soft drinks may have unintended deleterious effects,” state the study investigators.

    Dr. Jonny Comments: This is not the first time that diet soda consumption has been linked to weight gain and obesity. A 2005 study found that folks who consumed 1-2 cans a day of diet soda had a 54.5% greater chance of being overweight or obese. That same study found that for each can of diet soda consumed each day a person’s risk of becoming obese went up by 41%.

    So what to make of this?

    One theory is that calorie-free beverages that taste sweet fool the body and somehow upset the appetite control centers in the brain. Another is that the sweet taste may actually produce an insulin response in much the same way as Pavlov’s dogs became conditioned to salivate at the sound of a bell. (Insulin, as you know, is the “fat storage” hormone and rises dramatically when sugar is consumed.)

    But a third interpretation is that these studies don’t mean anything. Folks who take this position point out that people who are already overweight tend to consume diet drinks, but that doesn’t mean the diet drinks made them overweight.

    Truth is, we don’t know which- if any- of these hypotheses explains the facts, but the facts remain: For whatever reason, consumption of diet sodas increases your risk of gaining weight.

    And since there’s basically nothing good in diet soda– which is made of chemicals, potentially dangerous artificial sweeteners, and a bunch of artificial coloring and flavoring–  it’s hard to find a good reason to keep on drinking them.

  • Salt and the Low Carb Diet

    The following is adapted from the forthcoming book, “The Art and science of Low Carbohydrate Living” by Jeff S. Volek, PhD, RD, and Stephen D. Phinney, MD, PhD

    Whole books have been written about the history of salt. Wars were fought over access to salt. Roman soldiers were often paid with a measure of salt, hence the origin of the English word “salary”. Hunters and their prey, herders and their cattle, all shaped their actions and habits around access to salt.

    The reason, of course, is that salt (sodium) is necessary for life.

    Humans did not need to know chemistry to understand the value of salt. Salt deprivation leads to lightheadedness, fatigue, headache, and malaise. Aboriginal cultures could figure out that if they drank from one spring they began to feel lousy, but if they drank from that other one, they’d feel OK. The Inuit knew which ice to melt for water to boil their meat. Sea ice loses its salt content with age. Fresh ice had too much salt, fresh snow had none, whereas older seas ice was just right.

    Today we “know” that too much salt is bad for us, so why this long discussion of a discredited nutrient?

    The short answer is that the amount of carbohydrate in our diet changes our need for salt.

    High carbohydrate diets make the kidneys retain salt, whereas a low carbohydrate intake increases sodium excretion by the kidney. Hunting cultures seemed to understand this, and thus their highly evolved practices of finding sodium and consuming enough of it to maintain health and well-being.

    The body’s metabolism of salt is uniquely different when one is adapted to a low carbohydrate diet.

    Salt and water are more efficiently excreted, which is a good thing as long as you maintain an adequate minimum sodium intake.

    Ignore this lesson and you are likely to suffer the completely avoidable problems of headache, fatigue, weakness and constipation—maladies that any Inuit healer would have promptly resolved by giving you a bowl of blood soup, or meat broth made with sea ice of the proper age.