Health4Tips: myths

Showing posts with label myths. Show all posts

Tuesday, June 24, 2014

I think I love John Oliver :)

Apologies I have been a bit quiet on the blog, have had some big deadlines for work looming and have been focusing on my research. But after seeing this video on Facebook tonight, I needed to share it.

I think I love John Oliver
Watch this video and find out why!

Make no mistake. The most effective way to lose weight is by sustainable lifestyle change. Eating healthy, balanced nutritious meals in the appropriate amounts for your body and exercising more to get fitter and healthier. Slow, steady and effective. There is no magic and there are no quick fixes.

Read my blog post about these issues here : Weight loss cures and snake oil salesmen

And sit back and watch the best take down of Dr. Oz. EVER.

Lyndal @ Lean Green and Healthy

Weekend Flicks - Making Homemade Nutella (Dr Yoni Freedhoff)

Privacy myths , videos

Do you eat Nutella? Dr Yoni Freedhoff is a fellow physician and health blogger from Canada who I have spoken of before. This video is how I first discovered him - deconstructing nutella. Think hazelnut spread sounds healthy? Think again!

You can follow Yoni on twitter as @YoniFreedhoff or follow his insightful blog at weightymatters.ca
I am currently reading his book "The Diet Fix" and will post a review soon! In the meantime, hope you enjoy this clip.

Lyndal @ Lean Green and Healthy

Juices, smoothies or plain old fruit and veggies?

Privacy diet , healthy eating

I was sitting in the waiting room of my doctor's office today, watching rubbish daytime television (lucky me!) which included a stream of infomercials for juicers, blenders and shakes in packets. Many diet sites and nutrition books talk about juices and smoothies, and everywhere you look lately someone is carrying a glass jar with something green in it (what is it with jars?) Movies like "Fat sick and nearly dead" promote juicing for weight loss and many magazines promote juice "cleanses". Boost juice and other juice franchises are booming and fancy appliances are for sale in every shopping centre. You may feel that if you're not making juices or smoothies then you must be doing it wrong. So what's the lowdown on juices and smoothies and are there any health benefits over and above just eating fruit and vegetables? Let's have a look.

What's the difference between juices and smoothies?

To make a juice you need a juice extractor (or "juicer") which removes the liquid from fruit and vegetables leaving the pulp and fibre behind. A smoothie, however, is made in a blender or food processor and uses the whole fruit including the fibre. This difference in preparation has a big impact on the health effects of these drinks.

Let's start with juices

Proponents of juicing can be an extreme lot, with websites using words like "miracle cure", "cleansing healing" and many other health claims that make me distinctly uneasy. There are significant health benefits found from eating more fruit and vegetables but no reputable science to suggest that there is any health benefit specific to juicing. In fact there are some reasons why juicing should be approached with caution.

When using a juicer, the juice and most of the vitamins and nutrients of the fruit and vegetables are extracted, and the pulp and fibre are left behind. So does this matter? In fact it does. Dietary fibre is vitally important for the normal functioning of the bowel and only around 2/3 of Australians and half of Americans meet the recommended 30g of dietary fibre a day. Meeting that 30g a day can decrease the risk of heart disease, diabetes and bowel cancer. Juicing your vegetables will lower your fibre intake and make this situation worse.

Fibre not only provides benefit to your bowel, but within fruit it also binds the fructose (natural sugars) of the fruit so they are released more slowly. Remove the fibre and the juices can play havoc with your blood sugar level even if you are healthy, and dramatically so if you have diabetes.

Fibre also makes up a significant volume of the fruit - remove this and it will take a lot of fruit and vegetables to make a glass of juice. You may need to juice 5 or 6 oranges to make a glass of juice. Apart from being expensive, this also means the calories add up and even the natural sugars of fruit that are healthy in regular doses can end up being a problem in that big a dose. Have you ever tried to eat 6 oranges in a row? Probably not because you would get too full. Yet we would not think twice about drinking a glass of orange juice with our meal. That is just not healthy.

By definition juices do not contain protein or fibre, both of which are important to satiate hunger and make you feel full. This means that juices can leave you quite hungry afterwards so can lead to added unnecessary calories.

"Juice cleanses" are heavily promoted and should be avoided. The lack of protein, fibre and fluctuating sugars involved in a juice only diet can leave people fatigued, weak, and with rapid weight loss (which is usually muscle rather than fat.) This kind of rapid weight loss can have significant effects on the long term metabolism and make future attempts to lose weight harder (see this post). For people with diabetes or impaired glucose tolerance the risks are magnified and the blood sugar effects of juicing can be dangerous.

Some of the health claims made by juicing proponents are quite preposterous. Just looking at a couple of websites recently I found some claims that do not make sense. One site said that juices were excellent for "cleansing and detoxification" which is completely unjustified. Your body does not need to be "detoxified" - your liver and kidneys do that for you all the time without any intervention from you. And as for cleansing, considering it is the fibre in fruit and vegetables that "sweep" your bowel clean and keep it functioning efficiently, cutting out all the fibre by juicing is likely to not cleanse but in fact have the opposite effect! And apart from all the crazy claims of miracle cures of every disease known to man, one site even said juicing meant "nutrients were available in much larger quantities than if you eat them whole" - I am not sure how the juice extractor is going to actually make MORE vitamins? That's some scientifically magical appliance that I really need to see to believe!

So what about smoothies then?

As smoothies are made in a blender, the whole fruit or vegetable including all the fibre and pulp is retained. This resolves a lot of the problems with juices losing the pulp (and the fibre and nutrients contained in that pulp). It also means the volume of the fruit/vegetable is maintained so you use less of the whole product and it fills you up.

Smoothies use blenders rather than juice extractors (cheaper to buy and easier to clean) and are therefore a bit more versatile. If you use your smoothie as a base to add some protein (such as Greek yoghurt, egg or nut butters) and some low GI carbohydrates (oats, quinoa, low GI fruit) you can have a balanced home made meal replacement if you wish. Some people add protein powders, which is probably quite unnecessary but is an option. Some recipes have 4-5 pieces of fruit on board - just be careful if you start adding those commercial supplements, plus fruit, yoghurt, honey etc you can end up with a high calorie option. Be very careful of commercially made smoothies as some have up to 30g sugar (that's 6 teaspoons full).

So what's the bottom line?
Eating fruit and vegetables is very good for you - in fact is an essential part of a healthy diet. There is no scientific evidence that blending them and keeping the fibre has any nutritional or health benefit over eating them whole. Juicing them without the fibre can have significant health impacts (especially if you have bowel problems or diabetes).

1. If you are meeting your daily requirements of 2 serves of fruit and 5+ serves of vegetables and are happy with what you are doing, there is no health reason for you to start making smoothies. You're already doing it right!

2. If you are struggling to get all your serves of fruit and veg in a day and need another way, or if you are bored and you think a blended smoothie might be a nice change for you, then go right ahead. There are some great smoothie recipes online, but here's some basic principles. Treat it like a proper balanced meal, not just a drink with extra calories. Add dairy or alternatives, natural lean protein, low GI carbohydrates and keep the ingredients simple with one or two serves of vegetable or fruit. Remember the calories add up. It can make a great breakfast on the run and is certainly far superior to eating a processed breakfast bar, a fatty take away or skipping breakfast altogether. I believe there is no need to add a processed protein powder to your meal unless it has been recommended by a doctor or dietitian - there is very little evidence they are of benefit to most people with a healthy balanced diet.

3. I wouldn't recommend anybody take part in a "juice fast" or a "juice cleanse" at all. If you are going to drink juices, then stick to mainly vegetable juices, have them occasionally, and keep fruit juice as a drink for special occasions only. Treat all extracted juices with caution and monitor regularly if you have diabetes.

For me, I think I'll just stick with eating my fruit and vegetables and drinking my water :)

Lyndal @ Lean Green and Healthy

Related posts you may wish to read:
Stop dieting now. Please!
What to eat for a healthier you
The beauty of breakfast
When it comes to diets, one-size-doesn't-fit-all

Stop dieting now. PLEASE!!

Privacy diet , healthy eating

STOP DIETING NOW. Please. With a significant and growing proportion of our population now overweight or obese, I’m urging you, please, don’t go on any more diets.
Now before you think I’ve lost my mind, let me explain why.

You may have read my previous post on why "one-size-doesn't-fit-all" when it comes to diets. One of the points I make in that post is that the word "diet" traditionally just meant the food we eat every day, our daily menu so to speak. But in modern times this word has been charged with so much more meaning (and judgement). We now refer to a "diet" as a restriction of our food, as a set of rules or choices, as a formula or requirement to eat a certain way, and the implication that by "dieting" we are somehow restricting or depriving ourselves. And finally there is the Diet with a capital D - the food plan that comes with a name, a trademark, a book, a TV show, a range of supplements and a one true faith to believe in, often with a cult like fervour and a celebrity to endorse it. And in many cases it is sold as the one, the only, way to eat. Diet has become a dirty four letter word and can fill people with fear and dread.

So if we agree on that definition, and knowing that I'm a doctor and I want you to be as healthy as possible, then why don't I want you to go on a diet?

Firstly, "diets" make you gain weight. Yes, you heard right. I'm not talking about gaining weight during the 12 weeks you are doing the particular plan on the internet or the 60 days you follow the book or the three months you attend the meetings. Most diets, no matter how intense or how crazy, will help you lose weight during that time. I'm talking about afterwards. People who follow a restrictive "diet" generally end up fatter than people who don't in the long run.

The weight-amplifying effect of dieting was evaluated in a study in 2011 based on over

2,000 sets of twins from Finland. The results indicate that dieting itself, independent of genetics, is significantly associated with accelerated weight gain and increased the risk of becoming overweight. The researchers concluded, “It is now well established that the more people engage in dieting, the more they gain weight in the long-term.” This study adds to a body of research which shows that dieting and the ensuing cycling of losing weight, re-gaining weight, and gaining more weight with each subsequent diet, ratchets the baseline weight up even higher, beyond the original weight.

How does this work? The first issue is that very low calorie diets can cause the body to lose a disproportionate amount of muscle mass (which is not the type of weight that any one wants to lose). People are happy because they lose weight fast (on the scales) and look smaller but it is our muscle mass that actually burns the most calories for us in the background. Lose fat AND muscle and you end up thinner, but utilising less and less energy on a daily basis and therefore require less and less calories just to stay the same. After a while the weight loss slows, then stops then people start to re-gain weight even if they are eating the same amount. Do this cycle enough times and you end up with someone who is strictly dieting AND overweight at the same time.

Secondly, extreme caloric restrictions are a physical stress on your body. In patients on low calorie diets (and interestingly also in patients on a ketogenic low carbohydrate diets) some studies have shown markedly increased levels of cortisol, a stress hormone. Cortisol raises blood sugar, and stimulates laying down of fat, especially around your abdomen where it is most dangerous. The other metabolic effects of "dieting" can also cause a change in the hormones that control satiety and hunger - patients are more preoccupied with food, feel more hungry and are less likely to feel full, and this can continue for some time after their "diet" is over.

The statistical bottom line is that the vast majority of short term diets don't work. Sure you will lose weight short term (probably water, fat and muscle), but within 2 years the vast majority of people are the same weight if not heavier than they were before. Funny enough, we seem to know this intuitively, yet we still try keep getting back on the diet cycle. A current Australian weight loss company are using a celebrity in their advertisements who previously and publicly lost a significant amount of weight on their program, has regained it, and is now on their new TV campaign starting again, because she "knows it works". Really? Depends on your definition of "works" I guess. Her weight gain is nothing to be ashamed of and is not her fault, in fact its almost standard for any short term extreme diet, but I find it interesting that it is part of the TV commercial to sell the program. How many people do you know that have weight problems that say they are going to weight watchers again or signing up for another 12 week body transformation program again "because it worked last time". Did it really? If it worked, why do you need to sign up again?

Blogger Ragen Chastain actually describes this really well. She says "I think the diet industry continues to be so successful is that they have found a way to take credit for the (typically successful) short term results of dieting, but blame the client for the (typically unsuccessful) long term results. They know that almost everyone can lose some weight in the short term on almost any diet. They also know that their 5 year success rate is less than 5% but somehow they managed to convince people that the other 95% just didn’t doing it right, and should buy their product again. And we do!"

So if I don't want you to diet, what do I want you to do?

1. Firstly I want you to avoid a fad diet. According to the Better Health Channel Victoria, A fad diet generally has some or all of the following features:

Promises a quick fix
Promotes 'magic' foods or combinations of foods
Implies that food can change body chemistry
Excludes or severely restricts food groups or nutrients, such as carbohydrates
Has rigid rules that focus on weight loss
Makes claims based on a single study or testimonials only.
Is anything that you cannot maintain for the rest of your life without restriction, unhappiness or difficulty

2. I would encourage you not to focus on a diet but instead on a healthy eating plan. My eating prinicples are listed on my blog here, but the general principles for any health eating plan include:

Plenty of vegetables, legumes and fruits.
A variety of grains preferably wholegrain, low glycaemc index and minimally processed
Lean meat, fish, poultry or alternative sources of lean protein.
Milk, yoghurts, cheeses or alternatives sources of calcium.
Plenty of water.
A moderate amount of total fat and limited saturated fat.
A limited amount of salt.
A limited amount of processed and refined sugars, and food and drinks containing added sugars. In particular, limit sugar-sweetened beverages.
Limited alcohol intake, if you choose to drink.
Portion sizes appropriate to your size, age and exercise level.
Flexibility to enjoy treats in moderation.

3. I would like you to try and be mindful of your eating, responsive to your body and don't follow strict eating plans that are not tailored for you. No diet or meal plan from a book or off the internet could possibly “know” your hunger and fullness levels, or what satisfies you. Only you know your eating triggers, your personal likes and dislikes of food, and how foods impact on you physically and emotionally. If you need more structure and support than general principles, then I would encourage you to see a qualified dietitian to have an individual plan tailored for you.

4. Whatever changes you make, make them for life. Don't start doing something you can't continue. Don't get suckered into short term fixes, supplements or snake oil unless you plan to do it forever. Because when you stop these extreme measures, you may be worse off than if you never started. Small, sustainable changes are the key to long term success.

5. Be realistic and focus on the process. Patients who eat a balanced diet and exercise regularly are healthier than those who don't, no matter what their weight is. Obesity is much more complex than just calories in versus calories out - environmental, cultural, genetic and epigenetic, health, socio-economic and lifestyle factors all contribute. So don't focus on the numbers too much. Concentrate on making healthy choices every day. Chances are you will lose weight in a slow and sustainable way and keep it off and get closer to a healthy weight for you. But no matter how much weight you ultimately lose, you will definitely be healthier, and isn't that the ultimate goal?

Lyndal @ Lean Green and Healthy

Weight loss cures and snake oil salesmen.

Privacy diet , myths

Well this morning I had a run in with a fellow on the internet over his promotion of supplements for weight loss. He was posting in a group and his advertisement for his magical product encouraged people to lose weight by mixing his potion with milk, peanut butter and butterscotch pudding mix! His other recipe included Oreo cookies and Jello flavoured pudding mix. Mmm sounds like a balanced nutritional meal to me! (not!) Not surprisingly I got a little hot under the collar about this latest dietary scam and decided it was time to talk about weight loss supplements.

Every man and his dog seem to be selling a weight loss "cure" these days. With the rates of overweight and obesity rising, people who are not overweight have become the minority and manufacturers have the biggest potential profit margin EVER. If only there were a safe, reliable, effective weight loss supplement on the market, they would be millionaires. Sad truth is, that there isn't one.

Some meal-replacement programs are effective for short term weight loss under medical supervision, and if you are very obese your doctor may wish to try you with those. I am not personally a fan, because while you may lose weight short term, unless major changes are made most patients regain the weight when they return to eating "real" food. But they can be used effectively, particularly with multidisciplinary support, so I thought it best to mention them. But otherwise there are currently no diet supplements on the market with solid scientific research that are helpful for long term weight loss. Many weight loss supplements (particularly on the internet) are sold in extensive Multi-Level Marketing schemes so the poor people selling them need to push more sales of their product to recoup the money they have spent personally just to get the product themselves. To buy more product they must sell more product and recruit more people to sell more product. The people at the top get rich and the people at the bottom don't get slim! Most are ineffective. Worse, some of those that are on the market are unregulated, unproven or unsafe.

Overweight and obesity is the most rapidly growing health problem in the world and costs governments millions in health costs. More premature death and illness in Australia is now caused by excess body fat than by tobacco smoking or high blood pressure. If you are considering taking a weight loss supplement think about this - if there was a safe, reliable, and effective supplement that would help you lose weight, don't you think your doctor or another health professional would have given it to you by now? We wouldn't need to buy it off the internet, hell, we'd be putting it in the water supply!

The most effective way to lose weight is by sustainable lifestyle change. Eating healthy, balanced nutritious meals in the appropriate amounts for your body and exercising more to get fitter and healthier. Slow, steady and effective. There is no magic and there are no quick fixes.

And one final point: in my previous post on "diet gurus" and "the "one true diet" (read it here) I mentioned that if a diet is going to work, if you are going to lose weight and keep it off, then you need to consider if you could keep doing this forever. Any plan that you undertake short term will have short term results and when you reach your goal weight (or get sick of it) and go back to your previous life, the weight comes right back on (and then some). Unless you are planning to take this supplement (with its cost, hassle and unknown health risks) for the REST OF YOUR LIFE, then don't start now.

Don't waste your money. Just eat real food.

Lyndal @ Lean Green and Healthy

I'm going to hand the final word on this issue to Dr Yoni Freedhoff, who I have quoted before. He is a fellow physician and health blogger whose views I highly respect:

So what's the go with "superfoods"?

Privacy healthy eating , myths

I keep hearing about the terms "superfoods" and whether we should be eating more of them. Just like many other people, I started to wonder if there was something wrong with me that I wasn't eating boatloads of kale, acai, chia, goji berries and whatnot at every meal. Apples, spinach, nuts, fish? Suddenly my diet all sounded a bit pedestrian and... well... common. And besides, how could I get "healthy" by shopping at the supermarket and the farmers' market, shouldn't I be buying things at the health food shop?

So I've been doing some reading and you know, there's a lot of hype out there but not much evidence. "Superfoods" are not just foods any more, but have morphed into a marketing tool for companies to use to convince us to buy one product over another. This is not unlike the "superdiets" promoted by diet gurus and celebrities (you can read my previous ~~rant~~ post about the "one true diet" here). Lets take Goji berries for example -Australian consumer group Choice tested a range of "superfood" juices and found that you would need to drink about 300ml of Goji juice in order to obtain the same antioxidant benefit of eating one medium-sized Red Delicious apple. Goji juice is around $50 a bottle, apples around $5 a kilogram. Get the picture?

So what does "superfood" mean? Well, nothing. It's not a scientific term. It makes us think of foods that are full of nutrients, that are proven to have significant health benefits, that will make a big difference to your life if you eat them but interestingly most foods touted as "super" have none of those benefits proven. But there are foods that do exactly those things! So what, in my humble opinion, are the real superfoods? Well most fresh, unprocessed foods have great health properties and some of them especially so. The evidence is really strong for:

Fruits (especially berries and apples)
Vegetables (especially the dark green leafy kind)
Nuts and seeds
Legumes
Whole grains (especially oats )
Olive oil
Fish
Green tea
Red wine (in safe amounts)
Dark chocolate (I hear you cheer!)

And you know what? You don't have to go to a specialist health food store, order online, mortgage your first born child or listen to a celebrity chef or supermodel infomercial to buy any of them. Oh and they don't need "activating" either ;)

It's pretty simple, really. To quote the wise and succinct Michael Pollan, "Eat food. Not too much. Mostly plants"

Lyndal @ Lean Green and Healthy

To learn more:

Here's a great article on this issue by Australian chef Matt Preston - Real Life Superfoods
And for a much more eloquent and amusing version of what I just said, sit back and enjoy 9 minutes of "The Checkout" a brilliant Australian consumer watchdog program - satirical and cutting investigative journalism. You're welcome!

When it comes to diets, one-size-doesn't-fit-all

Privacy diet , healthy eating

When I meet people and they notice my weight loss (which is pretty noticeable if you knew me previously), the obvious question is "What did you do?" My standard answer is "diet and exercise! Who knew?" with a big laugh. This is almost immediately followed by "Wow. So WHICH diet? Paleo? Atkins? Low carb?" And this is where things become complex. How I live now doesn't have a trendy name. I followed a series of diet principles based on medical advice and research but I didn't follow a prescribed diet by an internet guru... and I don't think you should either. Let me tell you why.

Firstly lets look at the word diet and what it means - strictly speaking a diet is simply the food an individual eats on a daily basis. Good or bad, no judgement attached, that's what diet means. By this definition we are all dieting all the time, every time we eat we are taking part in our daily diet. But in modern times this word has been charged with so much more meaning. We refer to a "diet" as a restriction of our food, as a set of rules or choices, as a formula or requirement to eat a certain way, and the implication that by "dieting" we are somehow restricting or depriving ourselves. And finally there is the Diet with a capital D - the food plan that comes with a name, a trademark, a book, a TV show, a range of supplements and a one true faith to believe in, often with a cult like fervour and a celebrity to endorse it. And in many cases it is sold as the one, the only, way to eat. Diet has become a dirty four letter word and can fill people with fear and dread.

Do I sound a little cynical? Sure. Because I don't think there is one "right" diet for everyone. Many people will "go on a diet" and lose weight, no matter what the diet is, because they are paying more attention to what they eat and being more motivated. Will that weight stay off? Well it depends if the diet is sustainable, if they like it and if they can live that way for life.

Lets think about traditional cultures. People from all over the world have ethnic and cultural diets that vary hugely in their content and nutritional makeup. The Inuit in the Arctic eat a completely different diet to the Japanese, the people of Southern Italy or the Masai of Africa - yet none of those cultures traditionally have issues with overweight or obesity. They are all eating different diets, but you couldn't possibly suggest that each culture has it wrong - yet that is basically what these diet gurus claim when they suggest their way is the only way to go, and it makes no sense.

The important message is there is no single Diet (again I use the capital D) that is suitable for everyone, but a whole lot of dietary principles that are. Its pretty safe to say that any diet based on whole, nutrient rich, unprocessed food that is close to nature would be good for all of us. Variety and moderation is essential. And I think there is generally universal agreement that we should be eating a diet that is mostly plants, that avoids too much refined grains, refined sugars, trans fats and processed meats. This is what all the cultures I mentioned before have in common. They all have eating patterns that feature moderation, variety and whole unprocessed foods (and a whole lot of exercise also!). They also have traditions and culture and social occasions around eating which all adds to healthy eating behaviours (eating with your family as part of an event not at your desk, in your car or in front of the TV. Perhaps the topic for another blog post?)

There is another important point to consider when looking at a diet plan. If this is going to work, if you are going to lose weight and keep it off, then you need to consider if you could keep doing this. The pills, the potions, the extreme exercise routine, the fancy meals with obscure ingredients, the restrictions and elimination. Is it sustainable to incorporate into the rest of your life? Will you need to "cheat" at Christmas or avoid social events? Will you have difficulty sourcing ingredients or be unable to eat out? Because this needs to work long term. Any plan that you undertake short term will have short term results and when you reach your goal weight (or get sick of it) and go back to your previous life, the weight comes right back on (and then some). I'm going to quote Dr Yoni Freedhoff on this topic. He says "Just ask yourself the question "Could I happily live like this forever?" If the answer is "no" then you're on the wrong diet". I couldn't agree more. Any dietary plan that has an expiry date is a recipe for failure.

The American Diabetes Association reviewed its guidelines for people with diabetes last year and I think its comments are appropriate for all of us. They said a suitable diet should have:

"a variety of minimally processed nutrient dense foods in appropriate portion sizes as part of an eating plan that takes into account individual preferences, cultures, religious beliefs, traditions and metabolic goals". Indeed.

Eat unprocessed foods, mainly plants, with lots of nutrients, fibre, variety and colour, eat less salt, eat appropriate portion sizes, avoid excesses of anything, think about what you're eating, drink more water, cook more, sleep more, smile more, move more. And make sure you enjoy treats with pleasure and without guilt. And if those general principles aren't enough and you need more specific direction that's tailored to you - be sure to see an Accredited Practising Dietitian, not a TV celebrity or a diet guru.

Lyndal @ Lean Green and Healthy

Health4Tips

Tuesday, June 24, 2014

I think I love John Oliver :)

Saturday, June 7, 2014

Weekend Flicks - Making Homemade Nutella (Dr Yoni Freedhoff)

Wednesday, June 4, 2014

Juices, smoothies or plain old fruit and veggies?

Sunday, June 1, 2014

Stop dieting now. PLEASE!!

Wednesday, May 28, 2014

Weight loss cures and snake oil salesmen.

Thursday, May 22, 2014

So what's the go with "superfoods"?

Tuesday, May 20, 2014

When it comes to diets, one-size-doesn't-fit-all

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