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Gender and Racial Diversity in Registered Dietitian Nutritionists

Edit: Updated statistics are available at a new link on the CDR website: Current demographics show 98,053 dietitians, 90.6% female, 3.8% male, 5.6% not reported, 77.8% white as of July 3, 2017.  Here’s a list of other credentials issued by the CDR and respective demographics.  The rest of the article will be based on the 2013 demographics.

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According to the Commission on Dietetic Registration’s demographic profile of registered dietitians as of December 1, 2013, 94.3% of RDs are female and 81.8% are white.

Interestingly, many health insurance companies declare network capacity by ‘number of dietitians’ and not the diversity of providers.  I know this because I have had to try very hard to get in-network with a number of insurance companies that have panels 100% of white females only to be told that there is no discrimination policy or diversity quota in place for providers.

There should be.  Patients should have a right to finding a demographic of a provider they identify with: whatever race, gender, religion, or sexual orientation that they feel comfortable with.  Not 100% white females.

You can check this by going to your health insurance provider’s website, looking for specialists, and then selecting nutritionist, dietitian, or registered dietitian, depending on how the profession is listed at your health insurance company.

Don’t get me wrong, white females do very good jobs at nutrition counseling, are fully qualified, and it shouldn’t matter.  However, many different types of people exist in the world, and healthcare can be much more effective if the patient identifies better with their healthcare practitioner.

Being able to choose the demographic of your healthcare practitioner can enhance credibility, trust, and the feeling of being cared for.  Even if objectively there is no difference in the credentials and education, there are subjective differences that it is politically incorrect to even mention but can affect quality of care.  And I’m not talking as a healthcare provider, I’m talking about patients’ perspectives.

Patients come from a variety of backgrounds, cultural, gender, geographic location, religion, sexual orientation, etc.  Healthcare practitioners cannot control initial biases of a patient that may make them discredit the information they receive.  It is a reality whether we like to acknowledge it or not.  Sometimes a patient may not feel comfortable bringing up a question based on who the patient thinks the practitioner perceives him or her to be versus who he or she actually is.

I am all for equal pay and benefits to women and men for whatever job they do. However, if we are going to talk about women in engineering (or any STEM field or law), it shouldn’t be taboo to talk about men in dietetics, a traditionally female field.

Interestingly, women in engineering represent a larger proportion, 13%, according to MIT news, of their workforce than the 3.5% represented by men in dietetics.  I once had a personal training client who went on and on about women in engineering and law, ignorant of the number of men in dietetics.  And who is to say one is more important than the other?  I was able to connect on the feeling of being a minority in a field, but I didn’t feel at liberty to talk about under representation of men in dietetics because it makes me sound like a ‘meninist,’ which is a shameful political view.

Reasons why men aren’t in dietetics?  Many of the jobs do not pay enough is one.  The median full time pay is around $50k/yr, and as someone who is in the field, I can tell you that it is 10-20k less in Austin unless you are a director of a major organization, you may make more.  Since becoming a registered dietitian requires a minimum of a master’s degree starting in 2024, seven years of education to make less money is probably not appealing to men, who are often traditionally (and sometimes still) thought to have to provide for a family and fund the cost of dating.  (Note the RD is a 5 year credential, 4 years for the degree in dietetics and 1 year of supervised practice; many RDs have much more education than the minimum).

But that doesn’t seem to stop men from going into fields like teaching, which has higher numbers than men in dietetics.  In fact, 23.7% of teachers of primary and secondary schools in 2011-2012 were men, according to the National Center for Education Statistics.  So something else must be the case.

Another reason there are fewer men in the profession could be the perception that it has traditionally not been considered masculine to care about calories, have soft skills like counseling, ability to comfortably show empathy, people skills that can elicit behavior change from clients, and ability to meal plan.

Traditionally, men don’t cook or bake as much as women in the home or take care of children, and there are many other skills that traditionally women are thought to be better than men at doing.  (Yes, there are excellent male chefs and stay at home dads, but I am talking traditionally).

Discussions on breastfeeding and/or pregnancy, often done at WIC clinics, are something women are naturally more expert than men at doing because they have the anatomy.

Additionally, there were certain things in the educational experience left over from when the profession may have been more like home economics or closer to working as a chef such as a class on how to set a table, appropriately garnish a plate, and other food service skills.  These may not be appealing to guys in their early 20s in college.

Nutrition science is what attracted me to the profession.  I love the science: nutrition biochemistry and exercise physiology.  Recently, I have also taken a penchant for counseling psychology.  I’m competitive against my younger self at getting people to make changes with regards to their health and well-being in how I implement education and counseling.

In addition, private practice pay is based on how much business you want and how well you market and get client success.  As a competitive person, this is motivating to me.  Whereas working full time, possibly changing people’s lives, and getting paid less than the median expected pay in the profession while not having freedom to practice how best helps patients is a reason not to work as an employee in this field.  That is not motivating to me.

Are men openly accepted in this field?  In some ways yes.  I can tell you that a number of clients have specifically come into my office because of my gender, overtly stating they wanted a male.  I think I may bring in clients who normally would never see a registered and licensed dietitian.  I think diversity in the profession would only help more people to know what we actually do by bringing in more types of people who normally wouldn’t come in.

In MANY other ways, there was a lot of unjust discrimination I endured going through the education and training process of becoming a dietitian (and after becoming one) that, because of aggressive feminism (not true feminism, which is about equality of genders) and/or others’ projections about men, I felt unable to even be allowed to voice opposing viewpoints because it wouldn’t be considered politically correct and fall on deaf ears when 3.5% of the profession is male (much like I stated above, where men represent a smaller percentage of dietetics than women do in engineering).

In fact, I don’t even feel free enough to voice it on this blog.  Suffice it to say, after years of being underestimated and written off as a ‘stupid man’ (quoted, a supervisor during my internship stated under her breath) who couldn’t begin to understand the intricacies and emotions involved in nutrition counseling, it motivated me to start my own private practice because, yeah, I do know what I’m talking about. I feel competent to counsel individuals independently about nutrition and nutrition/exercise-related healthcare.  I certainly have gone out of my way to get the credentials and experience to prove that.

Unfortunately, I don’t have a professional counseling credential behind my name, but I have been to therapy for over 6 years (at time this is written) going twice a week in a group and individual setting and am very familiar with counseling skills having worked through my own issues and seen others of a variety of different personalities and backgrounds work through theirs.  And I’m out about that because I’m proud about it and hold my hat off to the various counseling professionals who are so good at what they do (and I do work with them–my office is surrounded by them!).  I know when to refer patients to seeing a counselor when it is beyond my abilities, which is what our code of ethics states we should do.

Back onto differences between men and women:

Men and women write and emote differently (or if looking at masculine vs feminine gender expression, there is a masculine and feminine way of writing and emoting).  If you are a man (or a woman who writes like a man), chances are you don’t write with many exclamation points in your emails, emoticons, and attempts to influence the recipient’s emotional response of your email.

In dietetics, the female manner of writing is expected in emails.  Our dietetic practice groups have explicit netiquette rules that state that anything that has the effect of disparaging any individual is inappropriate, too terse, bossy/demanding, and abrupt.  While ‘alternative points of view are encouraged,’ they really aren’t.

If you have an alternative point of view, it can have the effect of disparaging an individual if they wish to view it that way, and thus the email is inappropriate because it can feel critical on the way others practice.

I feel, as a man, if I don’t attempt to really spend time on my emails and make them less succinct, well good luck winning friends and influencing people in the profession.  And it’s not like I don’t have other things to do during the day.  It takes a lot of time to write emails in an attempt to not hurt any of the 89,300 people’s feelings in our profession and how they might misinterpret what I wrote and take it offensively.  Well guess what, as a man, I automatically am much more likely to offend someone in our field because of my gender because men are perceived ‘forceful’ in any opinions we have.

While it might be thought of as confidence and life experience in an older woman, for a younger man, it is considered arrogance, regardless of whether I actually have that confidence and life experience.

As someone who went to an all male Catholic school, I was not taught to write in a deferential manner.  I was taught to write to get my point across.

I understand that women’s rights are still not on the same level as men’s.  But to be a scapegoat for all the angst of women by being a male in the profession, that is the job of being a man in a 94.3% female profession (notably 2.2% of the profession didn’t declare a gender, so perhaps we have 2.2% transgender individuals).  I also am expected to behave up to a standard women in the profession don’t hold themselves to (many who don’t follow the code of ethics themselves).  I have personally received emails from multiple other dietitians telling me how to act since becoming a dietitian, both with the ‘tone’ of encouragement and with the ‘tone’ of attempt to control my behavior.

Even when going through my internship program, most of the members of my internship class went to a women’s conference together.  I was not invited or thought of.  I was left out on purpose.  Let’s suffice it to say I didn’t feel part of the group or welcomed.

Enough on gender differences though.  I digress.

There is a great need for more racial diversity within the field of credentialed and practicing licensed dietitians in addition to more gender diversity.  People who need nutrition services come from a wide variety of cultures.  Who better than a practitioner who is trained in the profession and comes from that culture to help people from within the culture?

As much progress in civil rights as there has been in the last century, it isn’t enough.  People of different races deserve the option of a healthcare practitioner of the same race to avoid unsaid prejudices from either side.  Prejudices still exist and need to be acknowledged.

Cultural competence is taught in dietetics education, but it is not enough.  We cannot control a patient’s biases as practitioners, and for the sake of a patient, he or she needs to have the option to choose a practitioner with whom they can at least have confidence fewer assumptions of bias are happening from either side.

Dietetics education programs should be making it a top priority, for the sake of the credibility of the profession and ability to have an impact on more people, to be inclusive of men and non-white racial groups.  An effort needs to be made to make the profession more appealing to minority groups and diversify the profession demographics.  Insurance companies should also have more diversity within their practitioners.  It is unacceptable for 100% of a list of specialists to be white females and that the insurance companies are ok with this.



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Repeal of ObamaCare and Possible Effect on Your Nutrition Counseling Benefit

At the time this is written, it is still too early to tell whether or not the replacement for the Affordable Care Act will result in the loss of coverage for preventative healthcare services or not.  President Trump has stated that some parts of the healthcare law will remain.

What worries me, as a practice and business that highly uses insurance-based nutrition counseling benefits, is that the loss of the mandate will mean insurance companies could cut their coverage for the services I do unless you have a formal physician referral for a specific medical condition.

Currently, most people do not know (and your insurance company is very evasive in letting you know) that you MAY (about 80% of my clients) get 100% coverage before you even meet your (enormous) deductible for preventative nutrition counseling, unless you have a grandfathered plan from before the Affordable Care Act.

Specifically, I can use a preventative code as a dietitian for preventative services with many insurance plans that results in no copay or coinsurance (yea, too good to be true, right?).

As a licensed dietitian in private practice, I am not allowed to diagnose any specific medical condition and am restricted to using a preventative code or a BMI code (because it is a calculation) to support coverage for nutrition counseling.

This allows individuals to just see me to work on their health rather than having to go do extra work and get other diagnosis codes from their physician, which may be subject to copays, coinsurance, your (huge) deductible, and cost to see your physician for the diagnosis (which also costs money!).

If ObamaCare is repealed, then I sincerely hope that the clause that allows coverage for nutrition services (CPT codes 97802/3/4 medical nutrition therapy) with a preventative ICD-10 code remains for a few reasons:

  1. Individuals who are overweight or obese without a formal diagnosis of a comorbidity (medical condition) face a financial barrier to getting on track with the professional who can literally reverse their condition without drugs or surgery.  Removing this barrier can be a huge boon to getting people in the door who need to work on themselves before they use a cop out excuse like “it is too expensive.”  Individuals WANTING to make a change to their diet and exercise habits needing legitimate information need all the support getting into my office they can get (a whole other blog post on the swamp of misinformation non-degreed fitness professionals give out about weight loss that you probably already self-pay for in personal training sessions).
  2. America pays more for the disease than the prevention.  Small fires are easier to put out than blazing forest fires.  This is a metaphor to saying overweight is easier to treat than type 2 diabetes, surgeon fees for coronary artery bypass, chronic kidney disease dialysis procedures, and pharmaceuticals for band-aid-fixing diseases that can be cured with lifestyle change.  Supporting the healthcare professional, through health insurance, that facilitates lifestyle change is supporting a registered dietitian and exercise physiologist (me).
  3. If my practice dwindles due to the repeal of the Affordable Care Act, I promise you that isn’t because everyone is healthy all of a sudden.  It is because there would not be coverage.  Even though the price of my services is inexpensive compared to what your surgeon or primary care physician costs, many people feel they are already paying for healthcare with their premiums, so they should not have to pay a dime more.  One of the major ways to have more coverage for services is if your premium is higher, to my knowledge.
  4. Loss of coverage for nutrition services would be a step backward in fighting many of the health problems that are easily treated by diet, exercise, and lifestyle changes.
  5. In appeal of Trump’s love for small business owners, as a small business owner, I have spent my blood, sweat, and tears slaving over my private practice for the past 3 years learning how to facilitate coverage for my services through health insurance for the benefit of helping clients and making a living myself.  By no means am I getting rich doing this.  I still work 7 days a week with a part time job seeing clients with my business and through an employer.  I have good success with the clients I do see (they let me know, or I see it myself).  I deserve to not have what I have built over 3 years burnt down just through a change in government administration.  I deserve to not have the rug pulled out from under my feet.  Not enough people are even using the benefit yet, nor is it advertised well enough through your health insurance company (probably because they think they lose money in the short term).

I agree the healthcare law is not perfect.  As a small business owner who is single, male and over age 26, I pay for my own health insurance through the Exchange without a husband or wife with a full time job with benefits a spouse can get on.  It is one of my biggest expenses next to paying for office space in Austin.

However, I also realize that as someone who is extremely fit, healthy, and barely uses his health insurance for anything except my flu shot and annual physical, I am paying for others who are not as fortunate as me to have the knowledge I do about nutrition and exercise and the desire to live the lifestyle.  And I’m fine with this.  I have no issues with it.  I can budget my money well if others need to use their health insurance more.

I know other young people are not aligned with this idea, and I do see the opinion that they feel they pay too much in premiums for something they don’t use and that as healthy people, they shouldn’t have to foot others’ healthcare bills who don’t care as much about their health as they do.

Clearly this is a complicated issue, and it is good that people can stay on their parents’ health insurance until age 26 and that 20 million more people actually have some coverage, but Americans also do not like paying for each other’s healthcare, and that is also a valid opinion.

I urge you to reach out to your representatives and senators with your concerns about the healthcare law reform.  If you are reading this post, you might care a little about preventative healthcare coverage and/or nutrition counseling coverage.  Please don’t be silent during this time when our voices need to be heard.

When it comes to nutrition counseling, Americans deserve legitimate information from a trained, degree-holding, licensed professional who is an expert on the subject and adept at working with individuals and groups.  Americans deserve the right to avert disease before it starts.  Americans deserve the right to prevent further healthcare costs down the road by taking action to a healthier lifestyle now, and they do not need additional financial barriers put in the way merely as a way to myopically cut costs and keep campaign promises.  Long term, it does not save.  Long term, we lose.

Yes, if you cut nutrition counseling, health insurance companies will save a little bit of money now.  But if you cut nutrition counseling long term, disease rates will go up and healthcare costs go up.  Clearly this is not a simple issue and needs to be considered carefully as a new healthcare law is implemented.

Edit 02/07/2017: A professional colleague alerted me to former President Obama’s recent article published in the New England Journal of Medicine on the possible repercussions and irresponsibility of repealing the ACA without a better replacement that is openly discussed first since posting this yesterday.

Please share or comment!



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17 Reasons People Eat

Some people prefer calorie counting, others like the hand portion size approach, and others like intuitive eating.  It is also myopic to think that people are overeating meat portions, vegetable portion sizes, and grain portion sizes as opposed to junk food portion sizes and alcohol.  Sure, it can happen, in a few cases, I guess.

Believe it or not, in nutrition counseling, I DON’T spend time educating people on the fact that one cup of broccoli equals one serving.  Most people aren’t overweight from eating solid, nutritiously balanced meals of real food, and many who aren’t overweight aren’t using calorie counting or use hand portion methods.

These are what I find are 17 reasons people eat.  The summary is that they are not hungry.  Never fear, there are not clickbait ads you have to scroll through a slide show to scan through all of these!

  1. Eating to socialize with others.
  2. Eating to avoid talking with others.  Social anxieties are common, and food is comforting as well as something to look like you are doing something.
  3. Eating when drinking alcohol.  It’s just something you do.  Some people smoke here, too.
  4. Eating when watching TV because you eat when you watch TV.  That’s just something you do.
  5. It is someone’s birthday at work (when is it not?) and there is cake.  You wouldn’t want to be disrespectful of their birthday, now would you?
  6. Becky/Mom/Grandma/Chad made cookies for you.  You’ll hurt her/his feelings if you don’t have them NOW and show how much you appreciate their effort.
  7. It’s a holiday.  Don’t be a party pooper by not eating with us.
  8. It’s time to eat.  It is 12p.  I must consume food now because it is “lunch time.”
  9. It’s after 7p.  I am not allowed to eat (and may feel guilty doing so), but I’m going to rebel against whoever made this rule (I don’t support this rule) and eat something off the record because I can.  Who are you, my mother?  I’ll eat whatever I want!
  10. Being told you cannot have something to eat, like a poptart, is a good reason to go have it and get off on your feeling of rebellion.  You showed them!
  11. Fear of not having food for a long period of time, so better eat more now.
  12. Overeating when starving.
  13. You worked out, so you deserve food now.
  14. You worked out and have been told there is a scientific yet magic 30 minute window of opportunity during which you will not benefit from any of your workout unless you eat now to avoid going all “catabolic.”
  15. Because you are emotionally drained, you eat in hopes it will give you energy.
  16. It tastes good and is pleasurable.  You want more of it.
  17. Because you are actually hungry and need the nutrition.

If I missed any, please add your non-nutritive reasons you eat in the comments.



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Women’s Body Image: Calorie Restriction, Strength Training, & Weight Loss

I get to work with a lot of women who want to lose weight on the fitness side as a personal trainer and on the nutrition side as a registered dietitian.  Most women who come in to “lose weight” really just want to change their body composition, and it is interesting to see whether people think it is their eating habits or their exercise program that will do that for them.

While I do assess whether they are actually overweight or not through a variety of different assessment parameters, weight loss often tends to reinforce a body image that is inaccurate for women in society, especially if they are not truly overweight.  That gets us to the methodology.

Restricting to maintain a light frame is not healthy because it is an unrealistic healthy body.  It is really just nutrient deprived and fitness deprived, especially as you age and are no longer able to maintain an idealized adolescent and thin teenage body that many women think is healthy.

Colleagues who work in eating disorders have found out that letting these women who really aren’t overweight or have health issues due to their weight actually attempt to lose weight is not helpful even if done in “a healthy way” because it reinforces anorexic psychology and behaviors.

I find this valuable information because often times, my belief has been that “hey, you can try it, but you won’t like the outcome when you get there because it won’t be the body type you are looking for anyway and are probably going to gain the weight back again without any change in overall fitness ability.”  Unfortunately, people are going to do what they want.

If they try to diet and weight comes back, I figure it is a learning experience because many men and women are determined to do what they’re going to do anyway.  Why be resistant?  Why not teach them to do it in a healthier way to reduce the risk of malnutrition and let them learn from the experience?

This is only for women who are slightly overweight according to some of the traditional weight assessments.  If they are clearly underweight or normal weight, I don’t help them on that restriction.  It is unethical.

What I find many women are often saying, is something like “I don’t like my body” or “I don’t feel sexy in my body,” and they are focusing on WEIGHT only as the only measure of that.
 
First of all, feeling sexy has to do with a lot of things, including having self esteem.  It is not just physiology and body composition.  Working with a qualified psychotherapist (I know a few good ones) often helps you figure out what to focus on and what is important.  Sometimes, a weight obsession is really tangent to something deeper.
 
Having worked with many women who come to me as a personal trainer to “lose weight” (even though physically training for a few hours a week results in mild, if any, weight loss, which is frustrating for them when it is explained to them on the first day), many women come out of it with a more positive body image, feel sexier, fit into their clothes better, have a tighter body, and they weigh MORE or the SAME while eating MORE or the SAME amount of food.
 
It is also obvious to me as a trainer which clients are restricting or under eating when working out because they never improve and are hungry working out on low calorie diets, among many other signs and symptoms I will not go into detail in a blog post.  They are stuck on the light weights.  They never fully recover.
 
While some women want to maintain an image of being small and frail, I do not support it when training because it isn’t healthy.  Osteoporosis, or lean mass?
 
Getting women to buy a healthier body image, ie one that is strong, can lift more than pink 5 lb dumbbells, and consume over 2000-2400 Calories is what I try to do.  It is difficult.  It is its own area of eating disorder work, not even recognized by the old school eating disorder specialists.  Of course, they don’t even lift or train people! 🙂
 
The summary of what I’m trying to say is that while some women are focused on body image, teaching women what a healthy body image is with strength training and eating more is probably what is most helpful for them long term due to the relapse rate of women who just try to modify their body with diet alone.
 
Many women will likely be focused on their body image either way, so why not give tangible feedback through fitness parameters they are not able to meet when restricting?
 
To clarify, strength training is NOT bodybuilding, as that is an ENTIRELY different concept.  Strength training produces results with very little time in the gym and very little loss of fitness in weeks of not doing it with strength goals rather than calorie burn and aesthetic goals.  Bodybuilding is aesthetics focused.
 
The problem is that when some women go to do a workout program, it is circuit training, non-specific, non-goal oriented resistance training, “go-for-the-burn spinning classes or CrossFit,” pink weights with dance music and air crunches (about as hard as it sounds), stretching, pilates, yoga, and a small percentage go with bodybuilding, which is also not what I would recommend for a positive body image because the focus is on aesthetics/weight/body fat% rather than fitness parameters you can improve with goal-oriented training programs.
 
Goal oriented training programs focus on overall increase in functional capacity like weight lifted, repetitions (reps), and sets with moderate progressive overload.  They focus on attaining better coordination, balance, agility, strength, REASONABLE muscular and cardiovascular endurance, flexibility, and body composition.  However, I’m not promoting the concept of mainstream “functional training” programs, as that is not standardized either.  Those programs sometimes make no sense to me either as to the purpose of some of their exercises.
 
In comparison to bodybuilding, strength training focuses not just on body composition but also other important and more readily testable exercises that show you are actually more adept at moving your body in space in time rather than just lifting weights till your muscles are broken down to the maximum for no purpose other than to build them.
 
Sometimes it is amazing to me how much exercise people do that is not doing anything for their bodies in terms of aesthetics, yet they are focused entirely on aesthetics for exercise.
 
I’m sure many of us have heard others say they walk 8 miles a day “to burn calories,” while simultaneously complaining they have no butt, or they adopt a running program for the sole purpose of calorie burn and again wonder why their butt isn’t getting nicer (it doesn’t overload the gluteal muscles and is not high intensity).  These are not fitness goals that are healthy, and frankly, it is an abuse of the purpose of exercise.
 
The problem is trying to get women to strength train, something that may make them fit into clothes better independent of calorie restriction (or even by eating more food!).  Some do not want to do it because of this unhealthy body image that women are supposed to be thin, skinny (more like skinny-fat), frail, and if they lift anything over 5 lbs they may start to look like a man.  This is an irrational, but all too common a belief.
 
Being frail is not cool!  If more women strength trained, I think it would cut down the number of women who are dissatisfied with their bodies significantly.  Bodies are made to move and be strong.
 
Strength training also can give realistic negative feedback on your physical condition as a result of cutting calories, thus giving negative reinforcement to the restrictive and thin mentality.  Use “that butt” as a reason to actually eat more food because you won’t get “that butt” if you don’t eat more and lift heavy.
 
Big guys train hardcore, sometimes have chemical help, and lift more than 50 lbs.  Most lift more than 100 lbs.  Getting to the 30 lb dumbbells as a woman and squatting your body weight should be seen as an accomplishment, not that you are manly.  Furthermore, male testosterone levels are much higher than women’s, so even if lifting the same amount as a man, you will not look like a man.  Times change, and so should women’s body image evolve to a healthier one that strength trains.
 


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Red Meat and Cancer News

There have been a lot of headlines this week regarding red meat causing cancer.  Any time you see the words “cause cancer,” your antenna should go up as something being a bogus, yet catchy headline.  Certainly, it makes professionals and non-professionals read that article, the former of which to find which studies they are referencing, and the latter to freak out about something new to avoid and fear because a reporter is spinning a story.

This is going around: “a 17% increased risk per 100 g per day of red meat and an 18% increase per 50 g per day of processed meat.”  Risk is not the same as causing.  However, the World Health Organization (WHO) did classify it as a carcinogen, but it may not be the same strength as other carcinogens.  It just means there is substantial evidence.

I went to Rudy’s BBQ over the weekend for a friend’s birthday party.  It was DELICIOUS.  I normally cook vegetarian when by myself, but when eating out I am not a vegetarian as I’m not an ethical vegetarian but a health vegetarian (and if vegetarian, eating red meat infrequently might get your iron stores up higher if low).

There were no vegetables on the menu other than potatoes, beans, and cream corn, which lacks the benefits of a vegetable as it is NOT low calorie, with pickles and onions only as something you could pick up from the side bar.  There was also potato salad and cole slaw, both not so good choices if you’re going to pick a vegetable, again because they are not low calorie or fibrous or colorful.

The group I went with mostly chose no sides (I saw a potato), but in their defense, you had to pay for the aforementioned vegetables other than onions and pickle slices separately.

I think colon cancer risk has more to do with NOT EATING ANY HIGH FIBER COLORFUL VEGETABLES AT ALL than it being red meat influencing cancer risk.  The type of people who eat red meat often tend to just not eat any vegetables or do other healthy behaviors, like physical activity, that cause motility of the lower GI tract due to the serotonin release that happens post exercise.

I know Rudy’s is a place families tend to eat multiple times a week because, yes, it is delicious.  I have not had better brisket than that in my life, and I grew up eating BBQ in Texas.  I am not receiving any financial or other ties to Rudy’s BBQ either to promote them, to be clear.

However, they could do the world a population cancer risk reduction by not charging for vegetables separately and steering off the full-on BBQ image by adding some non-traditional vegetables like broccoli, carrots, or side salads that are not iceberg lettuce with cream sauce and actually green and provide vitamin K and fiber.

Anyway, red meat should not be viewed as completely bad and should be enjoyed in moderation and with vegetables.  Moderation is not every day of the week.  Moderation is not 5 times a week.  Moderation is not 4 times a week.  Moderation is not 3 times a week.

Moderation is 2 or less times a week, in my strong opinion, provided you eat it with vegetables that are considered colorful, fibrous, and nutritious.  However, the American Institute for Cancer Research recommends less than 18 oz of red meat per week, which would be more than I personally recommend as a serving of meat is usually 3-4 oz (21-28 g of protein), so multiply that by 2 meals.

Resources on this topic were provided by Jeff Novick, MS, RD, LD, who does an excellent job keeping us RDs up to date with the latest on studies via the weight management dietetic practice group listserv.  Linked are what the World Health Organization actually said about red meat and cancer risk (study link too).  Read up, if you want to know.

Also, take into account the list of known carcinogens by the research, conveniently found on wikipedia.  It is not the list of the intensity of the carcinogen, but the evidence for it that exists.



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Low Calorie is Not Synonymous with Healthy

This is something I see over and over again, so excuse the rant post.

Everyone thinks they are an expert on nutrition these days.  You can find nutrition information all over the Internet telling you how to lose weight and exercise.  Everyone believes it is really simple science of calories in = calories out.

We run into special sorts of…first world problems in my profession.

Example:

Suzie read a journalist’s article on a website promoting beauty and fitness (nothing illegal in this realm on advice giving) with ads promising “pound shedding” and “fat blasting” and “washboard abs” (keyword rich content).

It may have even been one of those websites that requires you click to get to the next sentence 20 times in a slide show format because it optimizes the number of ads that can be shown per user who is dying to learn the secret to a ripped physique on this credible website (I’m not serious about the credible part).

In the article, vegetables are promoted as healthy for everyone in large quantities because they are low in calories and high in vitamins, minerals, and fiber.  MyPlate does something similar for the general population–making half your plate fruits and vegetables.

While this seems innocuous and may be an article promoting a much needed message when 2/3 of the population is overweight, sometimes the type of person reading this article can take things too far.

Suzie works out 6 days a week for 1-2 hours a day and is an active student walking to classes.  She sometimes eats breakfast, has a salad for lunch because salads are healthy, and she watches her portions using the standard portion sizes recommended on the side of packages for serving sizes.

She also runs when she feels tired and has a recent history of a stress fracture and tight muscles.

Suzie might be eating 1300-1600 Calories on a good day and isn’t even meeting her RDA for protein (the lowest recommendation for protein), and of course, she wants to lose weight and tone up.  This is a common goal for many women.  She has these insane cravings for sweets and feels guilty when she eats them because they are “not healthy.”

Suzie underestimates her workouts and overestimates her portion sizes while tracking her calories to the calorie.  She’s not losing weight and she is frustrated.

Is encouraging another salad for lunch for this individual healthy?  No.

Furthermore, the thought of going up on calories from 1600 to 2000 Calories seems like a dumb idea to her since, yea she might gain some muscle, which would solve the firming and toning issue.

Anyhow.  Nutrition is about matching nutrient needs to the individual.  Population messages are important but need to be taken in context.

It is important to match macronutrient needs (total calories, protein, fat, carbs) to the individual’s activity.  A message telling the population to choose low calorie foods and skimp on portion sizes is not an appropriate message for people like Suzie who is an “overachiever” with her goals and doing nothing wrong but reading nutrition messages on the Internet that are not tailored to her.

If you like this post please comment and share with your friends.  If you resonate with Suzie and would like to schedule a consultation, please send me an email.



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Food Allergy, Intolerance, Sensitivity Testing Impacts Disordered Eating

I am frustrated by the lack of clear information on food allergy, intolerances, and sensitivity testing on the Internet, so I am writing this post to show what I have seen as someone who works with those who may have had these tests in their past.

First off, we all know someone who believes they are allergic to certain foods.  Technically, allergies are serious, so we don’t take any chances with them. In practice, I try to work around people’s real or perceived food allergies, intolerances, or sensitivities.

When I think of a food allergy, I think of anaphylactic shock and hives.  When I think of food intolerance, I think of getting diarrhea due to something like lactose intolerance, where the food, when taken in large enough quantities, draws water into the gut from blood circulation and washes you out because you can’t create enough lactase.

I don’t know what to think about food sensitivities because they weren’t on the RD exam and were mentioned as not one of the two types of reactions you could have and even included as a wrong answer in that multiple choice question on the exam.

Common food allergy testing includes tests and protocols like ALCAT and LEAP, among many others.  A pharmacist, Scott Gavura, did an EXCELLENT blog post about food sensitivity testing for the website sciencebasedmedicine.org and did a lot of work on finding real evidence in the literature to support it.  The short conclusion?  There isn’t.  Check out his post for more detailed info.

Because I won’t attempt to do a better blog post than he did on this subject, I will say, in short, that I support that work he did.  The rest of this post will be what I actually see in clients who have had these sorts of tests as well as my own experience having had allergy testing early in life myself.  It impacts their lives both positively and very negatively.

I had the full 42 pricks in the back and 21 shots in the arm allergy testing done twice in my life, once when I was 11 or 12 and once when I was 22.  The first time, I supposedly was allergic to eastern and western weeds, molds, dust mites, and tomatoes.  Yet, I wasn’t going to get away from dust, molds, and tomatoes in my life.  Hell was I going to miss dad’s pizza on Sundays or not eat spaghetti.  I kept eating it and it had no real effect on me.

Growing up I always had a lot of inflammation in my nose such that I felt like I was congested but actually wasn’t.  Looking back, a lot of that actually just was undiagnosed generalized anxiety disorder, something I’ve struggled with my whole life for reasons that aren’t related to allergies or nutrition at all.

Having worked with an excellent pscyhotherapist on that, I don’t experience those symptoms anymore and can check in with myself when I get anxious.  With this life experience, I’m keen on seeing if it happens in others!

In others, I have heard sensationalized testimonials about how after having their food sensitivity test that they experienced dramatic weight loss and found God.  I won’t even dive into that subject because it is a case by case basis as to how eliminating certain foods can help people.

You would really have to see what that person was actually doing through detailed dietary recalls to see if their testimonial has merit from a nutrition standpoint.  Perhaps they also found love in the the meantime, which released anti-inflammatory cytokines throughout their body.  It could be a number of things.

Some clients have had these tests negatively impact their lives, and some of them aren’t even aware of it.  One client I worked with was told she was allergic to chicken among many other foods by the alternative medicine practitioner.  Her parents tried to keep her in line with her food restrictions throughout life (out of love, which is understandable) enough that she felt left out of social activities involving food.

Imagine going to a birthday party and not being allowed to have what everyone else is having.  Fast forward 10 years when she is allowed to have these foods now and can’t get enough of them such that it leads to overeating of them.

It’s the psychology of deprivation.  The more you restrict it, the more you want it.  Look what happened to Miley Cyrus.  Things will rebalance after they swing the other way for a while.  Right now, she’s just being Miley.

I have worked with others who have such an extensive list of foods they are not allowed to eat from these tests that they literally have trouble constructing a healthy diet out of it, let alone allow for variety.  This is a problem that these tests have that much power over people.

If the person got results and thinks it was from restricting certain foods that lack a legitimate scientific basis, they will live in fear of eating with others for the rest of their lives.  Granted, if you reintroduce some of these banned foods and notice symptoms reappear, then yea, maybe you should avoid them.

However, most of the time when you reintroduce these foods, you DON’T get the same symptoms.  Many find out that you are actually allowed to have all these foods you previously thought were bad for you based off a sham test that costs $450 that the desperate must pay out of pocket for.

Maybe you can start with just a little bit of the banned food and experiment to see if it actually gives you unpleasant symptoms.

Bottom line, these sorts of tests that give you extensive lists of foods to avoid beyond common allergens like soy, tree nuts, peanuts, dairy, wheat, fish, shellfish, and egg (for more info see foodallergy.org) should be given extra scrutiny and skepticism until proven by adding back in offending foods to see if they actually produce symptoms.  This is just called an elimination and reintroduction diet, and you don’t need a $450 test to try one.



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Why I List Out All My Credentials

The United States educational system allows you to pursue graduate degrees in many fields without the prerequisite background.  This is very true for degrees in the health sciences.  Typically, a master’s degree is about 36 credits and includes research-based coursework, which is often not practical to working with clients.

A master’s degree without a bachelor’s in the field lacks the comprehensive coursework and internship experiences required in a bachelor’s degree, which is usually around 120 credits.  While some of them are general education, most of the other coursework is coursework related to the degree.

Some master’s and doctoral programs require some prerequisites, but not all of them nor are they uniform.  The University of Texas, for example, does not require those with a master’s in kinesiology to have the bachelor’s degree.  Having done my master’s at UT, I would not say that it would qualify me to work in various areas of physical activity since it was such specialized knowledge in exercise physiology, a subject that is probably meaningless had you not had an undergraduate chock full of science to even understand the master’s.

I know what information was NOT in the master’s, so to be practicing without the undergraduate level work and experience required to get that degree is a problem with the educational system.  I also had to complete 3 internships at the undergraduate level for kinesiology.  To not list that against people who just have a master’s is to omit pertinent structured educational experience I have that others do not.  It is not to just list more letters off my name.

I adopted the UK’s manner of listing credentials because the British have it right in terms of recognizing that if you have a PhD, you may not have a bachelor’s and master’s in the subject.  If you have a master’s in a subject, you don’t always have a bachelor’s degree in it (especially in health and fitness).  “Practice in the UK varies from that in the US partly because it is designed to draw attention to the fact that not everybody who possesses a higher ranking award possesses lower ones as well.”

In my particular case, a nutritional sciences degree is NOT the same step-wise prerequisite that a dietetics degree is.  I had to go back to school after having a nutritional sciences degree for another 4 years to complete the dietetics coursework and 1200 hr internship, which is encompassed in the RD credential.  The coursework to become an RD is not 100% science, as my undergraduate education was mostly a pre-med degree.

Dietetics also includes classes on counseling individuals and educating groups, foodservice, community nutrition (WIC, government programs, etc.).  

Had I just had a dietetics degree, I wouldn’t list my other BS degree because it would be included in the RD credential.  The nutritional sciences curriculum at Penn State was a pre-med track with more advanced sciences required than the dietetics track.  Nutrition sciences had to take a more difficult organic chemistry, a microbiology with a lab instead of just lecture, organic chemistry lab, physics 1 and 2 each with a lab, and multiple levels of bio with labs including genetics and PCR.

Additionally, I took college-level anatomy and physiology in high school (and won the award for highest GPA in it at Strake Jesuit College Preparatory), physiology and exercise physiology as an undergraduate at PSU, and then multiple levels of physiology during my master’s, including being a preceptor for the undergraduate UT physiology course and leading study discussions.  Nutrition and fitness is a lot of human physiology.

On a side note, ask people who are “certified nutritionists” whether they had to pass high level sciences (and by pass, good luck getting into a dietetic internship with less than a 3.5 GPA).  You may get a quizzical look.  This is another reason why credentials are important in the nutrition and fitness field.  They won’t be able to stand their ground when it comes to tough questions on human physiology and nutrition.  No one has tested their knowledge and made them pass anything high stakes.

These sciences are a way to weed out people who think they know nutrition and human physiology for a reason.  Everyone thinks they are an expert these days, so it creates artificial competition against real practitioners.  I mean artificial because some people are not qualified to practice but there is no law prohibiting who can do nutrition counseling (or fitness) in Texas.

To think that people would pay people who are of these sham certifications baffles me.  I’ve been told before, “Your rates are too expensive.  I hired someone who charges $30.”  If you are willing to put your health into the hands of someone who only charges $30 an hour as a freelance professional to travel to your home, something is really fishy with that professional.

Even a massage costs 2-5 times that.  Psychotherapists charge 3-6 times that amount and people see them regularly.  $30 an hour doesn’t even pay for day-use office space in Austin among the other costs of being in business.  A small business must pay double taxes on their income as well.  About 50% of my clients only need one session to get them on the right foot, but those who visit more frequently have the best results, especially for weight loss, disordered eating, and eating disorders.

Back on credentials.

Master’s degrees are not uniform from school to school or subject to subject.  Sometimes other nutrition “professionals” just list a master’s degree after their name without saying what that degree is actually in.  If you aren’t listing what it is in these days, you are hiding something.  You should ask what their degree is in.  What if your nutritionist has a master’s in, say, computer science?  How does that relate to them being able to serve you?  Why are they listing it after their name on their nutrition services website?  What if their undergraduate was architecture?

One of the perks of being a credentialed healthcare provider through various health insurance companies is that it is a badge that the provider’s education is legitimate.  Insurance companies verify you actually have what you say you have.  It is a lengthy 3-4 month process for most private insurance except Medicare, which credentials faster within a month.

There are some in the fitness and nutrition field that say they have degrees when they do not.  No one is verifying their information.  This is a problem, so you SHOULD ask.  Anyone can practice fitness or nutrition counseling in Texas.  That’s the law.  They aren’t breaking any laws.  They just cannot call themselves a “licensed dietitian” or a “registered dietitian.”  Anyone can use the term “nutritionist.”  Registered dietitians can also call themselves “registered dietitian nutritionists,” which is also a protected term and credential.

Most personal trainers lack a kinesiology (or exercise science) degree.  Other fields require formal education before certification.  Personal training is backwards–they don’t even care if you have a degree when hiring at most gyms.  In fact, a degree is worth the same as a kettlebell or group exercise certification at most businesses that hire personal trainers in terms of pay rate increases.  This is utterly ridiculous, but it is true.

Now, let’s talk about this emerging field called “functional and integrative medicine.”  First, I am not trashing all practitioners of this field.  There are some people who know what they are doing.  Then there are the hippies who skipped and spurned all traditional education and now think they can practice at the same level as those of us with professional education.

It is one thing to go into functional and integrative (ie a new term for alternative, or non-evidence based) practice as a healthcare professional who has traditional credentials but also tries alternative therapies, and it is another thing to go into it with no professional education at all in the traditional sense and just do alternative therapies because you told yourself you are a badass.

It is another thing to go into the field, proclaim being at the same level, and have no academic background in the subject at all.  This is what a charlatan or quack is.  A charlatan uses marketing, emotions, and bells and whistles to appeal to those who believe that a traditionalist must not know anything at all.  I’m sorry if you had a bad experience with a traditionalist.  Sometimes even good practitioners are not on their game with 100% of their clients or patients all the time.  Maybe getting second opinions is what you need rather than one and blame the whole profession.

Is there more to practicing nutrition than knowing science?  Absolutely.  Good practitioners need to know how to ask the right questions, assess clients’ readiness to change, explore motivations, have good people and business skills, etc.  There is a lot of stuff going into the practice of nutrition than there is just pure science knowledge.  However, to consider all practitioners at the same level in spite of those of us who took the extra effort to actually know our field forward and backward before practicing is myopic!

Not many people get formal education in both nutrition and kinesiology and have a unique perspective of how they interact with experience in both fields.

Feel free to comment and share.



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Is Treadmill Running Bad for Your Knees?

Preface

I haven’t ever hurt myself or got knee pain from running on a treadmill.  I know a lot of people who scorn the treadmill as bad for your knees.  This post will discuss how I run on the treadmill.  It will also discuss how I see other people running on the treadmill as well as differences in gait on a treadmill compared to running not on a treadmill in the real world.

Another thing to mention before I get started is that I HAVE hurt myself running multiple times on flat ground outside.  There is gravel, uneven ground, tree roots, broken glass bottles, hard pavement, cars not looking for you, pollution, traffic lights, and DOWNHILL.

Downhill means even larger ground impact forces due to gravity because you have longer time for gravity to accelerate your feet into the ground due to different ground heights from when your foot leaves the ground to when it hits the ground again.

Don’t EVEN get me started about listening to music while running outside.  If you get hit by a car, that’s your fault!  Trail running might make that safer, I guess.

Joey Gochnour running shoes

They still are comfortable and don’t hurt my feet in spite of the wear and tear.

Suffice it to say, I have not sprained my ankle yet from running outside (trampoline is another story) despite all these terrain hazards, which also are part of the fun of running outside.  You get in touch with your primal self to avoid obstacles, which is a challenge in itself and a break from the gym monotony of running on the treadmill.

However, most of the time I run to accomplish whatever metabolic cardiovascular goal I have set for myself that week, and zoning out while running outside has been dangerous for me in the past.

The whole next two paragraphs are to get endurance athlete elitest jerks off my back about running on a treadmill.  This article is mostly for those who complain that running on a treadmill is bad for your knees.  If you are new to exercise, hang on, because we will get to the good stuff.

My speed will be either 7.1 if I’m doing a “moderate” cardio day, 8.5-9.0 if I’m doing an “intense” cardio day, and as fast as it can go if I am doing sprints (12.0 at my gym).

The purpose of me mentioning my speed is merely to show that I am not an amateur runner and have an above average VO2max at 63 mL/kg/min, measured during grad school on two occasions with the same result.  I no longer consider myself an endurance athlete compared to my training as a competitive swimmer from age 11-19, but I still do cardio now.

Now the good stuff

I turn the incline up to 3.5 when running.  This goes for all speeds.  My minimum incline is 3.5.  The reasoning for this is that walking uphill is less gravitational force impact on your knees per step compared to walking on zero incline.

I personally don’t find lower inclines to be enough for me, but anything above 0.0 incline should be less impact force on your joints.  If you think 3.5 is too much, start with more incline than 0.0, even if that is 0.5.

The incline setting means that at 3.5, I get a vertical ascent of 3.5 feet for every 100 feet I walk horizontally.  It is a 3.5 percent incline.  It’s really not that big of a deal in terms of difficulty, but it makes a huge difference on ground impact forces per step taken.  Multiply the number of steps you would take on the treadmill, and you are saving a lot of force on your knees.

Most gym treadmills will have some cushion or give.  This should lessen the force on your joints even more.

Last, I land heel to toe.  When my heel lands, I am already pulling backward with my hamstrings and gluts.  I am not pushing into the ground forward through my quadriceps.

If you are pushing with your quadriceps, that’s putting an acute forward force on your knee while the belt is going backwards.  It’s basically going to aggravate those ligaments in your knee that resist shear forces.  That’s a great way to give yourself knee pain.

I think it is very important to emphasize hamstring contraction to pull your foot back ASAP when on a treadmill because the belt is moving backward.  When you are on flat ground outside, you have more time to contract that hamstring since the ground isn’t moving and you are more aware of the ground.  Don’t let the belt do the work for you either.

Finally, I don’t land heavy.  If you can hear loud thuds when you run (you’re stomping), you’re releasing a lot of sound energy from impact forces.  It is inefficient use of force.  It’s probably not good for you.  It’s also annoying for everyone else at the gym.

It is a sign you are half-assing your gait and landing heavy because it’s too much effort for you to protect your knee and hip joints with the muscles surrounding them to cushion each footfall.  If you are this person, no shade, but you probably don’t know you’re doing it or realize it is tough on your body.

Joey Gochnour, registered dietitian nutritionist and certified personal trainer in Austin, TX

No Shade

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The Future of Inactivity Gaming Leisure: Virtual Reality MMORPGs & FPS

Background

As some of you may or may not know, I have alluded to the fact that I have a history of being a gamer.  A pretty hardcore gamer.  One semester at Penn State, I raided in classic (vanilla) WoW (World of Warcraft) as a human female frost mage against Ragnarok (a fire elemental that takes up your whole screen), and Nefarian, a big mean dragon.  My guild, Ambient Darkness, was stuck on Vael for longer than the even more hardcore guilds.

I had 5/8 Arcanist, and 3/8 Netherwind sets.  I was pretty decked out for the time.  I got to a 2000 arena rating in 2v2 as rogue and mage team (with a 14-year-old, when I was 20).  No idea what happened to that Canadian kid who was my rogue partner.  I’m still friends with the tank of my guild though, and it is 9 years later.  I’ve even met some of them in real life (irl).

These bosses took 40 players, which in retrospect, is something you should put on your resume as being something difficult to coordinate, recruit skilled individuals, participate in your role, and agree to split loot up fairly.  My parents did not understand these valuable skills that gaming teaches, nor do most employers who are run by non-gamers.

It remains off my resume, unfortunately, among other valuable experiences that are not recognized in the workforce as skills being acquired from legit sources.

Since WoW, I have played Aion Online, Diablo 3 (and I grew up with 1 and 2), and Guild Wars 2.  I always play some sort of mage, sorcerer, or mesmer, not for the nukes but for the crowd control and cool spell effects.  None of them had a pointy hat like Mickey Mouse got.

My Prediction–Gaming Will Be Less Sedentary

Part of the criticism of gaming is that it is antisocial, sedentary, and people take energy supplements and eat hot pockets, sammiches (sandwiches), Ramen, and soda instead of eating well balanced meals in the right amounts.

I can tell you that it is entirely possible to eat balanced meals, exercise, and maintain a healthy work-life balance as a gamer.  It also is only antisocial if you make it that way.  Many gamers are using some form of voice chat with each other.

I may have struggled with learning that work-play balance at one point, but I got through it.  Sometimes the struggle has nothing to do with the gaming, either.  Rather, gaming is just such a fun diversion that you forget about other things that are supposed to be important that you are avoiding on purpose.

If you’ve ever seen Pan’s Labyrinth, you will know what I’m talking about.  The girl creates a world of myth to avoid the emotionally unlivable reality of the war.  Perhaps you can relate to gaming being an avenue of escape, in that respect.

Smilodon Gaming Rig

Smilodon

Anyhow, with the way things are going in technology, I predict that gaming will be much more physically active as virtual reality comes to the home.  As the prices come down on this equipment, it will be much more available.  People will be able to enjoy lightning-fast internet speeds with Google Fiber, as well.

Imagine an MMORPG (massively multiplayer, online role playing game) or FPS (first person shooter) where you actually have to not be sitting down in order to effectively interact with your environment.

Currently, motivation is a HUGE barrier for physical activity.  Some people are not motivated by sexy abs, selfies, muscles, or their own health or a certain level of health they must maintain in order to be around for loved ones.

Some people are motivated by phat l00t (spelled with zeros).  If that means that you get up and move around during gaming, swing your arms in order to swing a sword, cast a spell, or shoot arrows from your bow, then people will be MUCH less inactive.  Additionally, they will have to make a choice to eat food mindlessly or actually succeed in the game to achieve their goals.

Once this type of MMORPG or FPS becomes mainstream, traditional MMORPGs will start to look like classic Mario, Pong, or Sonic the Hedgehog.  The next generation will wonder how we spent so much time in a seated position during our anxiety attacks that we are going to get shot if we round the next corner or that we’re out of mana after our partner dies in 2v2 while our opponent still has some.

It is up to the current game developers to create this type of environment.  My one suggestion is to not make the motions repetitive.  I would hate to see overuse injuries crop up in people due to casting fireball too many times or swinging their sword the same way.

If you like this post, please comment, share, and subscribe.  I mostly write on health, fitness, nutrition, and lifestyle.  I also do in-person and online nutrition counseling services.



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New Balance Training Technique–Spatial Sensory Parallax

I thought I’d share this experience with those who may benefit.

In case you don’t know, I personal train as an employee for about 15-25 hrs a week at the University of Texas at Austin department called RecSports.  I work with faculty, staff, students, grad students, UT community members, friends, family, and others who decide to join this gym for other reasons, such as convenience.

The facility is very nice compared to most gyms in Austin, and it is one of the few that actually has a pool and no shortage of very educated pretty people to look at, if that helps motivate you to get to the gym. 🙂

Anyway, today I was working with a client who has had a lot of trouble with balance and coordination.  One new technique I tried with her was to take a 5 lb weight and hold it outside of the body, experimenting with the area you are balancing into vs the limb off the ground.  We found that she has NIGHT AND DAY differences in her ability to balance when holding the weight outside of her body in the direction she is off balance.

For example, when walking up or down steps, your center of mass is tilted forward, so you hold the weight forward in front of you.  When walking sideways, your center of mass is tilted toward the direction you are going, so hold the weight out to your side.

We experimented with a number of different permutations on this concept, and she can balance SO much better now.  It was amazing enough that I HAD to blog on it!

I was never taught this technique in school or in any certification, so if this technique is already out there and being used, I guess I just stumbled upon it in a moment of creativity.  If it isn’t used, I highly recommend giving it a try if you are a physical therapist or other individual who wants to work on improving your balance and neuromuscular coordination.

My theory on how it works is that it forces your motor planning centers in your brain to reevaluate movement patterns by sending different rates of impulses down your motor neurons and to reevaluate the feedback coming back from sensory neurons.  The reevaluation teaches you how to move with more ease and builds confidence in that movement pattern.  This information is integrated and processed into new and improved movement ability.

Another metaphor for how this works would be similar to how astronomers detect distance from the stars using parallax.  They look at the star when the earth is in one position around the sun, such as during winter in their geographic location. Then, they look at the star again during summer when the earth is on the other side of the sun.  These two perspectives can give new insight as to distances, assuming a fixed object.

Similarly, I would call this a sensory experience that is much like parallax.  A parallax spatial sensory experience, if you will.  You experience imbalance without the weight, and then you experience imbalance with the weight.  Your body can coordinate the nerves to fire in appropriate fashion to make sure your limbs are where your brain actually thinks they are.  This should result in improved balance through improved neuromuscular precision and control.

Anatomically, balance training involves the cerebellum coordinating neuron firing patterns, among other areas of the brain and ears.

Holding the weight outside of the body shifts your center of mass, which challenges this neural system in your body to adapt to new and different stimuli.

My neuroscience and neuroanatomy teachers would be so proud of me 🙂

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Calorie Burn Estimates for Foods, on Fitbit, and Exercise Equipment are Deceptive

I would just like to say that I find calorie burn information deceptive and ineffective, bordering on misinformation, considering it is an estimate off an equation even if you are hooked up to a VO2/CO2 analyzer.

It’s like telling everyone to get on a 2000 calorie diet–assigning a specific number to a generic, abstract idea.  These ‘burn’ numbers aren’t exact at all.  For example, in this National Heart Lung and Blood Institute slide show, it says you can “walk leisurely for 1 hour and 10 minutes to burn 400 calories based on a 160 lb person.”

Does that differentiate between what you would have used in an hour and 10 minutes without exercising at all? Does this 160 lb person have 130 lbs of lean mass (18.75% body fat) or 145 lbs of lean mass (9.4% body fat)?

The leaner person can use more calories during exercise because they can exercise more intensely.  At a given pace though, they may burn fewer calories than the not-so-lean person because they are more efficient at that given pace.

Different people use calories differently, nor does exercise “burn calories” as much as it “increases caloric needs,” and is highly dependent on the amount of muscle mass and intensity the person can perform said exercise efficiently.  As I have blogged about before (Diet or Exercise posts), exercise alone is NOT an effective way to lose weight.  Great for maintaining weight though.

I’ve worked with people on the physical training side of things long enough to know that people don’t lose any weight (actually they gain weight) with exercise alone independent of diet changes, especially when people are struggling to reach the recommended 150 minutes a week goal for aerobic exercise, based on the Physical Activity Guidelines for Americans.

Is the take home from this sort of message: “Heck, I guess I can’t eat that because I sure won’t ever exercise that much!”?  If that’s the message they are trying to give, then ok, but I think many RDs give out the message of “How does this food fit in your overall eating plan?”  I think bringing in the exercise component based on wishy-washy calorie numbers just confuses people nor is it accurate.



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Video: How to Low and High Row, Fitness on the Forty Acres, Healthy Horns

Fitness series managed and edited by David Robbins, a kinesiology graduate who was kind enough to feature me in this video on low and high row on a Hammer Strength brand machine at the Recreational Sports Center at the University of Texas at Austin.

 



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Video: Overhead Press, Healthy Horns, Fitness on the Forty Acres

Video series managed and edited by David Robbins, a UT kinesiology graduate, who kindly featured me as expert on the subject.

Great compound exercise for the shoulders.

 



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Video: How to Squat–Healthy Horns, Fitness on the Forty Acres

The University Health Services of University of Texas at Austin did a fitness video series for Fitness on the Forty Acres, managed by David Robbins, a kinesiology graduate who helped organize the series. He was nice enough to feature me as expert.

 



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Calories Per Mouthful–Rehash Serving Sizes

Serving sizes.  Arbitrary quantities of food we can measure out to determine the nutrition within a set volume or mass of food.  These work great for people who are analytical and thinking types.  What about for the rest of the population?

I believe in multiple intelligences.  Some people are adept at verbal communication, some are skilled at math and science, some are better at creating new ideas, some are better at organizing, and some are better at learning new ways to move their body through physical space and time such as in athletics.

Not everyone is good at everything.  A person could be really, really bad at catching a ball and doing well in science class but one of the best writers or orators in the world.  They should not be penalized in life for not getting a nutrition label.

Nutrition Facts labels teach to math and science types because they are created by math and science types.  Analytic people.

Nutrition information on serving sizes is only given in one way: via the nutrition facts label on the side of a package.  Other than this, most people do not encounter nutrition information unless you seek it out on TV, the Internet, are the type of person who learns by experimenting on yourself, or you took nutrition in university.  Most high schools don’t teach it in health class.

The side of the nutrition package sometimes gives nutrition information in misleading and unrealistic amounts.  For example, who is really just going to have 1 graham cracker unless mom gives it to the kids in that quantity so it doesn’t spoil their appetite for dinner.  While a serving size is 5 prunes on the side of many brands of prune containers, many people believe that having more than one or two will cause too much bowel motility.

Whether or not this is true, the point is that sometimes you eat more or less than the side of the package considers 1 serving.

Analytic people can do the math in what they ate and convert that into the respective amount of calories, protein, carbohydrate, fat, and fiber.  These same people probably have a food scale that can measure food quantities when the side of the package declares a serving size in grams.

Serving sizes in grams are GREAT for analytic people.  You know exactly how much you get.  Grams make no sense to everyone else in the country, especially the US that doesn’t even use grams as a unit of measure.  People who live in the US are not raised with the metric system or grow up with an intuitive sense of how much a gram, kilogram, or milligram is like those in other countries.

Perhaps this is a small contributor to one of the MANY contributing factors to nutrition confusion in the US.  Sodium is listed in milligrams, for example.

Speaking to the original topic of this post, I propose alternative educational systems that need to be developed that speak to non-analytic people’s strengths in learning.

For example, why can’t nutrition information be listed in units like “Calories per mouthful”?  While a “mouthful” probably really irritates the logical, analytical people in that it is imprecise, it is not THAT imprecise.

It wouldn’t be useless and could be a much better educational tool than expecting non-analytical people to understand what a calorie is, considering the lack of basic nutrition education most people get in the US and the lack of educated nutrition professionals to be able to teach everyone this information efficiently.

(A calorie is basically a point system your body gets to maintain, lose, or gain weight as well as provide energy for activity.  Fat gets 9 points, carbs and protein get 4 points, and alcohol gets 7 points per “gram” according to the system.)

Some registered dietitians teach the intuitive eating concept, ie stopping when full and eating when hungry.  I use this technique for some clients as well.  It is much easier for some people to grasp than the math required with nutrition labels and serving sizes.  Portion/helping sizes are often not the same as a serving size.

A mouthful of pure fat would pack on pounds much faster than a mouthful of protein or carbohydrate, mathematically and bite for bite, but they all have different satiety factors.  Whether or not my idea of a mouthful being a serving size is a good idea or not, the point of this post is that nutrition labels tend to only help analytic people and not the rest.

There needs to be other ways for people to understand nutrition information that do not use math and science.



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What I Like and Dislike about MyPlate

choosemyplate.gov

Nutrition Education Tool 2011

Most people I discuss nutrition with have heard of the Food Guide Pyramid, possibly MyPyramid, but even fewer have heard about MyPlate, which is the current national nutrition education tool for general population nutrition guidance.  This post discusses my criticism of MyPlate after a brief criticism of the other nutrition teaching tools.

Eleven Grains a Day, What?!

Nutrition Education Tool 1992 Eleven Grains a Day while I sit at my desk, lolwut!

The Food Guide Pyramid was criticized for overemphasizing grains and not putting enough emphasis on fats, among other things.  It also had a hierarchy of importance of food groups, even though clearly protein and vegetables probably should be higher up on that hierarchy.  That said, all food groups are important for their own reasons.

MyPyramid attempted to divide the base of the pyramid into all food groups and had a base of physical activity as well, showing that all food groups are important.  A criticism of MyPyramid was that it was too hard to understand.

Nutrition Education Tool 2005

All food groups are important, but this image was too hard and too busy to understand for most. If you get to the top of the pyramid, I guess you get less food.

MyPlate came out in 2011.  It was set on a plate, which was supposed to make it easy for people to understand since most people eat off of a plate.  While I personally eat all of my meals out of bowls, plates are still easy to understand and can be thought of more as a pie chart.  Most people understand pie charts.  This is a good part about the current educational model.

MyPlate emphasizes vegetables and is the first teaching model to recognize that you just need “protein,” not necessarily meat, which accomodates vegetarian eating.

What I dislike about MyPlate is that there is no mention of healthy fats on there.  Where do the nuts and seeds go?  I guess in the protein spot.  I always point this out to my clients who don’t need a lot of carbohydrate in their diet due to low activity.  I also think that MyPlate makes you think you need a fruit at every meal, which I do not promote.  If you want to fit a fruit in every meal, you can, but I don’t think it is necessary.

MyPlate mentions dairy as the source of calcium in your diet.  While I have nothing against dairy and promote it as a great way to get high quality protein, vitamins, and minerals, you could just have soymilk, almond milk, or plenty of vegetables that provide calcium.  No one is forcing you to have dairy.  However, if you do have almond milk, realize you’re not getting protein and are basically having a fat-sugar fortified beverage.  If you can fit that in your diet, then enjoy.  (diet used loosely as eating habits)

MyPlate doesn’t work very well for certain segments of the population.  For athletes, for example, I decrease the size of the vegetables portion to increase the size of the grains portion.  Yes, you Paleo fans can make MyPlate work if you use potatoes and sweet potatoes, but not everyone is going to go Paleo, ok?  🙂  For weight loss clients, I sometimes decrease the size of the grains part of the plate to enlarge the vegetables part.  For some people who eat tons of fruit who have certain goals, I may decrease the size of that for them.

Harvard Nutrition Education Tool

Harvard’s attempt to compete with the government recommendations. Drab and requires IQ over 100.

The Harvard Plate shows that calcium doesn’t have to come from dairy, and it also cautions against getting too much calcium due to association studies for higher morbidity risks, such as elevated risk of prostate cancer in men.  The evidence is far from conclusive on that, so I caution even mentioning it.

Harvard also puts oils under nuts and seeds, which is interesting considering oils are processed from nuts and seeds.  Which is a more nutrient-dense source of unsaturated fat?  Nuts and seeds.  Vegetables and fruits are grouped together.  Someone could run with that and not eat vegetables then.  Fruits and vegetables were not created equal.  There is too much going on in this pyramid to critique it all in this blog post.  In short, it isn’t perfect either.

When I work with clients, I tailor a message to them.  I may reference MyPlate to jump start a conversation, but I actually use a different teaching method, one I developed myself, that I feel is more effective for clients.  If you’re interested, you’ll just have to book an appointment with me to learn about that 🙂

Please comment and share!



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Paradigm Shift: Weight Regained After Dieting Is Not Failure

I am often surprised by the number of people who claim that diets don’t work.  Perhaps there is a miscommunication on what they mean by that.  If anyone would clarify that for me in the comments, I would love to have a discussion on that.

All diets work.  You will lose weight if you change what you are eating to something with fewer calories.  All diets are rules of eating that get you to change what you are doing from an eating standpoint so as to consume fewer calories in the end than before.  Whether you want to do it with a fancy sounding trending word like a “cleanse,” a “detox,” or “paleo,” or if you want to add fasting into it (such as intermittent fasting), or if you want to do it less radically, the diet will work.  At the end of the week, you ate fewer calories than you did last week.

Not all diets are created equal.  When cutting calories, it is more important to make sure that the calories left that you ARE eating are actually doing something for your health.  You want them to be highly nutrient dense per calorie.  Otherwise, theoretically, you could deplete yourself of some nutrients and develop malnutrition during the process.  Then, how healthy will that diet actually be for you?  If you deplete yourself of nutrients involved in energy metabolism, maybe your body won’t want to lose weight as efficiently at that point.  It’s possible.

This is why it is important to work with someone who knows how nutrients affect your physiology so as to recommend diets that are healthy.  Shameless plug here for registered dietitians, a medically recognized profession that works with nutrition on a daily basis.  These are people to consult if you are planning on changing your eating habits for a goal.  Anyone can call himself or herself a nutritionist and set up shop.

To the main point of this article, however, a criticism of diets is that people gain the weight back.

My response to this?  So what?  Hear me out:

You still lost the weight for some time and learned from the experience.  This isn’t an all or none success thing.  Let’s not throw the baby out with the bathwater.  Diet failure is a highly pessimistic view of the experience.

Yes, it is important to view nutrition changes as things you should accept as long-term, but let’s say you are overweight or obese enough that it affects your ability to perform exercise at a level that you need to maintain your weight.  You will HAVE to go on a diet until you reach a weight at which you can start working out intensely without it killing your joints.

People who say that diets don’t work or that they fail do not understand the behaviors you must do to maintain your weight after you lost it.  The great part about finishing a diet is that you get to eat more food.  You also get to start working out more/harder because you have more energy from all that food you are now eating.

People who regain ALL their weight after a weight loss experience tend to not be progressing in their fitness level while going back to the habits and mindset that brought them to their original weight.  Weight loss requires cognitive restructuring of thoughts on how you view food and your relationship with it.  This is why cognitive behavioral therapy should be a part of the process.  The awesome part about exercise and fitness is that it is EXCELLENT for helping you maintain your weight post weight loss even if the way you view food psychologically hasn’t changed completely.

weight loss maintenance with exercise post diet

Exercise is excellent for maintaining weight lost post-diet.

You know when people plateau with exercise?  Their body has adapted to the stimulus.  This means that their body requires fewer calories during exercise and recovery because there is less breakdown of existing body tissue from that exercise because they are performing it more skillfully.  To get out of that plateau, you have to increase the intensity and get better at what you are doing by adding weight or reps so as to reach an eventual ultimate plateau where your hunger matches your energy expenditure–ie you are able to workout at a level that allows you to eat what you want.  This is the “nirvana” or “enlightenment” of nutrition and fitness, your ultimate goal of having maximized your physical fitness capacity while being at peace with the food required for that body.

If you DO regain all your weight back post diet and made good effort with progression in exercise, then you will just have to diet again and figure out what you were doing last time that didn’t work.  If you think about times of surplus and famine in history, dieting has happened for a long time.   There are times of the year you will be heavier and times you will be lighter.  There is always something you can do about it, so seriously, let’s just not say dumb things like “dieting doesn’t work” anymore.  At least be more articulate about what you really mean.

I get angry when I hear the idea that regained weight means it is a failure, which is stated even in scientific literature.  Yea, if you resume eating exactly like you did before without a change in your exercise habits, of course you will gain all your weight back.  That doesn’t mean the diet didn’t work.  It means you didn’t change the way you view and use food in respect to your activity and lifestyle.  Psychology is a huge part of the process.  Are you adaptable, and do you have grit?

You’re not going to get the weight off though initially without some form of a diet unless you are ok with extremely slow progress.  It is currently thought that achieving weight loss progress quickly builds adherence to the program (link to PDF).

So in short, dieting DOES work, and exercise is what you must progress with after dieting in order to maintain your weight.  Don’t use exercise as a means for weight loss because that doesn’t work, as shown in previous posts.  Use it to maintain your new weight!

Please comment and share!  If you would like to work with me personally, send me an email.

Edit: This article was featured on CureJoy on 02/24/15.  I encourage you to check out their site.  Disclosure: I do not have any financial or other incentive through the company.



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Calorie Recommendations, Dieting, and Exercise

Preface

When you’re trying to lose weight, how many calories is too low?  This question seems simple up front, but upon researching for “the correct” answer, I found that it comes down to what is called “clinical judgement.”

There are a variety of ways to assess how many calories you should be eating, called calorimetry, the measurement of calories.  The current best way to find it during one point in time is indirect calorimetry, where an estimate is taken based off of carbon dioxide to oxygen ratio per gas volume.  Direct calorimetry, or where changes in heat are observed in a closed environment, is not practical for humans.

Without indirect calorimetry, the next best way is to look at what you typically eat for a long period of time and find the average caloric intake from food journaling.  Food journaling is one of the best ways to assess your diet and look at what is working and what isn’t and serves a number of purposes beyond just finding the calories you typically eat.

Unless you walk around with an indirect calorimeter on all the time, the device is only so useful because it only looks at your needs based off of one data point in time.

Then we are left with predictive equations like the Mifflin-St. Jeor equation, which is the current most popular equation for predictive energy needs (1, 2).  These give you an estimate for your resting metabolism.  Then you must add an estimate of energy expenditure based on your activity, which honestly is an educated guess.

Predictive equations are great for a population but may not be as accurate for any particular individual.  You can assess your caloric intake on this website or use any online calculator you want.

What is Formally Recommended for Weight Loss

The simple answer is this one-size fits all calorie recommendation found in the Evidence Analysis Library (EAL) of the Academy of Nutrition and Dietetics.  For women, 1200-1500 Calories are recommended for weight loss along with physical activity.  For men, 1500-1800 Calories are recommended for weight loss along with physical activity.

Having completed the Commission on Dietetic Registration’s Self-Study Module for Adult Weight Management, as well as having seen evidence of this during my master’s and seen this in the EAL, we know that exercise is not an effective way to lose weight from a physiological standpoint.  Perhaps from a psychological or sociological standpoint, exercise is helpful because of reinforcement of good habits, including dietary habits.

Granted, we all know someone who has lost some weight with exercise, but having not followed them around to see how exercising changed their diet habits, I am still skeptical.  Some of my clients are very sure that they have lost weight with exercise alone and no diet change, so perhaps the research isn’t as sensitive to this or the particular people it has that effect on.

Exercise calorie deficits vary widely depending on how fit you are and what you do.  It is possible that some populations may be able to achieve weight loss from exercise, but it is a small percentage in the big picture, according to the research.

Below is a graph from some pooled evidence on whether diet or exercise is more effective for weight loss.  Notice how old the study is, yet people are still trying to exercise off their weight.

Diet beats exercise on weight loss

Not a significant difference on weight loss with diet vs diet and exercise.

Very Low Calorie Diets (VLCDs)

According to the 2009 Position Paper of the Academy of Nutrition and Dietetics on Weight Management, a very low energy (calorie = energy) diet (VLCD henceforth), is defined as “800 Calories (or 6-10 kcal/kg) or less per day” and is typically in the form of liquid meal replacement supplements that are fortified with 100% of vitamin and mineral needs.

These are prescribed under the supervision of an MD for people who are obese by BMI or overweight with comorbidities (like diabetes, cardiovascular disease, etc.).  They are supposed to result in rapid weight loss and can help provide encouragement to individuals with the fast results.  They are not recommended without a healthcare professional’s supervision because you REALLY have to make sure you make your calories count in terms of maximizing the nutrition density per calorie.

Some nutrients are of concern.  When you are not consuming a lot of food, electrolytes such as sodium and potassium, which aid in nerve impulse conduction and heart contractions (mainly calcium) can lead to heart arrhythmias.  Gallstone formation is another complication possibly due to less fat in the diet, and bile can concentrate with less gall bladder contractions.

If you are 250 lbs, a VLCD could be as low as 682 Calories or as high as 1136 Calories.  The 800 Calorie number is open to clinical judgment.  If you are 140 lbs, a VLCD could be as low as 382 Calories or as high as 636 Calories.  That said, you probably would not need to be on a VLCD at 140 lbs.

Since a VLCD starts at 800 Calories and requires medical supervision, beware of any diet that asks you to go to 800 or below calories.  The cabbage soup diet is a medically unsupervised, VLCD that does not provide the array of nutrients for meeting nutrition needs, yet people go on it often considering how popular it is.  I haven’t heard of anyone dying on it, but if you have, please let me know in the comments.

The calorie range of 800-1200 Calories seems to be a range of numbers where not much guidance is given in terms of recommendations for healthcare practitioners.  Many physicians fear going below 1200 Calories with patients, but unfortunately, some people just won’t lose weight at that level of calories.

That said, physician education on nutrition is limited to an elective or two during medical school, should they decide to take it and is not standardized across medical schools.  “On average, [medical] students received 23.9 contact hours of nutrition instruction during medical school (range: 2–70 h).”  So asking your doctor how many calories you need may not be the right question unless they actually studied nutrition.

Does this mean a recommendation of 850 Calories is too low?  It isn’t a VLCD, by definition, and would not require physician supervision.  It depends on who is recommending it and for whom.  A smaller person needs fewer calories than a larger person, so 850 may be very low for someone very large while it may be just low calories for someone smaller.

Registered dietitians are trained to make sure the calories count in your diet to avoid health risks while dieting.  Most of us will not even recommend something that low unless the patient has unsuccessfully tried other levels.

Summary

The take away from all this is that figuring out how many calories you need takes some effort.  We can estimate with equations and calorimetry.  Food journaling is the best way to figure out how to make changes to your diet and see where you can improve.

Very low calorie diets (VLCDs) are generally considered to start at 800 Calories and are not recommended unless you are speaking with someone who studied nutrition and have worked with them unsuccessfully trying other less extreme approaches.

Exercise is not considered a good way to lose weight unless it makes you make better food choices.  It will make you fitter and healthier though so should be encouraged.

If you like this post, please comment and share.  If you don’t like this post, please let me know why in the comments.



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Mind-Body Foods and Health: Alcohol, Chocolate, Tea

According to research, drinking moderately may reduce risk of disease and mortality.  This week, it is linked to a reduced risk of heart failure.  Not drinking or drinking too much is supposed to be worse than moderate drinking in terms of risk of disease.  This is often shown in association studies (observational studies).  Not cause and effect studies.

Chocolate is also supposed to be good for you.  Scientific opinion states that 200 mg daily has a cause-effect relationship on endothelial cell-dependent vasodilation (widening) of blood vessels.  Observational studies show it can affect memory, heart disease, stroke, and cholesterol levels.

Drinking tea has been associated with anticancer properties and blood pressure reduction.

I have issues with all of these topics, so this post is going to give you my personal opinion on all of them.

I stay up to date reading the news releases of the latest studies through various channels.  It can sometimes take me 2-3 hours a day to get through it all.  Combine this with my nine years of nutrition and exercise education and training as well as professional practice, I have developed some pretty opinionated thoughts when I hear news on alcohol being good for you or chocolate being good for you.

Here’re my thoughts on these topics:

Alcohol

Nutrition biochemistry says that alcohol can impair B-vitamin absorption and enhance pro-oxidant absorption since it messes with the integrity of the epithelium of the intestines.  Alcoholics are often deficient in thiamine, which is vitamin B1.  Pro-oxidants are the opposite of antioxidants.  One gives an electron and the other receives an electron.

Alcohol forces the liver to detoxify it immediately.  This is one of the few cases I will actually use the word ‘detox’ because it is appropriately used.

Alcohol is empty calories.  It does absolutely no good for your body as a chemical itself.  It is not a necessary nutrient.  It probably isn’t helping you control your weight.  Yet we make it harder on ourselves because some consider you weird if you don’t drink alcohol.

People can become alcoholics from alcohol.  It is used as a way to deal with their issues.  This is so common it is shown in movies and on TV.  You can get withdrawal from it.  It can cause liver cirrhosis, or liver scarring.

Because 71% of people drink alcohol, it is expected in most social gatherings.  It is a socially acceptable drug to use publicly.  Conversely, it is often perceived as socially unacceptable to not be drinking alcohol.

So, with all these things we know about how negative alcohol is to humans, SOMEHOW the studies show that moderate drinking could be good for us, NOT drinking is bad for us, and drinking too much is very bad for us.  There is a J-curve with alcohol consumption.  How does this add up?

The explanation I assert is that it isn’t the alcohol that is making people healthier.  It is the socialization, which is not controlled for in observational (association) studies because MOST people drink with other people at dinner parties or out on the town.

Think about it.  People who drink are out on the town having fun.  Being out on the town involves walking, which is physical activity that counts.  They aren’t depressed and sitting at home being sedentary.  Depressed and sitting at home is often associated with other negative behaviors in itself, such as overeating or drinking alone, and feeling left out.

People who don’t drink can feel pressured to defend their abstinence in social situations, depending on the person.  It can make for a very uncomfortable social experience to be assailed with questions on why someone isn’t drinking when being out.  A Google search of “why is not drinking weird” brings up many posts that can explain the mentality of those who choose not to drink and how it affects their life and other people’s perceptions of it.  Ovik Banerjee wrote a nice post on not drinking’s downstream social effects that got some great comments.

Having fun, laughing, and bonding with others relaxes blood vessels on its own because stress is low so the nervous system is less likely to be constricting your blood vessels.

Perhaps the small amount of alcohol that people feel is necessary for them to have in order to have fun, laugh, and bond with others doesn’t negatively outweigh the benefits of having fun, laughing, and bonding with others.  It may not outweigh the excitement of meeting someone new, being on a date, or being with people you like.

Alcohol is supposed to ward off cognitive decline, magically somehow.  I say this is because people who are drinking alcohol are socializing, which is actually a complex phenomenon of listening to other people, interpreting what they say, reflecting on it based on your own experience, and responding with empathy.  The alternative, sitting alone home by yourself, is probably associated with depression and boredom, which are not very stimulating states compared to socializing.  In my opinion, cognitive decline follows the ‘use it or lose it’ mantra.

People who don’t drink at all are missing out on the benefits of having fun, laughing, and bonding with others, but they also aren’t getting the negative effects of alcohol either.  After all, it does destroy the integrity of your intestinal mucosa and inhibit ion channels in nerve cells, which leads you to the popular mental effects of drinking alcohol.

People who binge drink, you know, those who in college are holding each others hair over the toilet or being propped up on their sides so as to not die in their own vomit, have the worst health effects.  Maybe they are drinking too much because they have other issues they are escaping, trying to fit in too hard, or just hate themselves and take it out on their bodies.

Chocolate

Most people know that it is dark chocolate that is supposed to be better than milk chocolate because it has a higher percentage of cocoa.  Well if that’s the case, then why don’t we just all save some money, leave the candy aisle, and just go to the cooking aisle and buy pure cocoa powder and start using it?

Oh right, it doesn’t taste that good by itself without all the fat and sugar surrounding the cocoa that makes what we know chocolate.  Milk chocolate tastes way better.  Let’s not kid ourselves.

Because I’m scientific and experiment sometimes, I have been purchasing cocoa powder from the cooking aisle ever since I heard about the benefits of chocolate.  I didn’t see the need to get all the extra saturated fat and empty sugar calories from having the candy form because, personally, I don’t need that stuff.  Maybe you do, but I don’t.

Based on the article linked above on the observational benefits of chocolate, I might experience lower cholesterol, heart disease, stroke, memory decline, and relaxation of blood vessels.  I had been adding it to my porridge in the morning, which makes it change color and look like chocolate porridge.  It is an…acquired taste…one that I actually enjoy after doing it for a while.

That said, I honestly don’t think it is doing much for my physiology.  Part of this reason is because I don’t derive the same sense of subjective relaxation and joy most people associate with chocolate, which can lead to the cardiovascular and memory benefits.

Some women say that chocolate stimulates the same area in their brain as sex.  Well, for me, I am not experiencing any orgasm from my cocoa powder in my porridge.  Therefore, it probably isn’t having the same effect on my brain and blood vessels as people who subjectively experience pure, better-than-sex bliss from eating this food.

This gets me to the subject of subjective experience from food.  There are people who will read a study or news release and make a behavior change based upon that study.  If chocolate is found to be good for you, they will start eating it because of the possible, yet mechanism unexplained, health benefits.  They will eat it like medicine.

I have worked with clients like this and probably am this type of person.  These types like to eat chocolate daily because the news releases have said that it is good for you.  Maybe it is good for THEM.  I’m not denying that.  But if you really don’t enjoy eating it, it probably is not giving you the health benefits the article says because people experience food differently.

The same thing goes for tea.

Tea

Compare the experience someone has who enjoys drinking tea vs drinking tea for the health benefits.

Having tea involves taking time out from your day to make the tea, wait for it to cool (or scald your mouth, whichever you do), and slowly sip it while reciting whatever pleasant mantra you have in your mind that relaxes you.  I choose “serenity now.”  Tea is an experience that promotes the flow of chi.  I imagine hearing the rolling waves of the ocean and the pleasant sound of water flowing while pouring tea into my self-crafted colorful pottery mug with its appropriately matching saucer.  Miraculously, I do not have to pee with all these water sounds.  I am spiritually centered and feeling warm zen as I slowly consume my hot water flavored with the leaves of the Camellia sinensis plant.

Now let’s look at another situation.

I boiled or microwaved water and poured it into my tea-stained reused white mug that has a tea bag that I purchased because it has health benefits.  I make sure the water is hot enough to disinfect any bacteria from the last time I used it.  Later, I forgot I poured the tea only come back to it two hours later in a rush as I’m leaving the house, so I quaff down the whole cup of flavored cool water.  It is kind of gross at this point, but I drink it anyway because it is good for me.

Which situation do you think lowered your blood pressure?  Obviously quaffing the stuff down as fast as possible in a rush out the door probably won’t have the same health benefits as sipping soothing flavored water slowly.

I can’t speak to the anticancer effects.  Maybe both situations benefit from just having the phytochemicals in tea.  Many health behaviors and foods are associated with a reduced risk of cancer, but there is not strong enough evidence to say that doing these things all the time will completely prevent cancer.  I would think that scalding your mouth with the tea may increase the risk of mouth cancer due to the turnover of epithelial cells in your mouth, but I can’t say for sure.

Summary

Sometimes the food itself has nothing to do with the reported health benefits associated with a food.  Perhaps some health benefits are chemically related to the foods themselves in some cases, but when association studies come out to promote certain foods, I like to examine things in contexts that people often don’t think about.

Alcohol, tea, and chocolate are good examples of the point that certain foods can have subjective effects on the mind that can confer health benefits for some people.  Others who do not get the same subjective experience from these foods are not weird but socially ostracized, which can have negative health effects if care is not taken to rationalize the whole situation and find other ways to achieve the health benefits.

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My Recent Weight Loss Experience: Part 1

In an effort to become a better personal trainer and registered dietitian, I decided to embark upon a weight loss journey on November 1, 2014 that ended December 15, 2014.  Granted, I didn’t need to lose weight for any health reasons, but I tend to go on some sort of a reduced calorie modified version of what I currently eat about every year and a half to reset to where I like to be.  Otherwise, I’d just keep gaining weight the way I like to eat and sometimes exercise! 🙂

Because this post got longer than I expected, you can jump to the how I felt when I did it part after the Preface heading, which gives background on my thoughts on weight and rationale for changing my weight.

Preface

Not everyone loses weight because they need to.  It is often a want to sort of thing.  For me, I enjoy being at different weights for different reasons.  Sometimes I like to emphasize the big heavy lifts, and more mass makes me better at that.  After a while, I tend to find it exhausting maintaining that weight, eating all that food, and keeping up my cardio to keep my body fat percentage down.

Add training and nutrition consulting with local Austin clients, working with private client hours on top of that who are not local via telehealth, and developing this website, it can get fatiguing after a while.

I also don’t like to be too lightweight.  In our society, a muscular male physique is valued more than a ripped, agile, and fast male physique.  I also just feel weaker than I can be and don’t emphasize endurance activities in my routine.  Rather, I do them for general health and maintenance.

The perks of being light include: I save money on my grocery bills, I have boundless amounts of energy, I can workout “forever” without getting fatigued, and my strength:mass ratio is probably the best due to these previous qualities.  Strength:mass ratio, ie maximizing your strength for a given body weight, is the way to go if you lift weights, in my opinion, as it takes less time to maintain the results and yields the most functional body type.

If you think about it, for a small framed individual to have tons of weight, be it muscle or fat, it makes the body less efficient at doing anything.  Your organs don’t grow enough to keep up with the body size changes.  Your heart prefers a certain size, your liver a certain size, your kidneys a certain size, and your lungs a certain size.  They just don’t grow like your muscles can, so when you pick a body size to be, understand the pros and cons.

Bigger people are stronger, but lighter people (to an extent…as there is too light) can be more athletic for anything that requires moving the body through space and time.  I prefer the ideal body weight equation over BMI when assessing weight ranges for people, but I look at both models and consider fitness status as well for the big picture.

My belief in the healthiest human body is one that is good at many aspects fitness but also absent of disease or disease risk propensity.  Aspects of fitness include skill based and precision work, muscular strength, muscular endurance, agility, balance, cardiovascular fitness, and body composition.

The heavier I get, the more strength and muscle I have, but also the more likely I will have high blood pressure, as it runs in my family.  Moreover, the less likely I will be good at running for any extended period of time over a couple miles.  Think of fueling a Prius vs a Hummer.

I have had either prehypertension or high blood pressure at a few points in my life of high stress, and it is more likely to come on as my weight creeps up.  Being able to squat and bench heavy at that point becomes moot to me.  I’m already a small- to medium-framed individual anyway so won’t set any big records there.

I’m a 5’10” male who likes to weigh between 165-175.  When I was a competitive swimmer, however, I weighed 150 and got my best times at 145 (age 17) when I had diarrhea during a meet that I was shaved, tapered, and wearing a fastskin for.  That experience taught me that losing 10 lbs of water weight (I actually lost from 155 during that meet) gave me collegiate division 1-worthy times for swimming.

I didn’t understand that at the time though, and obviously it is not a healthy thing to do due to the electrolyte abnormalities and possible heart risks with that fast of weight loss while competing at a high level.  But I digress!  Back to weight loss!

There are a few reasons I decided to lose the weight.  I knew the holidays were coming up, and I wouldn’t be able to work out as much or the way I wanted with family.  I also needed a break from working out, in general, to let my body fully repair and heal.  I decided it was a good time to do so.

My weight was creeping up to 182 at a peak but averaged around 177-178.  I carry a lot of water weight that fluctuates depending on the time of day, hydration, how much fiber and sodium I have had, stress levels, and exercise amounts.

I also knew I started lifting really heavy and found it easy, a sign I gained some muscle (and fat), which when working out as many years as I have, I know I don’t make many muscle gain or strength improvements anymore without a significant technique or routine change.

I also was becoming exhausted with less cardio than I used to.  Any extra muscle on my frame size at this point inevitably carries more and more fat.  You can’t continue to gain muscle with a low body fat percentage on a given frame size forever.

How I Lost the Weight–Diet Only this Year*

In the past, I have lost weight by the book.  I did both diet and exercise in the past.  This time, I just did diet only.  The asterisk means that I was still biking to my personal training employed job and still training clients (some who require more physical effort on my part than others, which is what goes with the profession), but I was doing no formal exercise as I usually do to push my own limits.

Usually, I hit all muscle groups heavy a little less than once a week, do high intensity cardio (run or swim), moderate and relaxing cardio (run or swim), bike to/from work, agility and balance and gymnastics skill work using bodyweight at playgrounds with parallel bars and monkey bars, or I’ll count a physical outing like hiking or kayaking as a workout for the day.  These make great date ideas that do NOT involve food…I’ll have to post on that topic another day!

In the past, I did it by cutting my food portions of non-protein calories like carbohydrates and fats down very mildly, as I still wanted to be able to fuel my workouts.  I have a food scale and use measuring cups and live alone, so it is much easier to track.  I believed in sports nutrition by the book in that it was supposed to have that magic 30-min to 2-hr window after a workout when you have to eat, or you lose all your gains!  More on that in another post.

I also still lost about 5-10% of my strength with weight loss, which is inevitable.  I couldn’t do as many reps or sets in the gym, and my high intensity work wasn’t as intense.

In the past, I also would get muscle cramps, tight muscles, and nights where I had to “refeed” the calories I cut that day in order to fall asleep because my body was trying to repair muscles that I wasn’t feeding.  I wasn’t even severely cutting my calories, but to be able to workout at the intensities I usually do, my body needed more calories and wouldn’t relax until it got them.

This time, I went into my weight loss journey knowing I would lose strength and endurance no matter what I do.  Why go through the psychological trauma of seeing your lifts decrease in weight and repetitions when you could just start over at the end?

As a trainer, I see unfit people get fit very quickly.  Losing your gains is not hard to get back.  My clients teach me this when they are gone for an extended period of time and then come back.  It is exhilarating to see, from my perspective, and made me less strict with my own regimens.

When cutting calories, my body doesn’t want to work out intensely.  It is just counter intuitive to push yourself harder while eating less as an already lean individual (for someone who is new or intermediate to exercise, this sentence may not apply due to relativity of ratings of perceived exertion during exercise).

This time, I got NO cramps, I didn’t have to wake up in the middle of the night to refeed myself food I had cut out earlier in the day due to working out raising my calorie needs.  I had no tight muscles.  Muscles shrink during weight loss anyway.  Why try to make them bigger during this phase of your life?  I took my own advice and experience and did it on myself this year.  The weight loss experience was much more pleasant.

I usually eat about 3000 Calories a day at my 175 weight, consisting of 4 meals and a snack.  Normally, I work out 5 days a week doing different activities at various intensities.  When I cut my calories, I started out having 3 meals and a snack.

The first week, I was hungry.  After the first week, I wasn’t hungry and didn’t get hungry for the rest of the experience.  I was able to cut down to 2 meals and a snack after I noticed I was losing weight slower and the fact I was starting to be satisfied on smaller amounts of food.

I probably ended up having about 1500-1700 Calories with those 2.5 meals when I finished my weight loss journey at about 160.  I could probably be more specific since I have my diet in a spreadsheet and could figure out the specific numbers, but that is beyond the scope of this post.

From a sociological standpoint, people were concerned rather than encouraging.  There is a stigma any time you cut weight and are already relatively lean, whether male or female, especially for those not familiar with athletic populations who do this often.

There is a lot of overlap with anorexia nervosa behaviors and effective weight loss behaviors.  I think the difference is whether it becomes a clinical problem of becoming underweight, malnourished, and having a distorted, unrealistic body image.  Another difference is knowing when to stop these behaviors.  There is a difference in knowing which thoughts are rational and which are irrational.

I think a lot of the concern is also self-reflective on those who are concerned about their own thoughts about body image.  Perhaps they want to lose weight, fear the process of doing it, and hesitate to do it.  It is a temporary lifestyle change, after all.  If you associate too much of your daily joy and life-meaning with the act of eating food, then that will be something to think about.

The bottom line of this? I cut calories more intuitively this time.  I didn’t have exercise and all its variability in energy expenditure making things complicated.  I used the intuitive eating technique for knowing when I wasn’t eating enough.

I only looked at my calories afterwards because I’m a registered dietitian and feel compelled to know this sort of information for the sake of my career and to better help clients, the few who actually understand and think in calories.  I have a different idea for ways the general population should better understand food calories in another post.

I overshot my weight goal of 165 to 160 on purpose (on average, as it dipped to 158 depending on the day) because I knew the moment I started eating more and exercising again, I would gain my weight back to 165 very quickly thanks to fluid shifts and storing more carbohydrates again.  Rather than having to restart adapting to fewer carbohydrates as energy again, which can take a while, I just decided to overshoot my weight goal a bit.

Interestingly, whether it is the adaptation to eating fewer carbohydates (due to lower calorie intake), or the fact I wasn’t always having blood diverted to my digestive system, I was much more mentally clear during the process.  Who knows?  The research isn’t out on that yet.  I do like to keep up on ketogenic diets though just for sheer interest in the unknown.  This is not to be confused with ketoacidosis.

Notice mental clarity is the same thing people on that religion of bulletproof coffee report.  I think it is more due to the weight loss and blood to gut diversion being reduced, not the “grassfed pure butter that is good for your brain.”  I would like to see some references for that statement.  Oh right, there aren’t any!

So, that is the end of my weight loss journey (and the midpoint to getting back to fitness).  Once I got to the point of finishing up, I was mildly irrationally afraid of starting to eat more food again and having to get back into shape.  What a pain, I thought.  I could see how people can get stuck on eating less and less food when you have been successful with weight loss.  It is an anorexic thought.

That’s why everyone should have fitness goals.  It’s not optional these days.  You HAVE to exercise to be healthy.  It lets you eat more food and feel great.  Who wouldn’t want that?

Now that it is a week or two back into my old routine, I’m back on 3.5-4 meals a day and am exercising again.  I feel great, lighter (weight didn’t come back instantly or anything), and healthier.  I lost a fair amount of fitness in that I’m not pushing myself to my weights I was pre-weight loss because I didn’t feel that would be safe.

That said, I probably only lost about 10% of my strength.  I expect to gain about 5% of it back in the next month, depending on soreness and when I can fit workouts in my schedule.  I’ll write Part 2 when that happens.

The whole point of the diet and no exercise thing this year was to better understand what clients feel physically when losing weight, and to prove a point that you don’t need to work out while losing weight because it can take twice as long and be accompanied by all sorts of musculoskeletal annoyances like tight muscles and overtrained muscles.

I also wanted to see if the weight loss process was faster this year (and it was).  That said, Part 2 of the post is to see how long it takes me to get back to full fitness, so I haven’t proved it is faster in terms of maintaining fitness yet.  The first week back I will tell you that I was SORE AS EVER.  I am not sure if the caps emphasize that enough, but I was a bit zealous in starting myself back to about where I should be mathematically speaking in terms of strength losses and cardio.  I also got winded in a half mile of intense cardio.  It will come back in a month.  I’m not worried.

This isn’t the first time in my life I’ve just let a high level of fitness go.  When I quit swimming competitively at age 19, I played 6 months of addicted World of Warcraft gaming.  I lost 17 lbs of muscle then (160 to 143).  No, it wasn’t healthy, but I wasn’t depriving myself of food.  I just wasn’t exercising then nor was I hungry.  So, fitness can come and go.  Your gains are easily reattainable.  Why try to choose two competing goals at the same time?

My opinion is that unless you are brand new to exercise and have to learn a lot of techniques and get into the healthy habit of exercising in order to build your self-efficacy to do exercise competently, then you may achieve physical goals faster and with more satisfaction by focusing on one at a time.  If it is weight loss and you are a very fit individual already, try to diet first.  Seriously, don’t try to increase the amount of exercise at the same time.  You will learn! 🙂

In the future when I lose weight again (after it creeps on again, as it will because the body is a master at caloric efficiency, which I do NOT view as a diet failure as media/science makes it sound…more on that in another post), I plan to do LESS exercise rather than NONE.  I may lose the weight faster with no exercise, but I lost more fitness this time than I would like.

I’ll keep readers updated for my next post (Part 2) in a month or so whenever I’m back at peak condition, hopefully at my 165 or 170 weight.  I really am not too concerned about whichever one it will end up as.  Life happens, so be as fit as you can be for it, and maximize your functional capacity!

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3 Ways Exercise Can Slow Weight and Fat Loss

Many people will amp up exercise in an attempt to lose weight because they know the law of thermodynamics that states that calories in must be fewer than calories out.  Knowing this, they will drastically reduce dietary caloric intake by adapting strange diets they won’t be able to stay on for the rest of their life.

At the same time, they start increasing the amount and intensity of exercise they do in an equally unsustainable manner.  Logically, this makes sense, unfortunately, it isn’t as simple as that.

In this article, we’ll discuss three ways exercise can get in the way of your weight loss.

1. Intense exercise and increasing the duration of exercise from what you did before will burn more carbohydrate calories as a primary fuel source, especially during the adaptation phase. Carbohydrates are the energy of intense movement.

All exercise, light to intense, will burn carbohydrates; however a greater percentage of fat is burned in the light to moderate aerobic exercise zone due to a state of metabolic efficiency being reached in carbohydrate burn state where carbohydrate metabolites aren’t overly produced and the slower fat oxidation systems have time to use the products of carbohydrate metabolism.

However, you’re still limited by carbohydrate capacity and aerobic training status (more aerobic enzymes burn carbs more efficiently).  Light to moderate exercise also causes less breakdown of muscle tissue, which is a good thing when thinking about weight loss and brings us to the next point.

 2. Relatively lean and fit people will already be able to push themselves intensely during exercise, requiring more calories on those exercise days than normal to replace glycogen stores (how glucose is stored in muscle) and rebuild lean tissue that was damaged from eccentric muscle activity and acidic denaturation of muscle proteins such as during high intensity exercise (resistance or aerobic-glycolytic).

This means they have higher calorie needs like anyone who has tissue repair needs, yet they’re consuming fewer calories for weight loss.  This leads to overuse injuries and overtraining syndrome, where stress hormones like cortisol increase to raise blood glucose to repair places of inflammation.  Stress, whether physical, physiological, emotional, or mental, and inflammation don’t go well with weight loss, which should be a relaxing, low-stress, anti-inflammatory state.

3. Intense exercise stimulates the body for lean mass gains. This means you GAIN mass, which requires more calories.  You don’t lose weight.  The number will not go down on the scale.  It won’t be a time when your body has calories to spare off your frame.

Some people will argue that the number on the scale doesn’t matter, it’s how fit you are.  This is true to an extent and is in agreement with the current research, as there isn’t much information on what happens to extremely massive people long term who are fit (not a huge segment of the population).

However, if you are extremely massive on a relatively small frame, it would theoretically require a lot more of your heart to pump blood through the extra space in your body, the lungs and kidneys to rid you of the waste products, and possibly increase blood pressure due to increased vascular resistance of blood vessels the heart must pump through.  Whether this is healthy and fit or taxing on organs is yet to be determined.

So in my opinion, excess weight is not good, whether fat or muscle.  You will not be as fast, agile, or aerobically efficient as your leaner counterparts, and your strength to mass ratio will decrease the more massive you get.  People might think you look good though, but that’s a sociological/contemporary phenomenon.

There are many parameters of fitness, including speed, agility, strength, muscular endurance, cardiovascular fitness, flexibility, balance, skill work and precision, as well as body composition.  It’s not always about body composition being the hallmark of fitness as popular culture may have you believe.

Knowing this, I stand by my comment in my interview with Megan Ware that exercise is often a detriment to weight loss if you do too much or too intense of exercise and are already pretty lean, ie near your ideal body weight.

If you are a beginner, you may get more leeway because you are not able to produce as much breakdown relative to the calories you are already taking in.  You also may not be able to push yourself to the intensity that breakdown occurs in your body, which spikes your calorie needs.  If you are spiking your calorie needs, you aren’t able to reduce them much from where you started, so the weight will not come off.

In fact, weight will increase if caloric needs are higher than what you are consuming, at least at first, due to the stress response and water retention.  Weight loss itself requires a consistent DIETARY calorie deficit in an unstressed state, so if you are telling your body to build muscle in your workouts, it will slow you down until it does.

How do I recommend going about fat loss?  It depends how much fear you have about getting out of shape during the weight loss process.

As a trainer, I know how relatively easy it is to get people into shape.  If you fear getting out of shape during the process of weight loss, then you probably are a candidate for a slower, “healthier (as currently recommended)” weight loss.  This will mean spreading workouts out as far apart as possible to limit losses in fitness yet still creating that dietary caloric deficit.

For example, strength training frequency may have to decrease so that you can lower your caloric needs enough to be able to cut the calories.  As your mass comes down, strength will also decrease, so you may have to lower the weight.

High intensity cardio frequency also will have to decrease.  Every time you workout, that increases caloric needs to repair yourself, so you will never truly achieve high caloric deficits necessary for faster weight loss.

If you are not already working out and very fit aka beginner or intermediate exerciser, it is unlikely that the amount of working out that you do will interfere with weight loss, even if strength training.  It is important for beginners to learn to adapt to the behaviors necessary for weight maintenance (ie exercising intensely and regularly) so that when they finish a low calorie diet, they will not regain as much fat weight back when resuming normal eating.

Most people reading this article will be beginners, so I do encourage exercise and diet at the same time for learning and psychological purposes and not because it makes weight loss faster—on the contrary.  For competitive athletes and highly active fitness enthusiasts who weight stall, things are a bit different.

Eating more on exercise days and less on non-exercise days is a great way to maintain your weight once you have lost it. This teaches a sustainable habit of balancing caloric intake with exercise expenditure while still eating a balanced, varied diet with all the food groups. You just modify the quantity of dietary intake while minimizing stress on the body, the essence of weight loss.  Weight maintenance is a different strategy than weight loss, however.

Unfortunately, exercise alone is pretty ineffective at resulting in weight loss.  I’ve seen it on the personal training side in both obese and lean individuals while also getting weight loss success in non-exercising clients who only seek nutrition counseling.  If an obese person does not modify caloric intake consistently below needs, they won’t lose weight.  If a lean individual over exercises and cuts calories, they will not lose weight but will just deplete glycogen stores and risk injury.

Weight loss is a complex process of creating a consistent dietary caloric deficit and maintaining light to moderate activity for the purpose of general health and circulation in an unstressed physiological state.  It is important to consider the calories relative to the exercise, as too few calories coupled with exercise doesn’t get you there faster.  Counter intuitively, it gets you there slower.

It is also not a linear process.  As you lose weight, your calorie needs decrease even more, so you may have to cut calories more to lose even more weight at the same rate or decide to be happy at the current weight while increasing lean mass body percentage with intense exercise (so you can eat more for a while before resuming the weight loss journey).  However, you will lose some lean mass with any weight loss, especially if already very fit.  The body has to stay proportional.  Super hero action figures are plastic toys, after all.

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Personal Training: Problems in An Unregulated Yet Needed Industry

Personal trainers are the experts on how to get healthy, fit, gain muscle, and lose weight.   Or so much of the public thinks who didn’t do their research.  Unfortunately, MOST personal trainers are given WAY too much undeserved credibility.  A quick Google search will show you how many certifications are online.  Freelance personal training, which is what most trainers do who hope to make it their career, doesn’t even require a certification unless you want liability insurance.

Do most clients ask their trainers if they have liability insurance or a certification?  No.

Do most clients even know what certifications are worthwhile?  No.

Do clients even want to put that much trust in someone who got a certification on a weekend online?  Apparently.

Do you even want to trust someone who got a certification from one of the more reputable sources (ACSM, NASM, ACE, NSCA, Cooper), which requires a testing center, when they don’t even have a formal education in the subject?  Apparently.

Do you trust them to take care of your diabetes, hypertension, orthopedic concerns, cardiovascular concerns, understand what medications limit exercise, etc?  Apparently.

What if you get light headed during training…then what should your trainer do to help that problem and explain it to you?  Are you being taught myths and fads or evidence based techniques?  Why are we doing this exercise?  

Apparently, YES, people do trust people with weekend certifications to know all this information.  The industry proves this due to how many successful fitness “professionals” there are without any education.  The industry is driven by charisma, unfortunately.  This is ONE big problem with the industry.  The number of barely qualified people doing the work far outnumbers those with formal education on what they are doing.

Does your trainer have a degree in kinesiology, exercise science, biomechanics, exercise physiology?  Have they ever taken an anatomy class?  You would think these would be requirements, but they aren’t!

In other fields, non-professionals doing the work of the professionals is not NEARLY as much of a problem.  Companies won’t hire you unless you have a degree in the subject and there aren’t many freelancers who think they can do better than they could do at a company.  You wouldn’t trust any other medical provider to operate on you or otherwise care for your health without formal education.  You wouldn’t trust someone without a JD to give you legal counsel.  Why is it any different with exercise science and nutrition?  People will accept information from ANYONE in this field!  Mantras like “everyone is different” and “it works for me/Cameron Diaz/Dr. Oz/Oprah/Arnold” dilute real knowledge and wisdom when we need it most as a nation.  The number of charlatans drowns out the true professionals.

A second problem is the fact that the lay public thinks personal training will make them lose weight.  It doesn’t make you lose weight.  If that were the case, personal trainers would be rail thin due to all the activity they do every day.  Exercise changes your body composition.  It doesn’t change your weight, and if you’re overweight, you’re not going to change your body composition enough to look like your trainer without nutrition changes.  If anything, you will gain weight because exercise stimulates your appetite due to the muscle breakdown.

You would do better spending your money on a registered dietitian if your goal is weight loss.  Weight loss is one of the biggest issues in America today, and people have the misinformation that exercise causes weight loss.  Most uneducated personal trainers will not know it isn’t the exercise but diet that causes weight loss, and if they do, will they tell you and risk losing you as a client to a registered dietitian?  Probably not because exercise is always good for everything right?  Wrong.

People give WAY too much trust to trainers on topics like nutrition.  Did you know that some people, such as registered dietitians and those with a bachelor’s degree in nutrition, are much more minimally qualified to counsel on nutrition issues?  These include: weight loss and weight gain, cholesterol, hypertension, performance nutrition, and many other nutrition-related issues.  You shouldn’t trust your trainer on nutrition unless they have a degree in nutrition and/or are a registered dietitian, which is someone with a degree who has been accepted into a competitive 1200 hour supervised practice program and proved their efficacy that they know what they are doing.  Not all nutrition majors get into these programs.

A third MAJOR problem is the financial disparity between employment and freelance personal training.  You cannot make a living at most places that employ personal trainers, especially since the Affordable Care Act (thanks Obama).  Some places prevent you from working more than a certain number of hours so that they don’t have to pay you benefits.  Now, the health and wellness specialist, the personal trainer, has to pay for his or her own health insurance.  Most commission places pay anywhere from 33% to 50% to 60% maximum of your client income, expect you to do the sales, and they don’t reward you for being a good trainer or getting results.

The only reasons you would get a pay increase are more certifications, more formal education, or more experience, but it isn’t enough of an increase to make the education cost-effective (but does make a better trainer and decrease risk of injury to the client and ability to achieve client results).  Plus, most of the fitness industry certifications are stupid.  I don’t think I need to get a certification on how to use a kettlebell, battle ropes (lol), vibration training, or TRX after having degrees.  Seriously?  Interestingly, getting a kettlebell certification is a similar increase in pay as a degree at many gyms.  That’s just ABOMINABLE, isn’t it?

Other gyms sell packages of sessions and don’t pay the trainer the rest of the sessions if the client doesn’t finish them with the trainer.  So if you do a good job and your client learns what they are doing ahead of time, they will stop seeing you because you’re a good teacher, and they think you’re pocketing the rest of the sessions.  WRONG.  The trainer just doesn’t get paid because he/she didn’t work the hours.  Additionally, most places make you do all the scheduling, so if you’re not working with a client, you’re playing scheduling whac-a-mole with all your clients times so that you aren’t working 12-15 hour days while sitting around for hours between clients.  If someone cancels repeatedly, you may or may not get paid for reserving that time slot.

Considering the fact that pay at employed training isn’t enough to make a living, many personal trainers end up having to “under the table” train, ie they squat at various gyms that did not hire them, stealing potential clients and not paying for the equipment they use.  Many gyms don’t think you’re training if you’re “working out with” the client–this is one of the stupidest policies I’ve ever seen in my life.  If an extremely fit guy is working out with someone not even at the same level, you think he’s doing it for free?  He’s just doing it out of the kind service of his heart?  You, as a gym, are ok with the liability of that?  Ok then!

This is also unfair to those who are employed legitimately at those gyms because these freelance trainers can charge what they want and not give half their gross to the employer (and a chunk to the government).  Some even only accept cash and then don’t report it on their taxes.  These trainers are taking business away from the gym.  Because it is the responsibility of management and not the other trainers to report “squatting” trainers (definition 3), they often get away with what they are doing.  Management has these policies to avoid confrontational events, but if management doesn’t enforce it, employed trainers just have to watch it happen and have to bite their tongue.

What makes this worse is so many of these barely qualified trainers do it as a hobby on the side and charge a fraction of the prices you must set if you need to make a living in the industry if you are a full-time trainer.  The amateurs are in a freelance, unregulated market, charging less against fully educated, real professionals.  These amateurs who do it as a hobby lack any experience or education.  Anyone can have a great body, but education makes you know the principles behind why it works and how to assess what other people need and teach other people what they are doing that is or isn’t working in a way that they will understand.  These trainers don’t know (or care in some cases) if their training style is healthy long-term.  Some trainers can be extremely enthusiastic but not know a thing about what they are really doing.

People often gravitate to what the cheapest trainer charges who looks good.  Well guess what?  You get what you pay for.  In many cases, this is eye candy.  Chances are the “ugly” or not overly muscle bound trainer knows what he/she is doing more if they are successful.

You might ask, then, what makes someone with a degree different than someone who just has the bare minimum?  The public thinks we’re here to just “give you a workout and tell you what to do,” and often doesn’t even take our profession seriously.  They think it is about leisure.

There are different techniques of training that yield different results.  Strength training is different from bodybuilding, which is different from endurance training.  Flexibility, agility, fat loss, muscle gain, and strength gain all are different training techniques.  Injuries require alternate techniques than uninjured people and have contraindicated exercises.  Diabetics need to know how exercise will affect their metabolism and how to deal with that.  Sometimes counseling techniques are needed to elicit behavior change.  It is impossible for any one trainer to be excellent at all styles of training, even with a degree, but the degree should give them an idea of where to start at  least.

A trainer with a degree in kinesiology will know a more comprehensive way of working out the body so as to not neglect underused muscles that get injured later on because the person didn’t strengthen the neglected muscles while progressing in their program.  The trainer with the degree thinks by anatomy and muscle actions, letting those needs dictate the training program than having a pre-made, one-size-fits-all workout of the day.  Speaking of generic workouts, many new and uneducated trainers think that you have to burn someone to the ground to train them.  This style only works with a certain population of well-fed individuals who want muscle gain who don’t want any specific training adaptations and are fine with not being able to use their affected body parts for days after.  This sort of training also carries a high risk of injury, such as rhabodomyolysis, which is when muscle cell integrity fails and spills contents (myoglobin) into the blood, which can cause acute kidney failure.

That’s not the point of training.  The point of training is to increase your lifetime functional capacity.  One of the most pointless adaptations is to be able to do something 10-15 times in the long term.  Where in life is this useful?  It’s currently a popular training style because people think that’s how many times you have to do each movement.  Granted, I do recommend somewhere in this range for beginners who are still learning movements and want lower risk of injury during the learning phase, but staying in this repetition range long term when you’re not an endurance athlete is nonspecific training.  The point is to get better at something.

Trainers who aren’t educated won’t know what energy systems and adaptations that produces other than it might make you socially look good for whatever body type is trending right now in the magazines and media.

In summary, the lack of education and low barrier to entry to credibility to the fitness field, the dilution of true professionals in the field, and the business structure of the freelance vs employed environment make the personal training industry a hot mess during an obesity crisis in the US.  Obesity is not fixed with physical activity yet people think it does, and registered dietitians are not even recognized as the key to weight loss on many health plans while the public thinks personal training is the way to do it.



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Save Your Money on Amino Acid Supplements for Weight Lifting

I see weight lifters, bodybuilders, and personal trainers promoting individual amino acid supplements, such as glutamine, leucine, or BCAAs.  BCAAs are branched-chain amino acids, specifically leucine, isoleucine, and valine.

What I would like to know is if there is research that differentiates between having dietary protein and having specific amino acids.  Because, frankly, it baffles me why people would buy individual amino acids when consuming high protein foods such as various animal flesh (chicken, beef, turkey, salmon, tuna), dairy, eggs, soy, or other higher protein foods like beans and seeds.  Supplement companies obviously want you to buy more product and will tell you anything.

In my frank opinion, if you are consuming adequate amounts of protein for your physical activity, i.e. active people need 1.2-1.7 grams protein/kilogram (1 kg = 2.2. lbs) body weight, and you are spreading your meals out throughout the day to maintain the pool of amino acids in your blood, then you should have more than enough amino acids available for anything your body is doing.  This is more than the RDA for protein for the general population that is not exercising, which is 0.8 grams protein/kilogram body weight.

Additionally, bodybuilding supplements could be contaminated with substances that improve your workouts that aren’t even amino acids, since as previous posts have mentioned, the supplement industry is not tightly regulated for quality, purity, and unadulterated ingredient listed on labels.

This post does not hold true for those who may be in the hospital or have a specific medical condition for which there is clear research on the efficacy of providing individual amino acids.  These cases often involve situations where dietary protein intake is limited for various reasons.  Often, your physician will order a specific amino acid in cases like these.

However, for working out?  Save your money, and go buy someone a present or donate to a charity you believe in.



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Paradigm Shift: Away From Idea of Exercising to “Burn” Calories

If you follow health news, there are often articles that discuss how much exercise it will take to burn off a cheeseburger.  The motivation behind these articles is to dissuade you from having that cheeseburger, logically at least, because it supposedly takes a “5.6 mile hike” required to “burn” it off.

When I see these articles, I get the good intent.  Most people without a science background don’t get the E=mc2 concept that matter and energy, or Calories, are the same thing.  Most people don’t think in Calories or have a very good abstract idea of what they are.  It’s pretty simple though in terms of what you need to know for nutrition: fat has 9 Calories per gram, alcohol has 7 Calories per gram, protein has 4 Calories per gram, and carbohydrate has 4 Calories per gram.  Fat is, thus, considered an energy-dense nutrient due to the high concentration of calories per unit of mass (grams).  Add up your Calories from each nutrient previously listed, and that’s your Calorie score.

However, every time I see these sorts of articles, I feel like I am banging my head against the wall out of frustration because they miss the teaching point.  I also don’t think these comparisons are very effective.  Here’s why:

1) A 210 lb male uses more energy to move about each day and to live than a 115 pound female, so the “5.6 mile hike” isn’t even accurate for most people anyway.  Who is this specifically targeting, then?  I can’t tell you that answer, as I was never taught.  If you know, please comment below.  Does this “5.6 mile hike” refer to a small female or a large male?

2) Exercise breaks down muscle.  If you are doing muscular endurance exercise, maximum strength training, cardiovascular training, sprinting, flexibility, or anything physical, including walking, you are breaking down muscle.  That is how you move.  Energy is released as heat and as locomotion.  So, depending on the type of exercise you perform, your body’s response is to rebuild that muscle back to normal and supercompensate it with either more energy storage or protein storage as well as create more mRNA for enzymes that favor the types of exercise you do.

Definition: mRNA is basically an intermediate between DNA and protein expression in the body.  They call this the “transcription” process of DNA in school (ie, DNA to mRNA; mRNA to protein is called “translation”).

3) People who are choosing the cheeseburger, even with this information do not make the right choice and are very aware it is not the right choice. People sometimes eat for reasons other than nutrition, such as social eating, emotional eating, rebellious eating, convenience eating, lack of time or poor planning, etc.  So it doesn’t matter what logical information you put on the product.  Perhaps a better campaign would be “talk to a friend instead of eating this cheeseburger alone.”

So what’s my point?  Any time you create breakdown in your body, it has to rebuild.  If you don’t let your body rebuild, either because you are over-exercising or not consuming enough Calories for that exercise, it creates a stress response that basically slows down your metabolism until your body DOES rebuild itself.  The stress response can include elevations in cortisol, which raises blood sugar.

The exercise you did tells your body to actually store weight in the form of muscle.

Wait, muscle?  That’s good right?

It is for some of the population.  However, what about people who are already overweight or obese and have a lot of muscle and a lot of fat?  Now is not the best time to be building muscle because you will not be losing weight.  In fact, it may slow your weight loss progress by slowing the speed at which the pounds come off!  Any excess weight on your frame increases the work your heart has to do to pump blood around your frame.  Your cardiovascular system just gets more inefficient the larger you are for your frame size, muscle or fat.

That said, exercise at any size helps improve overall health dramatically, so if you’re not at a good point in life to make better food choices, exercise will prevent you from experiencing many of the negative effects of being overweight or obese.  It can reduce blood pressure, increase HDL cholesterol, improve blood sugar sensitivity (attention diabetics!), acutely reduce symptoms of depression or anxiety, improve circulation, lubricate joints to reduce joint pain, and many, many other benefits beyond the scope of this post.

“But who cares about weight?  Shouldn’t we just care about lean mass?  Doesn’t muscle weigh more than fat?”  (Actually, a pound of muscle and a pound of fat weigh the same.  Muscle is more dense though and takes up less volume.)

Yes, to an extent.  But from a metabolic efficiency standpoint, frame size is important to think about if you do not want to be carrying around a lot of fat mass with your lean mass to mask how hard you work out.  No one will see your muscle striations if they are behind a lot of fat.

So, in summary, exercising to “burn” off Calories is not a good idea.  You will end up gaining weight over time, albeit muscle weight.

Instead, think of exercise as Calories you need to consume on top of the minimum amount of Calories you need each day.  If you don’t consume them, your body slows down your metabolism until it makes that energy available to remodel your muscles with what it has.  This is basically a state of “over-training” or “weight loss stalling.”  They are pretty similar metabolic states, in my opinion.  If you exercise and don’t eat, your body slows down.

Think of the exercise first, and then think of what you have to do to from a dietary standpoint to replace what you lost during the exercise.  Again, if you don’t replace what you lose, your body will slow you down until you do.  Don’t think of it as “eat the cheeseburger” then “I have to punish myself by abusing my muscles this many times.”  It’s not even the exact same molecules of energy from the food.  If you haven’t trained to store more energy in your muscles, that cheeseburger just goes to your waist, and if you’re not trained to expend large amounts of energy during exercise (as very fit people can), then you won’t “burn” that food off.  You’ll just break your muscles down some.

Yes, exercise burns some Calories, but it is not significant enough to eat pretty much any food you want.  Food choices are paramount.



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Seventeen Gym Etiquette Guidelines

Do:

1) Wipe down your equipment after use.

 

2) Re-rack your weights at the appropriate places.  This goes for dumbbells and plate weights.  So many times people “nest” plate/barbell weights between other sizes.  It makes it hard to get to the ones you need without taking all of them off the peg.

 

3) Use clamps on the end of barbells.  I’ve seen 2 plates fall off the bar of someone who lost control during a squat onto someone in the aisle nearby.  You may think you don’t need them, but use the clamps for the safety of other people.  As an added perk, it keeps the weight balanced equidistantly.

 

4) Use the safety bars on the squat racks.  They should be set just below the lowest point of your squat in case you keep going down and can’t come back up.  Using the safety bars is better than injuring yourself, and you don’t require a spotter to squat now!  Safety bars are there for a reason: safety 🙂  Most people should set them about hip or butt height.

 

5) Practice squats and dead lifts safely before going to the squat rack and adding weight.  If you can’t do a squat or dead lift without weight with good form, think how dangerous it gets when you do add weight!

 

Do not:

1) Walk off with free weights/dumbbells and not return them.  I can’t tell you how many times I have tried looking for weights during client sessions because they walk off and are never where they should be.

 

2) Monopolize multiple pieces of equipment without letting others work in.  If you are circuit training you should yield to those who aren’t.

 

3) Make conversation with people who don’t give you welcoming body language, such as being plugged into music or being in the middle of a set.  If they smile/stare at you or take an ear bud out, then they are open to chatting.

 

4) Grunt so everyone thinks you are having a man-baby or in the middle of coitus.  It makes other people uncomfortable, unless your goal is to make other people uncomfortable.  If that’s the case, then do whatever you want 🙂

 

5) Use spray on deodorant in the locker room.  Now EVERYONE has to breathe it.  This is egregiously obnoxious and makes my blood pressure spike.

 

6) Blow dry your family jewels at the sink.  Perhaps this is a generational thing.

 

7) Be too naked in the locker room.  You know who you are, person who was naked before and after I finish working out and is still naked in the locker room by the sauna when everyone else has the decency to at least use a towel.  There is even a sign you are ignoring that says “please use a towel.”  Also, perhaps a generational thing.

 

8) Eat food on the gym floor in the weight area.  Exception if you are a personal trainer and away from the weight areas.  I get you.  You’re there all day, and it is a physical job.

 

9) Work out in front of other people’s mirror space during their sets.

 

10) Work out too close to other people.  It can break their concentration.  They also don’t want to drop their weights on your toes.

 

11) Leave benches and equipment in walking aisles.  It makes the gym cluttered and increases trip hazard risk.

 

12) Offer advice to people who didn’t ask for it.  Exceptions for people who may end up with an acute injury and a medical bill if they keep doing what they are doing.  In these cases, make sure you know what you’re talking about.

 



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Saccharin Human Trial: Artificial Sweeteners News Part 2

Last week I discussed why you shouldn’t freak out about the latest news about artificial sweeteners.  This week, I will give a bit more information on the study, now that I have obtained a full-text copy of it from professional resources.  Specifically, I will let you how much the humans were consuming and real food recommendations you can take from this study, as yes, there are some take-home messages for some of the population, particularly diet soda/pop drinkers, and not as much for those who use packets of artificial sweetener.

Before I get started, I would like to link to this post in theguardian.com about how journals like Nature, Cell, and Science are damaging science due to incentives.  I agree with a lot of what this writer says.  Back to my post.

According to the human trial in this study, the only sweetener tested was saccharin, which is sold as Sweet N Low (the pink packets).  Thus, everything I say will apply only to saccharin.  The science doesn’t speak strongly for other sweeteners at this time because they were mice experiments.  Similar pathways and mechanisms for glucose intolerance based on species of microbiota present in mice can be surmised, but it is only preliminary and cannot be assumed the same happens for all human populations.

Before we go into specifics, the humans studied were not well-controlled based on the paper description. There is not a mention of the type of humans other than that they were “seven healthy volunteers (5 males and 2 females, aged 28-36) who do not normally consume NAS or NAS-containing foods for 1 week.”  NAS means non-caloric artificial sweeteners (more on researchers writing in code in another blog post…).  We don’t know anything about these humans’ weights, heights, race, diet, exercise habits, stress, family history of diabetes, etc.  That’s a lot of information to not have about these subjects.

The humans were given the FDA (Food and Drug Administration) maximum acceptable daily intake of commercial saccharin of 5 mg per kilogram body weight in three divided daily doses equivalent to 120 mg, totaling 360 mg a day.  They were monitored by continuous glucose measurements and daily glucose tolerance tests (GTT).  Doing some math, this is the maximum dose allowed for someone who is about 158 lbs.  There was no mention of the individual humans’ weights.  A glucose tolerance test is when someone ingests 75 g of glucose (which is about five 8″ tortillas or two cans of Coke, if Coke was pure glucose and not fructose, in 5 minutes time) and researchers measure blood glucose at regular intervals afterwards for three hours.

I would think that just taking a glucose tolerance test every day for 6 days would have an effect on glucose tolerance, but they were also consuming the maximum “safe” amount of saccharin on top of it.  There were four participants who experienced glucose intolerance, and the researchers noted that their gut bacteria had higher counts of Bacteroides fragilisWeissella cibaria, and Candidatus Arthromitus.

To get the same amount of saccharin (360 mg) a day the subjects had, you would have to consume 10 packets of Sweet N Low per day, since each packet has 36 mg of saccharin.  So unless you are using that many Sweet N Low packets a day, I wouldn’t worry about this study.

The only diet soda I know that still uses saccharin is called Tab, produced by The Coca-Cola Company, with 96 mg of saccharin per 12 fluid ounce can.  The FDA also sets a limit of 12 mg saccharin per fluid ounce.  So unless you drink 4 of these 12 fluid ounce cans per day, as well as eat large amounts of pure glucose sugar along side it equivalent to a glucose tolerance test without any other food to slow down that glucose absorption (such protein and fat found in whole foods), I wouldn’t worry about artificial sweeteners yet.

What’s your take on this study?  Do you disagree with my conclusions?  Did I miss something?  Please comment and share.

 



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Stop Freaking Out About Artificial Sweeteners

Edit 9/25/14: I have received a full-text copy of the study and made a follow-up blog post to this one on the human intervention part of this study as well as quantified the amounts of saccharin you must eat to experience the effects the humans achieved in the study.

One of this week’s catchy nutrition-related headlines is “Artificial sweeteners could cause spikes in blood sugar.”  Rant ON…

The real scientific article published in Nature says “Artificial sweeteners induce glucose intolerance by altering the gut microbiota,” and if you read the article abstract, which is all the public has access to unless you pay for the article or are at an academic or professional institution that has access to the article, you will see that the experiment was done on MICE.  They demonstrated that feeding MICE artificial sweeteners changes MOUSE gut bacteria, transplanted the gut bacteria into a germ free MOUSE, and then those MICE also had the same metabolic profile as the MICE eating whatever concentration of artificial sweeteners they were fed.

These studies have already been conducted, i.e. studies that show the gut microflora has an impact on your body chemistry, in other studies with mice fecal transplantation. There are also case studies of humans with bowel inflammation being cured at high rates with fecal transplantation from healthy individuals.

What this article does NOT show is that humans who consume artificial sweeteners, likely in amounts that don’t quite reach that which mice were fed (but who can say, since the public doesn’t have access to the article without paying), are likely to experience the same metabolic derangements.  Yes, humans may have some of the same metabolic pathways that could be affected by the bacteria, but the study did NOT show that humans who eat artificial sweeteners WILL GET spikes in blood sugar or experience glucose intolerance.

Glucose intolerance is affected by quite a number of other factors, not just artificial sweeteners, such as inactivity and overall caloric content and macronutrient distributation (carbs/fat/protein) of that diet.  The idea that a small amount of artificial sweetener is a game breaker for humans is highly unlikely.

I chew gum with artificial sweetener daily because it keeps my breath fresh when working with clients and lacks real sugar, which feeds oral bacteria that may promote cavities in humans.  Some days I might have 4 pieces of gum.  I don’t have glucose intolerance OR cavities.  Far from it.  I’m very physically active and eat a balanced diet to match my caloric expenditure.  Unless artificial sweeteners represent a significant portion by weight of food you are eating, I would not give these headlines any more credence.

These headlines are more likely to hurt those who exhibit obsessive-compulsive tendencies to avoid anything at all possible that MIGHT be considered bad (colloquially termed orthorexia).  Articles like these cause undo anxiety for these people who don’t know who to believe so just dot all their i’s and cross all their t’s when it comes to nutrition, regardless of the strength of the science and the source of the information.

Rant OFF.  Please comment and share.



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Why Fat Shaming Must Stop if America is Going to Lose Weight

A study posted on Medline this past week about fat shaming not motivating people to lose weight, possibly even causing more weight gain is the impetus for this blog post.

People who are overweight and obese are intimately aware of their body type.  Telling people that they are overweight or obese adds insult to injury.  I can definitely relate to not being in control of what’s going on in life in quite a few ways, but one of the ways I’ll share here in a blog post, as I realize I’m posting on the internet for everyone to see, so we’ll start with how I look.  Maybe another day I’ll disclose other more personal ways I’ve not been in control of my life in the past.

When I was balding in at age 22, people would tell me I was balding.  Guess how that made me feel?  Sad.  Scared.  Worse.  Angry at family genes.  I had different coping mechanisms than many people adapt, as I didn’t become an alcoholic or get on drugs.  Since then, I’ve come to terms with being bald and owned it.

I went through stages of feeling embarrassed, wearing hats, growing my hair out, shaving it off, growing it out again, trying Propecia, stopping Propecia because of side effects, trying a different style, shaving it off again, wearing hats, and then just stopped caring.  It took me half of my twenties to come to terms with what the gene pool dealt me, especially when you want to date in your twenties.  There’s really no cure for baldness because there’s nothing wrong with being bald physically.  I am accepting of it now and am a stronger person from having dealt with that already in my life.

Back to obesity.  People who are overweight or obese know that they are overweight or obese.  They may or may not have tried multiple diets already, obsessively weighed themselves, thrown the scale out, bought another scale, hired a personal trainer who beat them into the ground, still didn’t lose weight (because physical activity doesn’t actually help with the parameter of weight loss itself), etc.  It’s a sensitive subject.  Clearly, telling people that they are overweight doesn’t help.

Now let’s talk about a darker issue that judgmental people who fat shame may not be aware of.  How did obese people get obese?  How did overweight people get to where they are now?  Have you ever sat down and got to know someone who is overweight or obese?  For many people a few extra pounds is not what I’m talking about.  I’m talking you’re 50+ pounds overweight and it’s still going up.  You’re out of control of your life.  It’s not as simple as saying “stop eating, and eat more fruits and vegetables,” which is what many people think I do for a living–if only it were so easy.

It’s not as simple as telling people to go exercise more, while I, as the trainer-dietitian, am silently judged by others while working with an overweight/obese person for not pushing them during a personal training session and instead spending time by sitting down and talking.  If you read to the end of this, you’ll understand why I, as a trainer-dietitian, am talking instead of acting as a drill sergeant for a workout.

Our society is not one that is forthcoming with sharing vulnerable emotions, and different people have different ways of coping.  If you’re feeling rock bottom depressed, so anxious you can’t sleep, or so mad you think you’re going to bust a blood vessel in your head and have your eyes turn black Dark Willow style, many people have not been taught how to deal with these emotions.

Many people do not want to feel these emotions anymore, having felt them for enough time in their lives.  Some people have been taught to hide their emotions all life.  This is not uncommon in societies that promote an overly masculine male ideal, in cases of emotional abuse where a child was told they were not allowed to feel emotions they were having, or had to curtail their emotions for the sake of another, among MANY other reasons.

Some people will abuse alcohol to not feel emotions, which as common as alcoholism is, this is not uncommon.  Some people will engage in legal and illegal drug abuse.  Some people will get “addicted” to video games as an escape.  Some people will abuse sex and become “sex addicts.”  Whatever their poison is, they all lead to escaping painful emotions and become habit.

Others are able to reach out to others in a healthy way and share emotions in a supportive environment, but this is not as common for a number of reasons, including lack of supportive environments, a person is far enough gone that they are unable to perceive that such environments exist, or they have never had the experience in life of a supportive environment and were never educated on the benefits of one.  If you’ve made it this far in this post, you’ll see that overweight/obesity can be pretty dark subjects.

Let’s look at compulsive overeating and binge eating.  Did you know that carbohydrates, in particular, can play a role in brain chemistry?  They can alter the dopamine/serotonin ratio in the brain.  Excessive carbohydrate eating can produce a calming feeling, which results from increases in serotonin.  This is exactly what someone who is feeling uncomfortable emotions needs: a calming feeling.

The overeating solves that problem, since society did not solve it for them.  Society failed to provide them that comfort.  They feel calm and comfortable again…temporarily with the carbohydrate overeating.  Unfortunately, food has calories, which lead to weight gain if eaten in excess of what the body physically needs (not emotionally needs).

Add insult to injury, people shame people who overeat instead of figuring out what is going on with the person.  This can lead to even more overeating in a feedback cycle.  Additionally, people who overeat can get into the habit of using food for comfort.  Now, the very thing that gives them comfort is shamed, and they often shame themselves for using food as comfort even when others may not overtly.

The morale of this story is this: overeating is not a logical process.  It is more an emotional process.  People who are overweight or obese KNOW this and aren’t stupid.  They especially will not be wanting to share a vulnerable aspect of their lives with you after you demonstrated that it is unsafe for them to do so.

Overweight and obesity are our problem as a society as well as an individual’s problem, so rather than turn up your nose and shame the person, I encourage you to reach out and connect with them.  We shouldn’t have needed a scientific study to tell us this.  Overweight/obese shaming is one of the last socially acceptable ways to discriminate, and this must stop.

Please comment and share!



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Supplement Adulteration and Gut Immunity Health Stance

I recently answered a media query for health professionals on the best ways to improve your immune system.  I was NOT made aware that I would be put on a supplement website.  If you know me, I’m NOT a big fan of MOST supplements.  I received no form of remuneration other than my website being posted on their website.  Between 1 in 4 and 1 in 5 supplements in the US are adulterated.  This means they:

  1. Don’t have what they say they have on the label
  2. Don’t have any active ingredients they say they have
  3. Have other active ingredients that can be dangerous.  Some sports supplements contain steroids and STRONG stimulants, which can result in a collegiate athlete having a positive drug test and losing eligibility…and/or die from the stimulant and/or get the negatives of steroids.
  4. Are not guaranteed to have the amount of the ingredient stated on the label
  5. Could be pure white sand (silicon dioxide) when you thought you were getting creatine or probiotics.  That’s some expensive sand that went in one end and out the other!

Supplements are not regulated until someone experiences an adverse effect AND reports it.  It is the responsibility of the manufacturer selling you the supplement to ensure quality control.  This is completely laughable that this is allowed, but the alternative is using taxpayer money to increase government bloat programs on an elusive market as it is, since these companies come and go fast.  Some third parties will certify supplements, including NSF and ConsumerLab.  If you think I’m making up these statistics, I invite you to do your own research at ConsumerLab!

The panel of health experts has 85% good advice for promoting immunity, if you would like to check out the quote.  Those that I do not agree with include those who recommend probiotics for everyone.  As you see, registered dietitians are not in agreement on this.  I don’t understand how gut bacteria in a capsule that are supposed to survive in an alkaline environment in the large intestine can make it past the extreme acidic environment of the stomach alive and set up camp lower down the tract where they promote immunity.  Unless they’re using special capsule technology, the bacteria in these capsules probably die before they do any good.

The bacteria would also have to compete with existing microorganisms in your colon, which have already set up camp based on your diet, exercise, stress levels, etc.  You would have to continually consume these capsules to compete against the bacteria down there that your current diet supports.  The bacteria are called the gut flora, gut microbiota, microflora.  Did you know there’s a 90% cure rate for irritible bowel syndromes with fecal transplantation?  Just get over the ick factor.

I think it is MUCH more important to consume a variety of different types of indigestible carbohydrates, ie fiber, as these are considered “prebiotics,” which is what the bacteria ferment.  You would get these from eating a variety of fruits, vegetables, and whole grains (the food components in our diet with fiber).  Try to eat various colors and textures of vegetables.  I am not in the school of thought that everyone needs to take a probiotic.  There may be some cases where it could possibly help, but I think it is secondary to the big picture of consumption of more types of prebiotic fibers, which will select for certain species of bacteria.

The bacteria in the gut have coevolved with us through natural selection.  If you supply the appropriate food ingredients, they self-select for the limited real estate in your colon.  It’s like living in on an island.  Only those who can thrive in the area will be there based on the food present while waging war against other strains of bacteria for space.  The bacteria that enjoy a processed food diet that is low in plant fibers will flourish in the guts of those who eat those foods.

The gastrointestinal tract is not just for digestion and absorption.  It is an endocrine and immunity organ.  It responds to relative energy deficits and surpluses in the body through diet and exercise, which also selects for different types of bacteria.  This is a relatively newer area of science that is just now being charted.

For these reasons, I am not a germaphobe.  There are many good bacteria that I do not want to get rid of, which can happen through excessive antibiotic use and being overly antiseptic.  Don’t get me wrong: I still believe food safety is important for the general public that may have a weak immune system with limited varieties of bacteria present who cannot literally stomach any new invaders that cause foodborne illness.  People should throw out spoiled food and not take risks with food that has been left out, cooked to the proper temperature, or reheated to the proper temperature.

Other opinions I really disagree with on the quoted expert panel:

  1. I don’t believe you have to take glutathione, cysteine, and vitamin C in supplement form three times a day as one of the “experts” recommends.  Sounds like he wants to sell some supplements!
  2. Probiotic supplement pushers.  We were just fine without taking these many years ago.  You cannot get healthier than a non-disease state by consuming supplements, in most cases.
  3. We don’t all need to be popping magnesium.  Just because it is a component in physiological and biochemical systems does not support the recommendation you need to start supplementing without clear evidence of deficiency in real lab tests.  Don’t get me started on real lab tests.  That’s another blog post, but in short, there are a lot of sham lab tests out there that support a set agenda.  This woman has a conflict of interest that is pretty evident also.
  4. You cannot “alkalise [sic-British]” your body.  The blood pH is strictly maintained between 7.35-7.45 (slightly basic) via bicarbonate excretion of the kidneys and carbon dioxide release in lungs, which reduces the carbonic acid produced from the carbon dioxide produced at the end of glycolysis in the transformation of pyruvate to acetyl-CoA.  If your blood isn’t in this range, you likely are in a serious disease state, such as respiratory or kidney failure.

Janice Maras had a good quote.  Shout out to her.

If you have any comments feel free to post below.

 



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Inspirational Media Quote on beautyhigh.com

The best health and wellness advice.

Keep your eye on the prize
Focus on where you want to be and break it down into the smallest, most attainable steps you can achieve. Discipline takes care of the rest.
 Joey Gochnour, Registered Dietitian Nutritionist and Certified Personal Trainer

Read more: http://beautyhigh.com/fitness-and-wellness-experts-share-advice/#ixzz3Bhyc0RYO

I do not agree with the detox girl’s discussion on how nutrients are absorbed, or the guy who believes his dog lost weight from mental stimulation.  You will never hear me use the word “detox” in a good way because registered dietitians are supposed to promote evidence-based nutrition interventions according to our code of ethics.  She demonstrates a lack of understanding of digestive physiology and nutrient metabolism, which are classes I had to pass to hold my credentials.  I am not big on the trend with green smoothies, but the yoga instructor made a balanced one.  I would support that particular recipe.

I don’t know what super green powder is though.  If you’re going to make something with vegetables, make sure you start with vegetables and not supplement powder.  Supplements aren’t regulated until someone has an adverse side effect and reports the problem.  Until then, no one is guaranteeing that supplement has what it says it has in the bottle.  For all you know you could be getting GREEN SAND and saying you feel like your hair is shiny and skin vibrant, among other subjective claims.  Plus, vegetables are cheap.  The supplement powder is not.  I don’t understand the point of trying to go vegan/vegetarian and then increasing use of processed products.



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Food Stamp Challenge: Eating Balanced, Nutritious Meals Isn’t Expensive

As part of my training to become a registered dietitian nutritionist, I was required to attempt the Food Stamp Challenge.  For five days, I was allowed $21.90 to spend on all food for all meals and snacks.

At the time of the assignment, $22.50 was the actual amount you would get on food stamps for that time period.  Currently, the USDA thinks you can get by on $189/month as a household of 1, which translates to $31.50 for 5 days, if I were to do this assignment now.

To do the assignment, I assessed what I was currently eating in terms of calories and protein and figured out what I would need to go for if I made a meal plan with other foods.  If you are interested in this data, I can email it to you for a nominal fee of $20, as I did it the old fashioned way: food log + nutritiondata.self.com + Excel.  Considering that I am a single man who lives alone, eating similar foods every day, this is pretty much human experiment data.

Typical food bill

Typical week of groceries

The first thing I learned was that I was eating between 3200-4000 calories a day as a very active person and not-so-strict lacto-vegetarian (cheap food for grad school, but it was not my philosophy on life when eating out).  Buying this many calories was going to be a challenge, as I did not want to lose hard-earned muscle mass or feel lethargic while at my internship.  My preceptors can vouch that I actually did this.

I spent a good hour and a half at the grocery store weighing out the cheapest fruits and vegetables to meet needed servings of fruits and vegetables based on nutrient needs such as vitamin C and vitamin A.  I learned that broccoli was one of the more expensive vegetables.

I went to the bulk food aisle and filled up on salted peanuts and salted sunflower seeds.  Other foods I bought were a white onion, green bell peppers, small peaches, bulk carrots, small limes, jalapeño peppers, dried split peas, dried kidney beans, brown rice, and non-fat dry milk from the cooking aisle.  My total bill was $20.65.

Food Stamp 5-day Receipt

Food Stamp 5-day receipt

I cooked all the food on Sunday: pressure cooked the beans, peas, and rice separately.  When finished, I weighed the products so I could calculate how much of a serving I could give myself to spread the food out over the 5 days into regular meals and snacks.  I also dispensed the fruit and vegetables into similar servings.  The salted peanuts and sunflower seeds were definitely the best part in terms of flavor.

The food was incredibly bland because I did not purchase seasonings on my budget.  Even with buying high calorie, nutritious foods, I was only getting 2970 Calories per day.  I did not sign up to lose weight on this assignment, so…I cheated a bit by adding oats (another cheap food I didn’t buy but already had) and spices to the food.  I also slipped in some chocolate soymilk after a workout.

Maybe if I didn’t continue to workout, I could have found the calories on this diet sufficient for that period of time and wouldn’t have had to cheat.  From a taste perspective though, I had to.  It was so bland.

The assignment taught me how difficult it is to follow a meal plan.  Even if it is well constructed, you cannot predict how well you will like the foods on it, whether you will be hungry or full, etc.  I also learned that the capsaicin in jalapeños does not cook away as fast when cooking in water vs oil…I sweated that meal out!

I also learned what foods are cheap and nutritious.  I did not buy organic and, when putting my meals into choosemyplate.gov, I was doing well meeting my quotas for micronutrients, not just carbohydrates, fat, protein, and total calories.  The distribution of the macronutrients was also acceptable.

Foods I thought would be hard to afford on food stamps while having high calorie needs and still wanting to eat healthy included: organic foods, oils like olive oil and canola oil, packaged foods, broccoli, and fresh milk.  Dry milk was my most expensive purchase.  It doesn’t spoil and was slightly cheaper than fresh milk at the time.  Last I checked it is about the same as fresh in the current market, unfortunately.  At least it doesn’t spoil as fast.

Of course, the supplemental nutrition assistance program (SNAP), formerly called food stamps, is supposed to be supplemental.  You also aren’t allowed to buy a multivitamin on it.  In real life, you would not be limited to $21.90 and could afford to purchase spices, cooking oils, and other things that make food taste better.  You also probably wouldn’t break your budget doing so.

Ever since attempting the Food Stamp Challenge, I have viewed eating out at restaurants and food stands as a social luxury.  Yea, it is convenient and fun, but financially you are paying not only for the food but for the experience of eating out, the employees’ wages, the manager’s salary, overhead, supplies, etc.  You also are paying to not be in control of your portion sizes and ingredients, but that’s another topic!

The point of this post is not to encourage anyone who doesn’t need to eat on food stamps to go try; rather, the point is to counter the idea that eating healthy is expensive or that the meal plans to be fit and active are expensive.  I was still meeting my nutrition needs with adequate protein and calories for a fit and active person.



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