Getting Philosophical on the Mediterranean Diet

I did it again.  I bought another diet and nutrition book...which I happen to need like a hole in the head.  I wouldn't have bought the thing at all (I'm pretty sure I've got the subtle nuances of most major eating regimens down pat), but when I was scanning the pages in the store, I saw a section on the mineral phosphorous and thought this book might be more well-written and more in-depth than most.  Maybe this book would hold the key to simplify everything and will tell us all how to live to be 100 years old and fit as a fiddle the whole time.

But alas, it was just a typical overly-excited effort to convert others to some whack-a-doo regimen backed by the fuzziest excuse for nutritional science that the author sees as an inarguable truism.

What would make a really good diet book for me?  I want to see long-term studies.  I want some semblance of mortality data.  I want a real control group.  And for sure, I want less proselytizing.

Most doctors will admit it.  Even they cannot make a definitive mandate on what diet is the absolute best for general overall wellness and longevity.

Docs admit that a very low fat diet (the kind we all embraced in the 1980s) can yield respectable weight loss results and positive indicators for cardiovascular health...if a dieter can stick to it.  But we've all learned over time that with a very low level of fat, satiety is not always there for the dieter.  If, in an effort to feel satisfied, they down a whole pot of rice instead of the half cup portion allotted to them, a dieter can actually gain weight on a low-fat regimen.

Well, then, how about those high protein/low carb diets like Atkins or these new Paleo programs?  Aside from very low calorie liquid semi-fasts,  high protein/low carb diets are probably the quickest route to rapid weight loss.  But they may not be the optimal choice for dieters trying to correct a negative trend in their cardiovascular health or those on diabetes medication.  And sooner or later, someone is going to offer the dieter a piece of birthday cake which is going to instantly erase that arduous journey into ketosis.  This is another program that is tough to stick to for the rest of your days.

What about hardcore veganism, like the Engine 2 Diet?  It looks very compelling for cardiovascular health and it is gaining popularity...but it may not be so great for joint and bone health, and the average omnivore can't seem to make the conversion to a world with zero animal byproducts.

Gluten-free?  This regimen is an absolute necessity for someone with celiac sprue and it is  probably a desirable diet for someone who suffers from IBS, Crohn's, leaky gut syndrome or some other chronic gastro-intestinal disorder, but this diet is not necessarily designed for the average joe looking to shape up their general wellness. 

What about this Mediterranean Diet that is getting so much hype?  The Mediterranean Diet, which should read like an exercise in semi-vegetarianism, often gets misinterpreted by the average omnivore as a steady diet of chicken and turkey.  Actually, in a perfect world, the follower of a Mediterranean Diet would lean a little harder into the realm of vegetarian and seafood meals. Mediterranean Dieters also need to eschew white flour, bakery products, sugary sweets, and sweet drinks.   The medical world is excited about this diet because they feel it is sustainable...that even non-health-nut-type people can stick to it on a permanent basis and that it could therefore improve the face of public health (which really needs an overhaul as it pertains to diet-related disorders).

I agree that overall, the Mediterranean Diet looks pretty good:  The dieter gets all of the wonderful health-sustaining benefits of plant-based foods, steers clear of the atherosclerosis-causing microbiota found in red meat, stays full for longer than 10 minutes (since there is a nice film of olive oil in the tum-tum), can still eat some animal protein to blend in with the regular folk at a dinner party, and can be sociable and drink a toast  of red wine with the gang if they choose to indulge in that sort of thing.

I also happen to like the Mediterranean Diet because in addition to looking pretty nutritionally well-rounded,  it's just kind of how I choose to live my life and eat anyway (so I'm sure my tender ego feels vindicated in some way.)  But that's about all I know for sure.  In fact, I think that's about all that the "experts" know for sure, too.

Is the Mediterranean diet the key to being trim?  Maybe...maybe not.  Is it a way to prevent or reverse chronic disease? Maybe...maybe not.  Is it the key to a long life?  Maybe...maybe not.  Whether we follow the Mediterranean Diet or some other program that we think is good, does eating intelligently give us any guarantees?  Not really.  Even at the 8th Annual Obesity Summit at the Cleveland Clinic, the doctors were somewhat divided on the best program and there is very little data on mortality rates as it pertains to specific diets.

Whether you try the Mediterranean Diet, Veganism, Low Fat, High-Protein/Low-Carb, Gluten-free, or any of the myriad dietary plans out there, you may find you reap some short-term benefits.  And you may like the short-term benefits so much that you stick with the plan long-term.  But are you never ever going to have any cardiovascualr problems?  Sorry, no guarantees.  Will you never ever contract cancer?  Sorry, no guarantees. Will you be strong, mobile, and quick-witted as you approach your hundredth birthday? Sorry, no guarantees.

The only guarantee we have is today.  So just make wholesome food choices that make you feel clean, strong, and energized today.  Use that strength and energy to make it a great day that you are glad to be a part of.  And maybe you can use that strength and energy to something good for someone else out there, too.  Then get up and do it again tomorrow.  That effort to get the most out of each day is the only guarantee of a good diet, so I hope you find the plan that makes you feel that way.

Epic Fail: "Lifestyle Change"

I hate the word “lifestyle”.  It’s a dumb word, and it’s so overused that it has become sort of hollow and empty, especially as it pertains to diet and health.  Every day we hear,  “Don’t  go on a diet.  Just change your lifestyle.”  In an effort to do that, we decide we're going to adopt a couple new habits.  We join a gym, buy a bottle of olive oil, and swear we will eat baby carrots instead of potato chips. Our lifestyle changes last for a little while.  Sometimes the lifestyle changes don't make it past the 3-day mark, especially if we are under great stress and balancing 400 other things.  Sometimes the lifestyle changes go for a very long time-- 6 months or a year, especially if we are super-motivated and all the odds stack up in our favor.  And when we can persevere for a while with our gym rat/olive oil/baby carrot regimen and we've managed to make some good things happen to our body, we breathe a sigh of relief and say, “I did it.  I changed my lifestyle.”  

And then the wheels fall off.

Because, as challenging as those changes are, they're just not enough.  A bottle of Filippo Berio in the pantry and a much-begrudged periodic visit to Bally's do not a new "lifestyle" make.  You are on a collision course with your old ways and your old problems.

How can I be so negative?  Well, firstly because it is an absolute statistical fact.  And secondly because it has happened to me all of my adult life:  “Hey, I’m a lean marathoner and I’m capable of anything” rapidly turned into “C’mon sweetie, that new HBO series is starting and I made stew.  Let’s just take it easy tonight”  You can call it recidivism, you can call it relapse, you can call it whatever you want, but the numbers out there show that most of us who start a health kick really have a hard time making it our “lifestyle” for longer than a year.

But this tendency to not change our lifestyle is not an overarching lack of discipline...it is a biological system called homeorhesis.  Basically, our body regulates itself with hormones and brainwave patterns that we have  limited control over.  This regulatory process creates for each human body its own trajectory upon which it travels through life. Even if it is not optimal, your body wants to stay on this trajectory and it has a tendency to return itself to the trajectory it was on…even when you have done the work to go a different direction. So it is long-term fight against your own unseen biology to be a success.  Think about it in terms of your car.  Let’s say you’ve knocked the old jalopy out of alignment and it wants to pull dangerously left.  Now, unless you can afford to have major alignment work done, the old car is always going to pull left.  You are going to have to work every time you are behind the wheel and fight like the devil to keep it rolling straight.  You can’t let go of that wheel, or steer with your knees, or change the radio station, or lighten your grasp, because in the split-second that you do, you are just going to wind up veering left again.  It’s that fast.   

The moral of the story is, if you think you need to solve a health problem (whether it’s being overweight, having hypertension, having diabetes, etc.) through diet and exercise, you can never ever stop.  You can't let go of the steering wheel.  You can’t coast.  You can’t cheat.  You can’t make a deal that you’ll go back to being “good” after vacation.  You have to keep pulling that misaligned vehicle straight every day or you are going to drift left and get creamed.

That is a bummer extraordinaire, is it not?  You could find it very de-motivating and wonder, why even bother?   Most people are not lazy, and they are willing to do the hard work to get healthy.  But they are not willing to create a lifelong relationship with hard work…and yet despite the high failure rate of people trying to lose weight/get healthy, there IS a 35% success rate.  Yes, some folks really CAN do it long-term!  Better yet, that successful 35% who really stick with it can, miraculously, re-set their homeorhesis trajectory.   It takes like 5+ years of constant stick-to-it-iveness,  but these people re-program their brainwaves and hormones to those of a thin person!

So this 35% who beat the odds...what's their secret?  Are they harder workers?  Do they have an allergy to everything except broccoli?  Did they make a deal with the devil?  Why are they so lucky?

I'll argue that they didn't enact a "lifestyle change project"...they just flipped a switch and changed their lives.

More specifically, the success stories do share some similarities, mechanically.  By and large, all of the people who were able to make-over their bodies and their health as it pertains to weight and weight-related issues do the following:  they religiously exercise about 60 minutes a day, they find a healthy dietary regimen they can stick to every day, they periodically write down/record what they are doing and eating to make sure they are toeing the line, they weigh themselves regularly, and they maintain consistency all week and weekend long (no self-bargaining conversations like “I’ll start in fresh first thing Monday morning”)  

I would gander, though, that socio-culturally, the success stories also share similarities.  These folks don't just adopt a couple lifestyle changes.  On the contrary, everything in their world is re-framed.  Their closets probably look different, their pantries certainly must look different, their commute and daily habits may be significantly changed, and they probably made a few new friends whose habits mirror their own or in some way support them.  They might have even changed other things like career or relationships. They discard the dysfunctional habits of their old world, and openly embrace new ways of doing things.  They see the constant work as an opportunity rather than a burden.  And I’m sure you’ve heard people say things like “I’m a different person these days.  I don’t even want to go back to the way I was before.”   Their whole LIFE changes.  That is the key to lifestyle change.  Everything has to deviate from the way it was before.

Again, some people might be disappointed or flat-out angered by this.  They like their lives just fine, thank you very much.  And who the heck is this personal chef spouting off that they need to flip their world upside down to lose a couple pounds?  How dare she?  In all fairness, this assertion is not my personal invention.  I am relaying information as studied by the National Institute of Health and a host of scholars at the Cleveland Clinic’s 8^th annual Obesity Summit.   

To really create a change, forget the weak, watered-down term “lifestyle”.  Instead, realize that to improve your weight and/or your health, you have to change your life.

Gut Microbiota: Protect Your Heart and Your Hindquarters

This week I attended the Cleveland Clinic's 8th Annual Obesity Summit.   You might wonder why a personal chef would sign up for a seminar geared towards medical care providers.   The short answer is that I craved some real science for a change.  On a weekly basis, I sift through reams of nutritional dogma and fuzzy proclamations about health in an effort to help clients adhere to medically-suggested diets (not just for obesity/weight control, but for a whole host of health-related reasons), and I wanted some hard, empirical data that separates the best dietary habits from old wives' tales and fluff marketing put out by foodservice corporations.  Indeed, my goal was achieved and I certainly did learn some fascinating data about the human body and how it regulates weight.  Since I have copious notes on a great number of topics as they pertain to the subject of weight control, I will have to approach these topics in separate blog posts in the coming weeks.

But today I want to talk about your gut.  Or, gut microbiota, to be more specific.

Most of us are aware that there is bacteria in our gut that helps breakdown food.  For example, yogurt companies market the active cultures in their products as "friendly" bacteria that promotes good digestion.  You've heard of the stuff.

This gut microbiota, apparently, is hugely influential in your overall health. This bacteria influences not only whether you will be fat or thin but also whether your arteries will harden or stay pliable.  That means a significantly overweight person can count calories like crazy and do all the right things and not lose very much weight at all and still be on a path towards cardiovascular disease.  Not only does gut bacteria behave like its own little endocrine system, creating hormones that regulate metabolism,  it also produces products (trimethylamine n-oxide or TMAO) in the breakdown of nutrients that are directly linked to atherosclerosis, or the hardening of the arteries.  Scientist have even found when they insert microbiota from an obese lab rat into a skinny lab rat, the skinny lab rat soon becomes obese, too...with no real change to the formerly-skinny rat's diet or exercise habits.

This is where an overweight individual who is at risk for cardiovascular disease might want to throw up thier hands and say, "I can't win."

Well, yeah,  they can win, actually.

One of the most exciting things I heard at the summit was that long term vegetarian exposure inhibits the gut from forming TMAO, the compound linked to atherosclerosis.  And if they've been a veg-head for an extended period of time and decide they want a Delmonico for old time's sake...they still will not have a spike in their TMAO.  The long-term vegetarian diet effectively changes their gut microbiota!

If they are eating their vegetarian diet and exercising, their body will produce a hormone called irisin, which allows fat to be burned even while at rest.

So the diet books are not far off when they tell you to eat your vegetables and get exercise.  It's not just an empty mantra, it is a real prescription for metabolic change.

Now if someone's gut bacteria is really bad, and they have problems beyond obesity and cardiovascular risk, they can actually have a fecal transplant.  That's not as gross as it sounds.  It just means that the docs get their hands on some good gut microbiota and put it into the troubled digestive tract to effectively crowd out the bad bacteria, again with the promise to affect real metabolic improvement as well as improvement in overall health.

If you are not obese, but maybe are concerned about your overall wellness as it relates to your gut, what can you do?  Lay off the steaks and chops for one thing. (I know it's a disappointment, but the science is REAL), eat some hearty whole grains (these seem to produce good bacteria), have some yogurt with active cultures, get more exercise to make some irisin, and talk to your care provider about probiotics or prebiotics to see if they are right for your situation.

I find it fascinating that something so small..some little bugs in our digestive system...can matter so much for our cardiovascular health, our metabolic output, and our weight.  And I find it encouraging that there is action we can take to make real, positive change.  Getting our gut microbiota in line really can help protect our hearts and our hindquarters!

The Most Important Meal of the Day My Foot

My entire life I have been fascinated with diets and health regimens.  I've tried most of them..sometimes to see if I could drop a couple pounds, sometimes to increase my general energy level, sometimes to feed a specific athletic goal, and sometimes just to see what all the buzz is about.  One diet I tried for an extended period of time was based on the "Natural Hygiene" philosophy that calls for lots of raw, whole foods in general, but specifically insisted that nothing but fresh fruit be eaten during the first four hours of the day.  While it sounds a little restrictive, I have always loved fruit, and see it as a real treat, so having a daily breakfast of something ripe, juicy, and seasonal was not much effort for me.  And a fruit-only breakfast was so in-step with my busy lifestyle...if I woke up late, I just ran out the door with a couple apples or oranges in hand.

The fruit-for-breakfast routine was so delicious and practical that I held on to that tenet of the diet long after I had abandoned other parts of the Natural Hygiene program that did not work for me.  Of course, on the days that I wake up a little hungrier, I might supplement that fresh fruit with a dollop of yogurt, a handful of nuts, or even a piece of toast, but basically I keep breakfast a pretty light affair and am no worse for the wear.  In fact, I'm generally happy with what my doc tells me when I'm in for a check-up and I could be doing a lot worse on the scale (despite all my indiscretions later in the day), so I have stuck with the fruity breakfasts over the years.

Until today.

Rare is the evening I am not a member of the clean plate club, but last night I just couldn't finish the last few bites of my salmon and vegetables.  No worries, thought I---salmon and vegetables will make a protein-packed breakfast that will get my work week off to a high-energy start. What could be better?  I even blended those last couple bites of salmon and veg with a scrambled egg to make it really feel like breakfast.

So, how did I like my big breakfast?  Not much, thank you very much for asking.  That's just too heavy a way to start the day.  I feel a little sluggish, really.

I mentioned my uncertainty about big breakfasts to a friend who chided, 'Well, you know it's the most important meal of the day!"  Yeah, my foot.

I'm not buying it.  I don't believe there is a single most important meal.  I think there are routines that work well with certain lifestyles and routines that are counterproductive.  I think the body needs a certain number of high-quality calories ("high quality" meaning packed with vitamins, proteins/amino acids, minerals, and fiber) per 24-hour day, but whether you get those calories at 8am or 8pm matters less than what recent dietetic dogma would have us believe.  In fact, I've always found great reasonableness in the Tarzan philosophy of total health:  "Eat when hungry.  Sleep when tired."  But for pity's sake, don't choke down a bowlful of cold, sugar-bombed cereal and see-through skim milk (so you have no fat to slow the uptake of that refined sugary crap and possibly get some use out of some of those substandard calories) at 0-dark-hundred because you think it's good for you.  Have a shot of real fruit or vegetable juice (the no-sugar added/not-from-concentrate kind) to break the fast of sleeping all night, or crunch on an apple until you "come-to".  Then eat a larger more substantive meal later, when your stomach is actually rumbling at you.

I'm not asking you to forgo breakfast entirely, but I am suggesting you try keeping it light.  Because if you big-morning-meal-eating people are all walking around with the over-full sensation that I've got going on right now, I can guarantee that that dull feeling is a message from your body to pump the breakfast brakes a little bit.

And if you think you are keeping yourself fit and trim with a toaster waffle and a half pound of bacon, think again:  As recently as September 2013, research conducted by the Obesity Research Center at the University of Alabama found that breakfast habits and obesity do not have a direct link.  In fact, weight gain or loss is almost always a clear-cut matter of calories ingested versus calories expended.  You will expend a 150-calorie  fruit cup before you will expend a 500+-calorie sausage/egg/cheese biscuit.  So why not have two fruit cups?  You can have one when you wake up, just to get yourself going, and then have another one in another hour or two when you get legitimately hungry but maybe are not quite ready for lunch.  You get a bonus breakfast and still save yourself 200 calories or more.  And you won't feel like you swallowed an anvil along with your coffee.

Don't call me for brunch--I'm keeping it light from now on!