In a recent blog, New York Times columnist and the best-selling author of Food Matters, Mark Bittman, asks: “Which Diet Works?” That’s a huge question and a very confusing one for most Americans. In a new Atlantic Monthly magazine article, “How Junk Food Can End Obesity,” David H. Freedman takes on Michael Pollan. Every one seems to have the answer. But which one is right?
For people from traditional cultures, whether it is the French, Mexican, or Chinese, the food solution has been worked out over hundreds of years. The farm is close to the table. In the case of the Chinese, the high plant-based, low-animal-protein, no-dairy-fat diet has been working well for over a few thousand years. My guess is that they got something right during that time, or they wouldn’t keep doing it.
For Americans, we’re not only just beginning our culture (what’s a few hundred years?), but we may have gone backwards a couple of generations. What are we to do now?
Getting Rid of Non-Foods
What some have done is to reject industrialized foods. I call them “non-foods.” Michael Pollan, best-selling author of In Defense of Food, calls processed foods “foodlike substances.” That’s a start, but does a generation raised in the suburbs on processed, refined foods, lots of corn-fed meat, little or no fish, lots of the wrong kinds of fat, too much salt, and massive amounts of refined sugar and high fructose corn syrup know what to eat? And what about the poor who don’t have access to fresh foods and don’t read books by Pollan or Bittman?
Obesity is a massive problem, and not just in America. It’s clear to me that when people start eating out of “boxes and cans,” as they say in Mexico, they get fatter and sicker. It’s also clear to me that most Americans don’t have a sustainable solution, even those who shop on the outside isles of their grocery store or who frequent health food markets. Have you noticed, most health food stores are set up just like regular groceries with most selections in the center where all the packaged foods are shelved?
Keep It Simple
As a practicing doctor of over thirty years, I’ve found that what works best is to keep it simple. Take one steady step at a time. Don’t make radical changes. Your body doesn’t like biological chaos. Be gentle. For most people, gradual consistent change is best. Of course, if your cholesterol is over 350, radical change may be prescribed.
What I suggest is taking a daily inventory of what you eat. If it’s not healthy for you, make a note to not buy or order that non-food product again. Eliminate non-foods one at time. When you remove a food, or bad eating habit, that doesn’t serve you, replace it with a healthy choice. For example, you like crispy potato chips. Sure, they’re made from potatoes and may be baked rather than fried in transfat, but they are a high glycemic refined carbohydrate non-food, and they are unhealthy. Get rid of them. Replace them with real potatoes, or organic nuts like almonds or walnuts.
Refined Carbs Trigger Food Cravings
We used to think that a calorie was a calorie, and that too many of them caused weight gain. It’s still true that one pound of body fat is approximately 3500 calories. If you eat 500 calories less or burn 500 calories more than you eat each day by exercising, you would lose one pound per week: 500 calories x 7 days = 3,500 calories or one pound of fat. That’s basic thermodynamics. But the body is not a machine.
Much like the saying “it takes a village,” we now know that losing weight involves many body processes all working together. When you eat simple carbohydrates, like high-glycemic index chips (even healthy designer organic ones), your blood glucose levels sky rocket and then within four hours they plunge into hypoglycemia. Now you’re washed out tired and can’t think straight, so you crave sweets or more high-glycemic foods like chips or pizza, or fries.
Countering hypoglycemia and sugar/carb cravings requires that you eat four smaller meals daily and increase your protein intake. Not complicated. And, don’t skip breakfast. And, it means you have to plan your day better. Avoid refined non-foods (nothing in cans, bags, or boxes including what you buy at the health food store) and eat more whole, fresh foods.
Don’t go extreme by avoiding all carbs. You’re body requires complex carbohydrates for energy. They also contain lots of fiber. Your digestion works better on complex carbohydrates, and so does your elimination. Of course, if you’re allergic to gluten, you have to avoid wheat.
The Right Mixture of Fat, Salt, and Sugar Drives Food Addictions
Salt and pepper, natural fats and oils, and even some sugar are good for you. Back in the 1960s when science was cool, every technological solution was hailed as an achievement of modern technology. Since then we’ve come to a time of reckoning over asbestos, pesticide residue, and oil spills. But, it’s taken us longer to accept that junk foods are slowly killing people.
It seems mega corporations control us: big pharma, big medicine, big oil, big agriculture, big tobacco, big government, too-big-to-fail banks and Wall Street firms, and big food. Michael Moss in Salt, Sugar, Fat: How the Food Giants Hooked Us, blasts Pillsbury and Nabisco, Coca Cola and other big food companies.
The industrial reconfiguration of salt, sugar, and fat has shaped America’s eating habits and waistline, and now is influencing the rest of the world. Food scientists found that taste receptors perk up in the presence of sugar and the right combination of fat and salt. Eating them makes you crave more. The right combination, engineered by food scientists, can trigger feel good neurotransmitters in the brain providing a kind of drug-like high. The ingredients are cheap so profit margins are extraordinary. Junk food manufactures have gotten rich while consumers have gotten fat and sick.
I fared better health wise than most because I was raised on an old-fashioned working farm. I work very hard every day. We had a huge garden and stored the excess by canning in glass jars and in a root cellar that was filled with cabbages, onions, squashes, and apples. In late February and early March, I got up a 4:00 in the morning to tap maple trees for sap that my mother boiled down to maple syrup. We always ate foods freshly prepared, farmed raised and locally grown.
When I was twenty-years old, I embraced a yogic lifestyle including a vegetarian diet, which I strictly adhered to for fourteen years before adapting to a semi-vegan, once-in-a-while fish diet. It served me well.
Small farms are healthy. They employ people. They keep you active. They don’t rely on too many chemicals or use big, heavy equipment that packs down the soil. They provide habitat for animals and birds. And growing green plants helps capture carbon and makes more oxygen. Whenever you can, buy your produce directly from small organic farmers, and try to grow your own. Wholesome, farm fresh foods are environmentally superior to factory farm non-foods, and the produce is good for you.
Bottom Line Recommendations
I’ve found that once you’re obese, it’s very difficult to return to normal weight. But, it’s not impossible. I recommend starting with a panel of blood tests to include markers for inflammation, a condition now associated with obesity and diabetes, as well as the hormones insulin, DHEA, and TSH. Work with your doctor to get the numbers into the desirable range, and preferably in the optimal range.
Weight Loss Blood Test Panel
- Lipid Panel
- Hemoglobin A1c
- C-Reactive Protein
- Free T4
- Free T3
- Vitamin D, 25-Hydroxy
Tend Your Liver
Your liver function also has to be in good shape. If you have fatty liver disease or even mild liver inflammation, it will be much harder to lose weight. Take lipotropic supplements that help your liver better process fat once you start to lose weight. Lipotropics include amino acids and B-vitamins and can be taken orally or by injections.
How Your Doctor Codes Your Weight
Obesity makes you more susceptible to many other diseases, and that’s gravy for conventional doctors and weight loss clinics. But in order to get paid by insurance companies, being fat has to be a medical disease match to a diagnostic code. For insurance and other medical communication purposes, your doctor uses a set of disease-specific codes.
Recently, the American Medical Association officially recognized obesity as a disease, a decision that induces physicians to pay more attention to the condition and spurs more insurers to pay for treatments. Every few years, these diagnostic codes get a make over. We’ve been using ICD-9 codes, but new ones are already in place.
ICD-10 Codes for Overweight and Obesity: E66
Excessively high accumulation of body fat or adipose tissue in relation to lean body mass; the amount of body fat (or adiposity) includes concern for both the distribution of fat throughout the body and the size of the adipose tissue deposits; individuals are usually at high clinical risk because of excess amount of body fat (BMI greater than 30). Having a high amount of body fat. A person is considered obese if they have a body mass index (BMI) of 30 or more.
Being fat is great business for big food companies, bariatric surgeons, doctors, weight loss clinics, and diet food suppliers. Don’t buy into the promises. Look at all the codes doctors can use to get insurance compensation. It’s a racket.
- E66 Overweight and obesity
- E66.0 Obesity due to excess calories
- E66.01 Morbid (severe) obesity due to excess calories
- E66.09 Other obesity due to excess calories
- E66.1 Drug-induced obesity
- E66.2 Morbid (severe) obesity with alveolar hypoventilation
- E66.3 Overweight
- E66.8 Other obesity
- E66.9 Obesity, unspecified
Seven Tips For Changing The Way You Eat
- Don’t make radical changes. Change the way you eat step-by-step.
- Don’t eat out of boxes, cans, and bottles. Eat more whole, fresh, organic foods.
- Don’t eat fatty meats. Eat more fresh vegetables.
- Don’t overeat sweets, including fruits. Eat more vegetables.
- Don’t skip meals. Eat equally sized moderate calorie meals four times per day.
- Don’t eat simple carbs like pasta, bread, chips, and cookies. Eat more protein.
- Don’t buy into weight loss promises. Nature knows best. Take your time, take a trip to a local farm, and grow your own.