There is just no getting around it. You have to control your diet and exercise regimen and watch carefully what works for you. The one size fits all treatment that doctors prescribe is just dangerous.
I have written previously how a low carb diet seems to work for more than half of the population -- including lowering cholesterol, triglycerides, and blood sugar. A stubborn few will raise their cholesterol so that is why it is critical to get your blood work done before you start the diet and then monitor it closely while you are on the diet. (I had good cholesterol before the diet, and now my cholesterol is even better, and that is eating eggs, bacon, and cheese practically every day. You just cannot combine these things with white refined flour carbohydrates -- or you will kill yourself.)
But I never questioned exercise. To my mind, no one had ever questioned the value of exercise. Well, it turns out, for a stubborn few, exercise doesn't do a thing according to a recent exercise study.
“There is astounding variation in the response to exercise. The vast majority will benefit in some way, but there will be a minority who will not benefit at all,” says Claude Bouchard of Louisiana State University in Baton Rouge, US...
Previous reports indicated that there are huge variations in “trainability” between subjects. For example, the team found that training improved maximum oxygen consumption, a measure of a person’s ability to perform work, by 17% on average.
But the most trainable volunteers gained over 40%, and the least trainable showed no improvement at all. Similar patterns were seen with cardiac output, blood pressure, heart rate and other markers of fitness...
Bouchard reported that the impact of training on insulin sensitivity – a marker of risk for diabetes and heart disease – also varied. It improved in 58% of the volunteers following exercise, but in 42% it showed no improvement or, in a few cases, may have got worse.
This study was very comprehensive. Please read the whole thing. And I am not advocating people not exercising! Far from it! (I know exercise works for me, not that I do it enough.) What I am advocating is that people watch what works for them -- because no one else is going to do it like you can. (And remember, I am not a doctor... I am just putting things on my blog that I would tell my daughter.)
And if you have diabetes, please read these articles about how you can really take control of your treatment.
This is why I find this article from Duke on weight loss so disturbing. These guys are supposed to be the weight loss experts.
"We do know that if you eat fewer carbohydrates, you're going to replace them with protein and fat," she says. "And eating a high-protein diet can raise your risk of cancer. There are already some studies that have suggested that. It's definitely not good for your kidneys, because your kidneys are the only organs in your body that can break down and dispose of extra nitrogen from the protein you're eating. If you're also not eating the same amount of carbohydrate as before, you're also probably eating more fat. And we know that a diet high in saturated fats is linked with an increase in heart disease."
Where do I start "to fisk" this paragraph? We know that a diet high in saturated fat that is also high in carbohydrates increases heart disease. We are getting more and more studies that show a diet high in fat can decrease your risk of heart disease factors -- as long as there isn't a lot of refined carbohydrates!
"There's also the concern that if you have a diet that's relatively low in fruits and vegetables and whole grains, you might be missing out on some nutritional elements that are important in reducing cancer risk," warns Howard Eisenson, a professor of medicine at Duke who directs the Duke Diet & Fitness Center. Eisenson has a long list of people he wouldn't recommend going low carb, because there are no studies on the diets' long-term health effects: pregnant women, children, the elderly, and those at risk for impaired kidney function, osteoporosis, or kidney stones.
So now it isn't about heart disease, it is about cancer and kidney stones. OK, they must be talking about the people who don't read the books on low carb dieting -- who don't know that they are supposed to eat vegetables, lots of green vegetables, spaghetti squash, cauliflower, etc. and GOOD fiber... Now, the list of people who should be cautious is perfectly fine. (I have my kid on a modified low carb diet -- they just don't get 300 carbs a day like most kids.)
"The decent studies on low-carb diets are in their infancy," he says, adding that he recommends the traditional low-fat diet for most patients at his center looking to lose weight. "Our low-fat diet has the greatest weight of scientific work behind it. We've been doing it for a long time. We feel most confident in this as a way of life. If you haven't tried a traditional low-fat diet in a very serious way in a well-supported setting such as this, that's our leaning."
OK, flat out here, they are saying that we are going to advocate what we know, not necessarily what works best for you or your body. It doesn't matter that you haven't tried to lose weight a million times before, you haven't tried to lose the weight here at Duke. (Oh, and goodness knows what happens when you leave the "well-supported" setting at Duke.)
They even admit that it took patients to get them to even look at the low carb approach:
Eric Westman, an associate professor of medicine at Duke, didn't buy Atkins' weight-loss sermon and, after reading his best-selling book, Dr. Atkins' New Diet Revolution, was convinced the Atkins plan had little scientific merit. "It's a very slick book, written to sell books," he says. Westman even advised his overweight patients against trying Atkins, warning them that the added fat that accompanied their high-protein regime would raise their cholesterol and triglyceride readings. But when three former patients disregarded his advice and returned to his office in 1997 trimmer and with improved triglyceride and cholesterol readings, Westman figured he had to learn more.
He did a study where they found:
That follow-up study, involving 120 obese patients randomly assigned for six months to either the traditional low-fat diet recommended by the American Heart Association or the Atkins plan, produced a few other surprises. The study, published in the May 18, 2004 issue of the Annals of Internal Medicine, found that low-carb dieters not only lost more weight than the low-fat dieters--an average of twenty-six pounds compared with fourteen pounds--they also lost more body fat, lowered their triglyceride levels, and raised their HDL more than the low-fat group.
But even with that, they still don't advocate these diets... only if they have to... and only very reluctantly... and for not more than 6 months.
Westman and Yancy's results parallel two other studies published in the past year that found low-carb diets to be at least as effective in losing weight as low-fat diets, for at least the first six months. But whether low-carb dieters regain their weight and whether these individuals suffer any medical problems when they continue their diets beyond six months remain open questions. "No one really knows," says Westman. "There are people who have done the diet for years, but not in a large enough number and not with monitoring to know that they're healthy by all of the parameters that we can measure. In both of these studies, I closed up shop after six months and told the patients, 'I'm not even sure you should be on this diet.'"
As a practical matter, both Westman and Yancy counsel their overweight patients not to go low-carb for longer than six months. And when restricting carbs, the researchers insist that dieters be monitored by a physician, particularly if they have diabetes or high blood pressure. "This really shouldn't be your first method of losing weight," advises Westman. "But over the last six months, I've come to the conclusion that if you've tried other ways of losing weight unsuccessfully and if obesity is your main problem, then this is a viable option with monitoring. The times are changing quickly, and a lot of it has to do with ongoing research."
But, of course, the ultimate goal remains (based on what studies I would like to know):
And, as they lose weight and become more active, I think it would be okay for them to eat 55 to 60 percent of their calories from carbohydrates, as the major health organizations recommend."
I would be a balloon, always hungry, at that level. And then of course, the diet isn't environmentally friendly and more expensive:
Eisenson doesn't believe low-carb snacking or dieting will be medically detrimental for the typical healthy consumer, just expensive--foods high in protein and fat are higher in price. (They're also less environmentally friendly, points out Politi, because a given serving of meat and dairy exacts a higher toll on our environment than, say, fruits, breads, and vegetables.)
"I may sound a little cynical," adds Eisenson, "but I don't think most [consumers] are going to do low-carb for very long. In our society, we like quick solutions and, in my experience, a lot of people play with low-carb, but they don't really understand it. They go out and buy low-carb products, but they don't adhere diligently to it. A fairly significant percentage of them tire of it. They get to the point where they feel too deprived, and they give up. So I don't know how much medical harm we're really going to see. We're probably going to see more harm to their pocketbooks."
OK, to be fair, I did pick out the more egregious comments -- and they do include a lot of caveats that leave the door open for low carb, but at least in this article, you could tell that the author was more pro low carb than the doctors. (And please read the whole thing and make your own judgment!)
If you must have your white bread, then low carb isn't for you. If you can live without it (I can) but can't live without meat, fat, cheese, etc., can't live the rest of your life being constantly hungry, and your body responds well to low carb -- give it a try -- and keep monitoring. You have to do it, because your doctor has too many patients to try to individualize care the way that you can, and they are afraid of lawsuits so they can't advocate anything that is outside the mainstream health advice.
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