Eating for Health, Not Weight
ALMOST half of Americans are on a diet not surprising,
since two-thirds are overweight or obese, a frightening statistic that inspired
Mayor Michael R. Bloomberg to push through a ban on large soft drinks in New
York City. The country is preoccupied with calories. McDonald’s, for instance,
is now posting them. But our widespread hope for weight loss makes us
vulnerable to all kinds of promises, even ones that aren’t true, when it comes
to food.
Perhaps the biggest misconception is that as long as you lose
weight, it doesn’t matter what you eat. But it does. Yet being thin and being
healthy are not at all the same thing. Being overweight is not necessarily
linked with disease or premature death. What you eat affects which diseases you
may develop, regardless of whether you’re thin or fat. Some diets that may help
you lose weight may be harmful to your health over time.
A widely publicized study earlier this year showed that a
low-carb Atkins-type diet might be a faster way to lose weight. That may have
given many people the idea that eating meat and butter is the route to thinness
and thus health.
In 35 years of medical research, conducted at the nonprofit
Preventive Medicine Research Institute, which I founded, we have seen that
patients who ate mostly plant-based meals, with dishes like black bean
vegetarian chili and whole wheat penne pasta with roasted vegetables, achieved
reversal of even severe coronary artery disease. They also engaged in moderate
exercise and stress-management techniques, and participated in a support group.
The program also led to improved blood flow and significantly less inflammation
which matters because chronic inflammation is an underlying cause of heart
disease and many forms of cancer. We found that this program may also slow,
stop or reverse the progression of early stage prostate cancer, as well as
reverse the progression of Type 2 diabetes.
Also, we found that it changed gene expression in over 500
genes in just three months, “turning on” genes that protect against disease and
“turning off” genes that promote breast cancer, prostate cancer, inflammation
and oxidative stress.
The program, too, has been associated with increased
telomerase, which increases telomere length, the ends of our chromosomes that
are thought to control how long we live (studies done in collaboration with Dr.
Elizabeth Blackburn, who shared the Nobel Prize in 2009 with Carol Greider and
Jack Szostak for discovering telomerase). As our telomeres get longer, our
lives may get longer.
In a randomized controlled trial, patients on this lifestyle
program lost an average of 24 pounds after one year and maintained a 12-pound
weight loss after five years. The more closely the patients followed this
program, the more improvement we measured in each category — at any age.
It’s not low carb or low fat. An optimal diet is low in
unhealthful carbs (both sugar and other refined carbohydrates) and low in fat
(especially saturated fats and trans fats) as well as in red meat and processed
foods.
WHAT you eat is as important as what you exclude — your diet
needs to be high in healthful carbs like fruits, vegetables, whole grains,
legumes, soy products in natural, unrefined forms and some fish, like salmon.
There are hundreds of thousands of health-enhancing substances in these foods.
And what’s good for you is good for the planet.
Calories do count — fat is much denser in calories, so when
you eat less fat, you consume fewer calories, without consuming less food.
Also, it’s easy to eat too many calories from sugar and other refined carbs
because they are so low in fiber that you can consume large amounts without
getting full. Sugar is absorbed so quickly that you get repeated insulin
surges, which promote Type 2 diabetes and accelerate the conversion of calories
into body fat.
But never underestimate the power of telling people what
they want to hear — like cheeseburgers and bacon are good for you. People are
drawn to Atkins-type diets in part because, as the study showed, they produce a
higher metabolic rate. But a low-carb diet increases metabolic rate because
it’s stressful to your body. Just because something increases your metabolic
rate doesn’t mean it’s good for you. Amphetamines will also increase your
metabolism and burn calories faster, which is why they are used to help people
lose weight, at least temporarily. But they stress your body and may mortgage
your health in the progress.
Patients on an Atkins diet in this study showed more than
double the level of CRP (C-reactive protein), which is a measure of chronic
inflammation and also significantly higher levels of cortisol, a key stress
hormone. Both of these increase the risk of heart disease and other chronic
diseases. A major research article published recently in the British Medical
Journal studied 43,396 Swedish women over 16 years. It concluded that “low
carbohydrate-high protein diets ... are associated with increased risk of
cardiovascular diseases.” An important article in The New England Journal of
Medicine examined data from a study showing that high-protein, low-carb diets
promote coronary artery disease even if they don’t increase traditional cardiac
risk factors like blood pressure or cholesterol levels. A diet low in fat and
high in unrefined carbohydrates caused the least amount of coronary artery
blockages, whereas an Atkins-type diet caused the most.
Outcomes from more than 37,000 men from the
Harvard-sponsored Health Professionals Follow-Up Study and more than 83,000
women from the Nurses’ Health Study who were followed for many years showed
that consumption of both processed and unprocessed red meat, a mainstay of an
Atkins diet, is associated with an increased risk of premature death as well as
greater incidence of cardiovascular disease, cancer and Type 2 diabetes.
About 75 percent of the $2.8 trillion in annual health care
costs in the United States is from chronic diseases that can often be reversed
or prevented altogether by a healthy lifestyle. If we put money and effort into
helping people make better food and exercise choices, we could improve our
health and reduce the cost of health care. For example, Medicare is now
covering this program for reversing heart disease. In an increasingly polarized
political landscape, this approach provides an alternative to some Republicans
who want to privatize or dismantle Medicare and some Democrats who want to
simply raise taxes or increase the deficit without addressing the diet and
lifestyle choices that account for so much health spending.
This way of living helps you lose weight and keep it off
while enhancing rather than harming your health.
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