Fat and the screwed up medical community

Why We Get Fat by Gary Taubes provides a much more in depth explanation of the dynamics of fat storage than was in my last posting, but it goes well beyond that as well. Taubes is pretty scathing in his description of how off track the medical community got with respect to diet since World War II, and to the great detriment of the average American’s health.

If you believe, as most people seem to today, that carbs are the chief culprit, it’s absolutely shocking to look with fresh eyes at the food pyramid. Introduced less than 20 years ago, the explicit recommendation was for 6-11 servings of bread, cereal, rice and pasta vs 3-5 servings of vegetables! No surprise that the FDA replaced it in June with MyPlate, a much saner guide though still probably off for someone trying to lose weight. In the meantime the obesity problem has achieved epidemic proportions.

A lot of smart people got caught on the wrong path with two overly-simplistic models: Cals in v. cals out, and If you eat fat, you get fat. And, implicitly, if not explicitly, they cultivated the view that obesity is a symptom not a cause. Of what? Why of gluttony, sloth, and a lack of willpower, of course.  The reality is that some people have a tendency to get fat and some don’t. Most of us who are over 40 know that our current selves are in the former, and that our former selves didn’t have to think about diet. Why is it so hard to believe that a fat guy has an inherent problem, not a lack of willpower. Unfortunately, there’s no silver bullet in the book. If you tend to fat, you can’t eat carbs; if not, you can.

The implications are pretty well aligned with the diet I’ve suggested for losing weight. But there are a couple of differences. First of all Taubes would take issue with my suggestion that counting calories can accelerate weight loss. I’m not sure I buy it, but he poo-poos that whole notion. And, while he suggests that exercise is great for a bunch of other reasons, diet it the dramatically dominant factor in weight loss. One of the key dynamics he cites is the relationship between exercise and eating. Most people eat more when they exercise more which offsets the weight loss benefit. Finally, he’d have you eat more meat than I was suggesting; no reason to limit at all. I suppose I could test all this by putting 40 pounds back on and giving it another go…nah!

A barefoot layman’s view of the biochemistry of fat storage

The dynamics of fat storage are pretty complex; here’s a boiled down version:

It all starts with the regulation of blood sugar (glucose).  Glucose is transported by the bloodstream as a source of fuel for our cells, however too much sugar in the blood is a problem, so the body regulates it by pancreatic insulin secretion. The quickest way to get sugar out of the blood is to shuttle if off for storage as fat in fat cells, and insulin in the blood triggers just this process.

As carbohydrates are digested, they turn into glucose. In reaction, insulin in the blood directs glucose into fat cells (and away from muscle cells). In the process, fatty acids in the blood, say from eating bacon, will be also be turned into fat. So, the carbs indirectly cause temporary building up fat from the carbs and other fat sources. If everything is working properly, glucose levels come down, insulin follows, and everything is hunky dory. Over time built up fat gets burned off into energy for the rest of the bod.

The foods we think of as “carbs” (and sugar) are hyper-easily digested, turning very rapidly into glucose and thus cause the body’s red lights to start flashing and insulin secretion to spike. This control system evolved over millions of years of pre-agrarian history in the days before French fries and even rice or bread. So it was not designed to handle the spikes caused by these foods. Human diets evolved much more rapidly in the last 10,000 years than bodies have. As a consequence, the sugar control system operates imperfectly in the face of conventional modern diets. Insulin levels stay high longer than they are needed, keeping energy from going where it’s needed causing another familar control system takes over…we get hungry, the thing that causes us to eat. It’s no surprise that eating one potato chip causes us to crave another.

Carbs are not just potatoes and bread; you’ll find them in all kinds of foods including very healthy vegetables like spinach (known sometimes as “good carbs”). So if you eat a whole lot of spinach you could ingest a lot of carbs. However the carbs in spinach are bound up in fiber, which is very slow to digest, thus glucose is released more slowly into the bloodstream.  Spinach contains almost as much fiber as carbs; a potato has 10X carbs over fiber. So eat a potato and some bacon, and all the glucose and carbs get stored as fat; put a bunch of bacon on your spinach salad and the fat in the bacon is burned as fuel.

Fructose, the sugar in fruit and dominant processed food sweetener, strains the system in a particularly complex way. Fructose is only processed in the liver and when there’s insulin in the blood, it causes fat build up in the liver. Through a not very well understood mechanism, over time this causes a condition called insulin resistance. Cells throughout the body become less sensitive to insulin, thus requiring more of it to be secreted and for longer. More insulin in the blood means more fat buildup. Wrap the fructose in a bunch of fiber to slow it down, as in fresh fruit, and it’s not so bad. Liberate it in juice, or worse, refine it as syrup, and it’s pretty bad. (“Poison” according to Dr. Robert Lustig in this 90 minute, worth-watching, video.)

I’m not sure I’ve got it all right, but there is little argument about the fact that carbs turn to glucose, glucose triggers insulin, and insulin facilitates fat build up.

Barefoot calorie counting on both sides of the equation

The simplest model of body weight dynamics says there are g’zins and g’zouts and to lose weight the g’zouts must exceed the g’zins. So, if you are really aiming to lose some weight, it’s an excellent idea to track your caloric intake versus output. For me, that practice turned the daunting endeavor into a game with my score reported by the scale every morning. My competitive juices provided the discipline to keep the calories down and the exercise up.

Years ago my mom would diligently look up various foods in a little paperback pamphlet. Today, if you are at all technologically bent, software makes it a lot easier. Google “counting calories” and you’ll find scores of options. Most are free web apps where you get an account, enter your stuff and it tracks it for you. They all are pretty similar; the key is to find one with a good database. Piecing together what’s in a salad from McDonald’s is tedious, but if you need only enter “McSalad- Southwest,” that’s easy. Some of the sites have social media aspects, so you can “friend” with other dieters and build a support group. For me a key feature was having an iPhone app available, so I could carry my tracking software in my pocket. I did a little research

Barefootin’ on Boston TV

One morning in mid-June, ten or so of the New England Barefoot Runners faithful gathered by the Charles in Cambridge for our TV debut. Channel 5 weather guy (and avid runner) Dave Brown was working on some stories about running in Boston for Chronicle and had contacted Barefoot Preston Curtis who put out a casting call.

Although we didn’t get a great workout, it was fun and interesting to see how local TV sausage gets made. Dave and his photographer started by interviewing Barefoot Mama, Therese Withee, the first woman to run a barefoot Boston marathon. Next up was Todd Byers, a buddy of Ken Bob Saxton’s, and the world record holder for barefoot marathons with 102 under his belt. Both are great folks,

Phil’s unlimited barefoot wonder diet

By popular demand…here’s what I was eating when I was losing about three pounds a week:

Breakfast- The easiest breakfast for me, because I tend to eat at work, is a packet of instant plain Oatmeal. It’s a little dull, but when you are diet hungry, even dull foods taste wonderful. Oatmeal, although a little carb heavy, is also good for cholesterol. More in line with most of the low carb diets is 2 or 3 ozs of meat and a bunch of vegetables, leftover from the night before.  So, I was mixing it up between the two. Vegetable omelets are great too; I usually just don’t take the time.

Lunch- Salad (about 8oz) including 2oz of chicken or hardboiled eggs with oil, vinegar and black pepper. This was really easy for me and continues to be my daily lunch. I’ve come to love the plain o/v dressing. We have a cafeteria at work with a salad bar, so after I exercise at lunch, I swoop in there and toss together a salad. It is completely satisfying. They come in a plastic container with a top allowing

Phil’s recommended reading for barefoot dieters

There have been countless wonder diets published over the years. Nephew Dan Gould was questioning how there can be so many different right answers. How can one diet tell you to eat X and another to avoid X and eat Y? I can’t claim to have done exhaustive research, but my sense is that there is reasonable consistency amongst the popular diets today.

The common theme is that to burn vs. store fat, you want to keep your blood sugar levels low and flat.  You get there by losing the carbs, eating lots of vegetables, and drinking lots of water. A helpful rule of thumb is to avoid white—Rice, potatoes, milk, sugar, bread, etc. (The notable exception is cauliflower, a great potato substitute.)

My reading started with The Four Hour Body. It’s not a diet book per se, rather an empirical study of many aspects of how bodies work

Barefoot running may not be the whole answer

Ok, here’s a little secret: My knees still bug me a little. Like many barefooters, I shed the shoes for health reasons, among with others. In my case there we no acute issues, but I did have the sense that my knees and hips could impede my running one day. I can unequivocally state that I don’t even think about the hips any more.  And, I’ve definitely improved on the knee front, but more, maybe, from shedding pounds than shoes. So, I’m broadening the discussion here to diet and general health, as that’s where my research and attention have been going of late…still doing 15 miles of barefoot running per week.

Sadly, casual running alone is no longer sufficient to keep my weight in check. I have difficulty not consuming large volumes of food, perhaps in part due to being active, and my metabolism ain’t burning the cals it did when I was a younger man. Most guys I know observe that the ol’ bod  significantly downshifts at 40. No doubt getting exercise is a net positive, but nonetheless, last December 31, I found myself weighing 228. For context, I’m 6’2″ and over 50 (uggh) and that weight was 30 lbs over my soccer/rugby, in-shape weight, 25 lbs over my unstated goal,