No doubt about it, if we continue on the current path of increasing obesity among children and youth, the future looks grim. Extrapolating from childhood obesity rates in 2000, researchers estimate that by 2020 as many as 44 percent of American women and 37 percent of men will be obese. The increased incidence of obesity has paralleled the skyrocketing cases of diabetes as well as other illnesses. According to the Centers for Disease Control and Prevention, when compared with people of healthy weight, obese adults have seven times the risk for diabetes, four times the risk for arthritis, three times the risk for asthma, and two times the risk for high cholesterol.
One may well ask what catastrophic change in our society has brought about this epidemic of obesity. A variety of factors seem to be involved. Increased consumption of “empty calories” from junk foods and sedentary lifestyles are two major culprits. Others include possible genetic predisposition, a commercial structure of advertising, and an instant gratification philosophy that encourages unhealthy eating.
When looking at weight control, diet is generally the first place to start. Knowing about options is a theme you will see throughout this book. It applies to being a healthy woman in so many ways, and diet is no exception. Take the simple caloric restriction diet. It seldom works because people think their only option is a blanket curtailing of calories. They don’t realize they can selectively reduce their calories by differentiating, for example, between calories from the sugar of as apple, as it naturally occurs, and calories from white, granulated sugar, in its unnatural form. Without knowing about the option of choosing a selective calorie reduction diet, a person wanting to lose weight is often drawn to a diet that is doomed to failure.
The typical diet also considers only one desire of an adherent: to lose weight. But that means that other desires and feelings, such as the loneliness that may be compelling a person to binge on junk foods, doesn’t enter the picture. Maybe the reason that so many diets, including ones with tens of millions of followers, which often look good on paper, have only had marginal success is because they have not tried to work with the whole gamut of issues related to losing weight, which involve emotional and physical needs as well.
In understanding the etiology of weight gain, it is important to look at how hormones regulate food intake. When a person’s stomach is relatively empty, the hormone ghrelin is released, telling the brain it is hungry and needs to eat. Once food has been consumed, leptin, a hormone made by fat, goes to the brain and tells the body to stop eating. From the brain’s end, this is controlled by a number of integrated entities, including the hypothalamus. It has been theorized that some people with a genetic disposition toward obesity do not have enough leptin or they do not have the receptors to bind to the leptin so their brains are not getting a proper message telling them that they are full.
Surprisingly, as demonstrated in a study with mice, higher leptin levels were found to be associated with obesity. On the surface, it might appear that leptin should be scarce, not abundant in cases of extreme weight gain. However, the research showed that excessive leptin can result in leptin resistance, which essentially means that the body stops reading weight-suppressing messages from the hormone, even though it is present at high levels. Another study exploring the role of leptin in rats found that while the hormone had some effect on weight control in lean animals, no weight-loss benefits existed when the subjects were overweight, unless an exercise regimen also was involved. This led the researchers to conclude that exercise can reverse leptin resistance.
When to eat and how much have been the subject of ongoing medical debate over the past thirty years. Some physicians have argued that overweight people, as well as those with diabetes, insulin resistance, or the metabolic syndrome conditions, should have many small meals per day. Others have contended that three meals should be the norm.
Recent research on this topic makes a decisive contribution to the discussion. Dr. Markus Stofell and colleagues in late 2009 published the results of their study, based on an analysis of physiological processes, which determined that eating three “high-quality” meals with no snacks was the preferred pattern because fasting between meals was necessary. The research centered on transcription factor FOXA2. As explained in a summary, “Transcription factors are proteins that make sure that other genes are activated and converted into other proteins. The control element for FOXA2 is insulin in both the liver and hypothalamus. If a person or animal ingests food, the beta cells in the pancreas release insulin, which block FOXA2. When fasting, there is a lack of insulin and FOXA2 is active.” So what is FOXA2 doing when it is active in the bloodstream? For one thing, it moves into the brain where it assists in the formation of proteins that sharpen awareness. As the scientists pointed out, “If mammals are hungry [which means FOXA2 is being produced], they are more alert and physically active.” However, if one is constantly snacking, there is little downtime in which FOXA2 can course through the body. Insulin is released with every snack, thus suppressing FOXA2, which in turn means that we do not feel the need for activity, such as exercise.” Considering the danger of a deficiency in FOXA2 brought on by too much insulin in the body, the researchers concluded it is healthy to get hungry between meals.
Now that we know how often during the day we should eat, we can take a look at what foods are best. In the previous chapter, we discussed diet and nutrition, and provided a list of super foods, which are packed with immune system boosters and natural energizers. Too many women today are asking their bodies to run on the wrong fuel: refined carbohydrates. Surrounding themselves with wholesome choices that consist mostly of fruits, vegetables, grains, and legumes is the key to staying healthy and fit. A woman taking this dietary route will arrange her day something like this: In the morning, she chooses a cereal that contains whole grain ingredients and no artificial sweeteners. Later in the day, she may supplement lunch with a green smoothie, made from blending and juicing leafy green nonstarchy vegetables. Fresh vegetables usually contain fewer carbs than fruit, many contain fiber, and they are naturally low in fat and sodium. For dinner, our health-conscious woman enjoys vegetables by lightly steaming or sautéing them. She adds shredded cabbage or coleslaw to salad; and includes beans and legumes in a soup or salad to meet daily protein requirements.
When looking at weight management and considering what carbohydrates to put into your diet, it is worthwhile to pay attention to the Glycemic Index (GI). This ranks foods based on how quickly carbohydrates raise blood glucose. A high GI number indicates that carbs break down quickly into blood sugar. In general, the higher the fat and fiber content, the lower the GI of the food. By contrast, the more cooked or processed the food, the higher the GI will tend to be. Watching your carbs in terms of their GI value will not only help you lose weight, but will curtail the blood sugar surges that commonly occur after meals packed with high GI foods. Chronic insulin overload caused by such a diet leads to further weight gain and is associated with all types of age-related diseases.
It is important to keep in mind that GI value does not say anything about portion control. Portion size is crucial for managing blood glucose and for losing weight. Moreover, a simple GI value doesn’t tell the whole story since many foods break down more quickly or slowly when they have been eaten in combination with certain other foods as opposed to how they release glucose when they are consumed by themselves alone.
In discussing the danger of inrushing blood sugar, let me tag the way food producers have played on Americans’ proclivities to sell them a bill of goods, in liquid form. Americans always have an eye out for a bargain. So when they hear or see one of the billboard or TV ads saying, for instance, “Drink Super Fizz Apple Juice, made of 100 percent juice,” they rush to buy it. Why? For one, they think they are getting a bargain, since instead of buying, say, five apples, they are getting five apples in one glass. Moreover—and this is the insidious part—they want to be healthy and have been told, by the commercials, that these fruit juices and concentrates are good for you because they contain the nutrients found in fruits.
In fact, the very idea that the fruit is coming to you concentrated should warn you of what’s wrong with this message. When you eat a whole apple or other fruit, the sugar in the food enters the bloodstream gradually as the stomach breaks down the item. If, however, a number of pieces of fruit are concentrated, the natural sugar in them is also concentrated, and put in liquid form so that there is a quick release of the fructose that can spike serum insulin.
While these advertised juices are unhealthy, fruit itself is filled with attractive qualities. There are adequate amounts of folic acid, vitamin C, fiber, carotene, and nutrients in whole fruits as well as in frozen fruit, both of which are crucial to a healthy diet.
I might add that while these juice concentrates are of little value, there are other extracted forms of fruits and vegetables that can do great good for the body. To give a single instance, I recently learned of the value of mulberry leaf powder, which decreases fasting glucose levels and raises the levels of good cholesterol in the body. In studies conducted in both India and Japan, researchers found that in patients who took mulberry leaf powder daily with their meals there was a reduction in harmful lipids (which boost cholesterol) as well as a diminution of free radicals.
Having mentioned the misleading advertising used to sell fruit juice—I find food commercials are more often misleading than downright false—let me turn attention to the blandishments that are put forth in relation to another product line. Food companies plaster certain products with the labels “fat free” and “low fat,” representing such commodities as always beneficial. Not so. Look at the labels. Many of them are loaded with sugar calories in the form of high fructose corn syrup, sucrose, and cheap, fortified processed ingredients. Whatever value might have been in the food in its untouched form is undermined or cancelled out completely by this raft of additives and sweeteners. A good example is green tea, which is a strong health promoter in its natural form, but is often sweetened with sucrose. Salad dressings also see their natural ingredients sabotaged when they are combined with high fructose corn syrup.
On the topic of fats, let me mention that here again a distinction has to be made. Recognizing and monitoring the quality and type of fat consumed is essential to maintaining a healthy weight. Most people have heard about the dangers of eating transfatty acids. While some of these can be found in beef, the majority are created by food processing, so that they are highly present in junk foods, baked goods, and fried food, such as French fries and fried chicken.
How dangerous are such transfats? In a recent study, scientists found the risk of diabetes in women to increase by nearly 40 percent from a “miniscule” 2 percent increase in calories from transfats. This compared with a 37 percent reduction in diabetes risk from a 5 percent increase in calories from polyunsaturated (good) fats. You can have a rich and healthy diet by replacing transfats with flax oil, extra virgin olive oil, sesame oil, hemp oil, avocados, almond oil, coconut oil, and pumpkin oil.
If we want to think of diet in terms of calories, then cutting calories by three hundred to five hundred per day should lead to a loss of between one and two pounds per week. Some may say such a cut in calories is difficult to achieve for an overeater. In my experience, though, this is a realistic target. Others may say the oneto two-pound-per-week reduction is too slow. It may seem that way, but it would add up to a weight loss of more than fifty pounds in a year, of which one can be proud.
To achieve this calorie reduction, switch off the fats, which contain more calories per serving than what is found in carbohydrates and proteins. For nutrition, lean heavy on the whole grains, beans, fruits, and vegetables. Here are some rules of thumb that will help you achieve the weight loss goal:
Finally, don’t be tempted to skip breakfast or any meal to lose weight. While skipping a meal will reduce your calorie intake for that moment in time, it will leave you much hungrier later on. When it comes time to eat, you will be tempted to overeat to compensate. Irregular eating habits also disrupt your body’s metabolism, which makes it harder to lose weight in the long run.
On this diet, it will take a week or two before you notice any changes, but they will steadily appear. After about thirty days, you will notice your clothes are looser, your energy is greater, and your self-esteem is increasing. Keeping your motivation up is one of the most difficult aspects of dieting. There will be days when you backslide. Perhaps, you go to a party and see a table overflowing with junk food. Everyone else is eating it. The host offers you a platter and without thinking you chow down. It happens. Healthy eating has gone out the window for that one night, only to be continued the next day. There may be weeks when due to such lapses you may not lose much or any weight. But remember at such times that weight loss is a process that with this change in eating habits will be slow but sure. Even if you only lose one pound in a single month, it’s preferable to putting that one pound on.
Celebrate the new you as it achieves weight-gain goals one by one. What pleasure can top that of stepping on the scale and seeing the weight drop? Your only regret will be you have to restock your wardrobe as you drop in pants or dress size.
I use the word diet to describe the change in eating patterns I’m advocating, but that’s really not the right word, at least with the connotations that word has now. Think about it: going on a diet usually suggests taking a temporary detour away from normal eating patterns. For the time being, while on a diet, the person eats foods that are healthy but generally not liked. As soon as the weight is off, provided the diet is a success (which, in fact, is not that likely), the person can rush back to eating junk food again.
You can see that is not what I envision for weight losers. My “diet” is not a temporary aberration from one’s normal eating. Instead, it is a lifestyle change. What I am prescribing are the eating habits you should keep for your whole life, provided you want that to be a long and healthy one.
Lifestyle changes will make the difference when diets don’t make the grade. But the lifestyle changes laid out in this book do not stop at eating. Eating is part of an integrated, multi-layered program. The typical diet is food only. It has no other components, such as advice on how to cope with emotional crises. As explained before, people often eat as a way to face emotional difficulties, rather than because they’re hungry. For example, after a bad day at work or after a row with a loved one or as an end to a long week, a woman will “allow” herself a junk food meltdown, as it were, in which she overeats chips or ice cream or another guilty pleasure.
Dieting does nothing to cope with the possible emotional roots of eating. If anything, it makes people more depressed because it becomes one of the issues that causes overeating. When a person “falls off the wagon,” and breaks her diet plan, this may engineer later meltdowns, in which, unable to deal with the self blame for the violation of the plan, she binges once again. The only people who lose weight and keep it off are those who make permanent changes to their (and to their family’s) eating and exercise habits. They, to borrow a phrase from Leonard Cohen, are the “beautiful losers.”
Among the other lifestyle changes important to weight management, as well as overall health and well-being, are exercise, bodywork, meditation, detoxification, and living mindfully.