Wednesday 160309

Workout

Wednesdays with Lori

400m Warm-ups

6x
200m Run (80% effort)
200m Walk

400m Cool Down

From the New York Times

Making a Case for Eating Fat

By ANAHAD O’CONNOR MARCH 4, 2016 5:45

Credit Mark Hyman
For years Dr. Mark Hyman was a vegetarian who kept his intake of dietary fat to a minimum. Whole-wheat bread, grains, beans, pasta and fruits and vegetables made up the bulk of his diet, just as the federal government’s dietary guidelines had long recommended.

But as he got older, Dr. Hyman noticed something that bothered him: Despite plenty of exercise and a seemingly healthy diet, he was gaining weight and getting flabby. At first he wrote it off as a normal part of aging. But then he made a shift in his diet, deciding to eat more fat, not less – and the changes he saw surprised him.

He lost weight, his love handles disappeared, and he had more energy. He encouraged his patients to consume more fat as well, and many of them lost weight and improved their cholesterol. Some even reversed their Type 2 diabetes.

Today, as the director of the Cleveland Clinic’s Center for Functional Medicine, Dr. Hyman has become an outspoken advocate about the health benefits of eating fat. He promotes it on talk shows, educates other doctors, and has even managed to wean his close friend Bill Clinton off of his previously prescribed low-fat vegan diet.

Now in a new book called “Eat Fat, Get Thin,” Dr. Hyman takes a deep dive into the science behind dietary fat, making sense of decades of confusing health recommendations and building a case for why even saturated fats, which have long been vilified, belong in a healthy diet. Dr. Hyman argues that Americans have been misled about the benefits of fat because of a disconnect between nutrition science and food policy. In the book he challenges the nutrition orthodoxy while also exploring the food industry’s outsize influence on official health recommendations.

Recently, we sat down with Dr. Hyman to discuss his thoughts on the gap between nutrition science and health recommendations, the reason you should always plan your meals, and why he never leaves home without a stash of “emergency foods” in his backpack. Here are edited excerpts from our conversation:

Q.
Why did you write “Eat Fat, Get Thin”?

A.
I wrote it because we’ve been suffering from 40 years of bad advice about fat that’s led to the biggest obesity and diabetes epidemic in history. The myth that fat makes you fat and causes heart disease has led to a total breakdown in our nutritional framework. I felt it was important to tell the story of how fat makes you thin and how it prevents heart disease and can reverse diabetes. I think people are still very confused about fat.

Q.
In the book you argue that nutrition recommendations are often contradictory. How so?

A.
This year, for example, the U.S. Dietary Guidelines for the first time removed their longstanding restrictions on dietary fat. But they still have recommendations to eat low-fat foods. They say total fat is not an issue, but you should drink low-fat milk and eat low-fat dairy and other low-fat foods. It’s a schizophrenic recommendation from the government, and it’s the same with other professional organizations such as the American College of Cardiology and the American Heart Association. There’s a mismatch between the science and the government and professional recommendations.

Q.
What’s driving this disconnect?

A.
I think the government based its recommendations on some very flawed science, which took hold. It became policy that was turned into the dietary guidelines and the food pyramid that told us to eat six to 11 servings of bread, rice, cereal and pasta a day and to eat fats and oils sparingly. It’s very hard to overturn dogma like that. It’s embedded in our culture now. It’s embedded in food products. The food industry jumped on the low-fat bandwagon, and the professional associations kept driving the message. Unfortunately the science takes decades to catch up into policy and into practice. And I’m trying to close that gap by bringing awareness to the latest science on how fats and carbs work in your body.

Q.
You reviewed hundreds of studies while writing this book. What is your conclusion on saturated fat?

A.
It’s a huge area of controversy. But large reviews of randomized trials, observational research and blood-level data have all found no link between saturated fat or total fat and heart disease. Yet there are still recommendations to limit saturated fat because it raises total cholesterol and LDL cholesterol. But it also raises HDL, and it increases cholesterol particle size, so you actually get a net benefit.

Q.
What do you say to scientists who argue that saturated fat does in fact cause heart disease?

A.
I think the challenge with the research is that a lot of the data combines saturated fat in the context of a high-carbohydrate diet. The real danger is sweet fat. If you eat fat with sweets – so sugar and fat, or refined carbohydrates and fat – then insulin will rise and it’ll make you fat. But if you eliminate the refined carbs and sugar, that doesn’t happen. I think saturated fats can be bad in the context of a high-carbohydrate diet. But in the absence of that, they’re not.

Q.
What foods do you eat and recommend to your patients?

A.
What I eat is a cross between paleo and vegan diets. It combines elements of the two, so I call it a “pegan” diet. It’s Read more Wednesday 160309

Tuesday 140909

Workout

Dead Lift Use 90% of your 1RM + 10 Lbs
65% x5
75% x5
85% x5
65% x AMRAP (stop at 10)

MetCon
3x of:
400m Run
3:00 rest

300m Run
2:00 rest

200m Run
1:00 rest

From The Atlantic

The Awful Reign of the Red Delicious

How the worst apple took over the United States, and continues to spread

At the supermarket near his home in central Virginia, Tom Burford likes to loiter by the display of Red Delicious. He waits until he spots a store manager. Then he picks up one of the glossy apples and, with a flourish, scrapes his fingernail into the wax: T-O-M.

“We can’t sell that now,” the manager protests.

To which Burford replies, in his soft Piedmont drawl: “That’s my point.”

Burford, who is 79 years old, is disinclined to apple destruction. His ancestors scattered apple seeds in the Blue Ridge foothills as far back as 1713, and he grew up with more than 100 types of trees in his backyard orchard. He is the author ofApples of North America, an encyclopedia of heirloom varieties, and travels the country lecturing on horticulture and nursery design. But his preservationist tendencies stop short of the Red Delicious and what he calls the “ramming down the throats of American consumers this disgusting, red, beautiful fruit.”

His words contain the paradox of the Red Delicious: alluring yet undesirable, the most produced and arguably the least popular apple in the United States. It lurks in desolation. Bumped around the bottom of lunch bags as schoolchildren rummage for chips or shrink-wrapped Rice Krispies treats. Waiting by the last bruised Read more Tuesday 140909

Monday 140421

Workout

3x

400m Run + 10 KB Swings
3:00 Rest
300m Run + 10 Ball Slams
3:00 Rest
200m Run + 10 Pull-ups
3:00 Rest

Tomorrow, back to Texas Squats.

From The Atlantic

Slimming Down Alone, Together

Weight loss is often framed as a personal endeavor, but the best outcomes stem from group efforts.
A pair works out in an outdoor exercise area at Macombs Dam Park in the Bronx section of New York City. (Mike Segar/Reuters)

For many overweight and obese people, getting in shape can feel like an act that is meant to be publicly announced and privately executed. Consider NBC’s The Biggest Loser, which has consistently drawn in millions of viewers over the last 10 years by showcasing the spectacle of rapid physical transformation. Sure, the contestants’ dedication to improving their health might be inspiring, but more alluring is the promise of watching a sweaty, shout-filled struggle, with a Big Reveal at the end of the season.

In non-reality show reality, being gawped and sneered at by their fit peers has actually led heavier gym-goers to become members of facilities like Downsize Fitness in Forth Worth that cater exclusively to bigger clientele. There’s a sense that no one will be singled out for the state of her health but, instead, welcomed as part of a community with a shared goal. Emphasizing the importance of community to curtail the prevalence of obesity is the goal of Drs. Walter Willett and Malissa Wood, the co-authors of Thinfluence: the powerful and surprising effect friends, family, work, and environment have on weight.

Dr. Willett is a professor of epidemiology and nutrition, and chairman of the department of nutrition at the Harvard School of Public Health, whose research helped to instate modifications to the USDA Food Pyramid. Dr. Wood, a clinical cardiologist and staff physician at Massachusetts General Hospital in Boston, is co-director of the Corrigan Women’s Health Program and an assistant professor of clinical medicine at Harvard Medical School. As lead investigator of the HAPPY Heart Program, she researched the impact that community-based programs might have on the health of low-income and minority women in a Boston suburb.

Jointly, the two hope to counter the notion that getting in shape is a solitary pursuit and the sole responsibility of the obese. I spoke with the pair about the influence of friends, family, and public policy on weight loss.


Thinfluence’s subtitle states that the book is about the “powerful and surprising effect” that friends, family, work, and the environment have on weight. Why is it important for people to understand the significance of these networks?

Willett: If you look around the world at wealthy countries like the United States, you see very different rates of obesity. In Japanese women, prevalence of obesity is under 5 percent; in Swedish women it’s about 6 or 7 percent. In the U.S., it’s between 35 and 40 percent—and we know that when people come from these countries to live in the United States, they fatten up. That’s a clue that there is something pretty important going on that’s related to where we live, and that there are very important factors operating [outside of us as individuals].

We’ve started to understand some of these; they’re often complex but it’s a clue that Americans aren’t simply completely irresponsible people. And looking at kids, too, their obesity rates have about tripled over the last four years, or quadrupled among some groups. It’s not that kids have become massively irresponsible in such a short time, but that there are obviously factors outside the kids’ inner-selves that are operating here.

So much of what people have been told is that weight is just about individual change. We’re not saying that there is no such thing as individual responsibility, but sometimes even very responsible people can have a hard time making the choice that’s in their best interest if there are a lot of barriers in their daily life and environment. Most diet books just focus on what we should or shouldn’t be putting in our mouths [without] looking really comprehensively at all of the factors around us.

One of the ways you try to categorize the impact of different areas of people’s lives is through a “circle of influence” graph. What are the most important areas to focus on, at least in the beginning of a weight-loss or healthy-eating initiative?

Willett: The closer-in factors will probably be the first things that people pay attention to, because that’s usually where you can make a difference the fastest. You have more control over things like yourself and your relationships, and as you go farther out you have less and less control—but not zero. A lot of people, for example, live in a place where healthy foods are relatively unavailable or very expensive, and often there are small convenience stores that don’t have many healthy choices. Those more distant factors are possible to change but it takes active individuals in groups to make it happen, and change often happens over a period of years, not weeks or months. So you may be working on these bigger factors more for your kids, perhaps, than for yourself.

In terms of the circles of influence, you parse through various internal and external factors that impact weight and unhealthy eating habits. What is the dividing line between those sides?

Wood: Internal factors are important because we don’t give enough credence to the fact that stress, anxiety, and depression are really driving a lot of overeating; those drivers are behind this unhealthy relationship with food that a lot of people have. Many people take an internal struggle and try to solve it by getting comfort from something that’s attainable. What we try to point out is that the links between those factors—stress, depression, anxiety, and obesity—are so strong that addressing the inherent cause of some of those things can have a benefit downstream.

That’s exactly what we did at HAPPY Heart. We recognized that those women had stress and anxiety that were off the charts, and we tried to address the major source of their angst, whether it was, “I don’t know how to balance my checkbook,” or “I’m worried about my home being foreclosed on.” Then, we gave them a forum to really discuss these things and get support from their friends to ameliorate some of the stress in their lives. In this book, we’re trying to do the same by helping people address some of these internal factors that they can manage—and obviously a chemical kind of depression would need to be managed by a professional—so that they can take steps to climb out of that dark space that overeating becomes a part of.

We feel very strongly that there has been so much guilt associated with being overweight or obese as a personal failure, that we want to open it up and say, number one, recognize that your choices reflect a web around you of many environmental factors, which are very important. Second, understand that some of those things you can change and some you can’t, and learn to recognize what you can. It’s harder to change that unless you really help them to see that this is something they have control over.

Thinfluence isn’t only geared toward people who want to become healthier, but to the family members and friends of people who want to lose weight. What is the best way to be supportive but still realistic about a friend or relative’s state of health without badgering them or shaming them? Is that even your job at all?

Wood: I think it is your job in the sense that if you have made some successful choices and you see someone who’s struggling, giving them a bit of advice or support and being there to encourage their choice improves the likelihood that they’ll be able to successfully make that choice consistently. The perfect example is someone who is a really big smoker, and you basically sit down with them and say, “Hey, I know you’re used to this, but I’m here to support you to make other changes. Not only that, but let’s think of things we can do together.” In this case, that could mean walking together or getting involved in some group exercise.

alifench/flickr

The more people you engage in your process and the more supporters you have in your circle, I think the more likely you are to succeed. Although it’s very extreme, you see something similar in the CrossFit world. If you go to one of their gyms and talk to the people that are there, a lot of them are formerly very, very heavy people. They got into the concept of that group dynamic and were able to stick with it because there was a group of people that were going through the same thing they were going through, and sweating it out, and doing the workouts, and afterward celebrating and enjoying each other’s company. I think that kind of thing is the magic sauce.

So then getting rid of your friends isn’t really necessary in order to engage in the weight-loss process?

Wood: Well, I think there are friends that you have to get rid of. If you know someone is going to drag you down and they’re not interested in making a change, then I think it’s important to kind of separate yourself from them, at least when you’re in that behavior-changing mode. You really have to get into a space where it is automatic that you’re not going to drink six margaritas and eat four bowls of chips with your friends every time you go out. If they’re not interested in doing something else, you’ll have to break from them for a while. It doesn’t mean that you don’t like them or can’t spend time with them down the road, but when you’re adapting to a new change in your life, I think it’s really hard to continue spending time with people like that.

I think some people would find that incredibly off-putting, for the sheer fact that it might seem extreme. It’s hard telling a friend that you can’t—or don’t want to—spend time with them. Is this something that you’ve seen patients do successfully?

Wood: To be clear, I think the only reason to separate from someone is if you really can’t be around them without doing what they’re doing. We’re certainly not encouraging people to stop spending time with the people they love and care about, but if you’re actually making an effort to succeed at weight loss, and the person we’re talking about is someone for whom food is the center of their life, it’s really not in your best interest to spend a lot of time with them while you’re adjusting to your new lifestyle. If they’re not willing to adapt a little bit to accommodate your needs, that’s the only reason to cut them loose.

But I think many of us have friends that would say, “Yeah, I’m totally willing to do that. I think it’s great”—and then they’ll go and do what they want on their own time. So, in the book we try to put more of a positive spin on it: Choose to spend time with people that are willing to support you and join you in this move, versus getting rid of the ones that don’t. Just spend less time with them.

How does that work in the office? Some workplaces ban things like communal treats out of consideration for people who find constantly being bombarded with food difficult, whereas at other places, a smorgasbord contributes to the feeling of community.

Wood: If it’s a big group at work and you’re having a birthday celebration, you have to learn that in that situation, you can’t change a large group of people. People have to have a life and need to enjoy special occasions, so I’d focus much more on making those day-to-day positive changes rather than banning cake in the office. People will bring in snacks, or food, or have bowls of M&Ms in the office that everyone will chow down on, but I think the work culture change is about making healthier choices most of the time.

In terms of your own choices, in the book you say that it was important to you to teach your patients how to make and stick with better choices in the long-run, rather than “placing stents in the heart arteries and sending patients on their way.”

A water break during a free Zumba class organized by non-profit LiveWell Colorado. (Rick Wilking/Reuters)

How are you able to successfully provide personalized information, and how feasible is that for other physicians given the many constraints, particularly time?

Wood: I think that for me it’s been doable because I’m pretty effective at communicating. I’m frequently able to meet somebody and quickly identify their situation by asking the right questions and developing a plan. I recently met with a 29-year-old woman who had very bad hypertension during her pregnancy, which was complicated by preeclampsia. That is a marker of early heart disease and stroke, and she came to see me because her cholesterol was high.

It has been a year and a half since her baby was born and she still weighs 180 pounds, but she’s not exercising for all the usual reasons: She has work; she’s busy, and she has a baby to take care of. I spent 15 minutes with her giving my encapsulated version of what a working mom can do at home, spending no extra money, for 20 to 30 minutes a day. I know not everybody has 15 minutes, but I think the key is being able to identify which people need that counseling and providing the right resources after that.

If you can seek out a physician specifically for counseling, that’s a luxury and that’s great, but I think that people who are caring for patients need to have more access to reasonably-priced or free opportunities. I try to tailor the resources I mention based on my patient’s financial picture. If they’re low-income, I know they’re not going to be able to get a personal trainer and probably don’t want to spend $80 to see a nutritionist. So I’ll tell them about other options and tools that are available online. Maybe they can invest in a Fitbit instead or use sites like MyFitnessPal to get basic nutritional counseling, support, and to connect with others—which is huge—at minimal cost.

At the more overarching level of policy, what are examples of effective policy work that you have seen, Dr. Willett, with regard to weight loss?

Willett: First, policies can operate at all levels. You can have policies in your home: “We don’t keep soda in the house.” That’s a health policy that can be really helpful, especially for kids. If it’s not there, they’re not going to drink it, and then that becomes the norm. There can also be policies at work, for example, that there are healthy options like whole grain if you have food service. Then there are policies that operate at the state, federal, or global level, like the World Trade Organization, which has policies that are sometimes not in the best interests of people, but are more about protecting corporate interests. And of course there are lots of agricultural policies at national level that sometimes are intertwined with global policies, as well.

One that we have worked on quite a bit is trans fat. We did a lot of work showing the adverse affects on health outcomes, and then we tried to make that information available to consumers. We worked with other groups and got the FDA to require trans-fat labeling; that was a big step forward. Food manufacturers conducted their own consumer knowledge surveys and found that a high percentage of people, especially women, didn’t know that trans fats weren’t good for them. Now if it was on a food label it had to be taken out of the product. That was a policy decision that actually helped a lot of people; even if it consumers weren’t concerned with or thinking about trans fat, it was out of the product in a very visible way.

Another example is a soda tax as a potential policy. A lot of subsidy goes into making the ingredients in soda extremely cheap so that it can be sold for a cheap amount and still make a huge profit. The problem is that the price of soda is not really paying for the consequences of drinking three sodas everyday. You’re really ramping up your risk of diabetes, and you’re not the only one paying for it because we do have healthcare insurance. So there is a good justification, I think, for a soda tax that really makes bare the true cost of soda. And we know that that will influence behavior and cause alternative beverages to be available at a lower cost so that people will have more choices.

Are there any starting points that individuals can begin at to have some sort of influence, even if it’s the first step of something that might take years?

Willett: Getting sodas out of schools has been a policy achievement that essentially happened because of concerned parents starting in a local school district; then it spread and became a national movement. A group of people realized that it was very hard for one kid not to drink soda when everybody else around them was drinking soda. A parent could have their hard work at home totally undermined by what was going on at school. There are lots of other issues in schools where things start with one school at a time, or two concerned parents who talk to others, or at parent-teacher organizations. I think that’s very interesting.

When you look at changes that have been important, they’ve almost always started that way—it wasn’t national. They started in single towns or cities with a few people, sometimes just one person. And it’s pretty clear that if everybody is just acting on their own, these changes would not have happened. It means that part of the solution comes from people working together to make changes, not just for themselves but for their community, which can wind up being the whole country.

Read more Monday 140421

Thursday 130516

Workout

“Big Kate”
1200m Run
20-GHD Sit-ups
10-Ring Dips

600m Run
40-TTB
10-Ring Dips

400m Run
60-Sit-ups
10-Ring Dips

From PBS.  Study?  Where are the numbers?

Study Pinpoints Link Between Fitness and Cancer in Men

BY: SARAH CLUNE

Photo courtesy: Flickr user Josiah Mackenzie

There’s new evidence out today that being fit reduces your risk for getting cancer.

The study, released at the American Society of Clinical Oncology’s annual meeting, looked at the link between fitness in middle-aged men and the likelihood of a cancer diagnosis later in life.

Doctors focused on the top three cancers in men: prostate, colorectal and lung. According to the Centers for Disease Control and Prevention, more than 400,000 men were diagnosed with one of these cancers in 2007.

The study tracked 7,000 healthy, 45-year old men. Their fitness was assessed during their regular preventive health exam by putting them on the treadmill. How far — and how well they were able to tolerate increases in the speed and grade of the treadmill — determined how “fit” they were.

Two decades later, when the men were 65, doctors looked at who had developed cancer and compared that to their previous fitness levels. They saw a link — “fit” individuals were less likely to develop cancer, and if they did develop it, they generally had better prognoses.

“That’s what’s really sort of amazing is that there’s really no other population where we have the assessment back in time, when they were in their middle age,” according to Dr. Susan Lakoski, the study’s primary author. “We followed them all the way to past the age of 65 and beyond to track whether or not they’ve developed cancer to see what this relationship was between fitness and cancer risk.”

The study began in 1970 at the Cooper Center Longitudinal Studies in Dallas. The participants were predominantly Caucasian.

Dr. Lakoski focuses on cardiovascular health among cancer patients. She spoke with PBS NewsHour earlier this week.


PBS NewsHour: In a nutshell, what did the study reveal?

Dr. Susan Lakoski, University of Vermont College of Medicine:The study shows that cardiorespiratory fitness predicts cancer risk and prognosis after a cancer diagnosis in men. This is a new finding, because traditionally patients self-report their physical activity. But in our study, we measured it with an objective exercise sonar test.

This is the first study that really addresses the issue of fitness being a prognostic marker of cancer risk in men, and then a marker of prognosis after a cancer diagnosis. We specifically looked at if “fitness,” or the ability to get on a treadmill and go as far as you can, predicted whether or not you’ll develop cancer. And it did predict it. So people who had lower fitness, or went less time on the treadmill, were more at risk for developing cancer later in life.

NewsHour: What’s the difference between physical activity and fitness?

Dr. Susan Lakoski:Physical activity is one Read more Thursday 130516

Saturday 110827

OK…Let us see if we can beat the Master athletes from the most recent CF Games…the winning time for this event was 3:42

For time:
95 pound Overhead squat, 21 reps
21 Hand-release push-ups
150 yard Shuttle run

95 pound Overhead squat, 15 reps
15 Hand-release push-ups
100 yard Shuttle run

95 pound Overhead squat, 9 reps
9 Hand-release push-ups
50 yard Shuttle run