May 8, 2010

A new review of our book filled with factual and contextual errors!

Tim Boyd recently reviewed our book SPEED. This review was published in the Spring 2010 issue of the WAFP magazine, Wise Traditions in Food, Farming and the Healing Arts and is also on there website. As confident as we are in the material that we have published we know that there will be people who disagree with varying amounts of it. In fact, we hope that others can find some weaknesses in our arguments so that we can continually improve our recommendations. But the errors in Mr. Boyd’s review are so egregious that you would think it was a joke or we were being punked. But it was not a joke and Ashton Kutcher did not jump out of a van. Again, a thoughtful critique is welcomed, but one that seems to be blatantly flawed in its facts and logic is not acceptable. The following is our attempt to set the record straight. The flow of the rebuttal will follow the flow of the review.

We start with the third paragraph. Mr. Boyd states “The authors eventually get around to talking about calorie restriction and tell us 20-40 percent restriction is necessary for weight loss. This is followed by a long list of benefits to calorie restriction. Lower insulin tops the list. There is no explanation of the fact that calories from carbohydrates tend to spike insulin levels while calories from fat tend not to. So, is calorie restriction a radically new idea? I don’t think so.”

Before discussing the calorie restriction aspect specifically, we wanted to touch on the “eventually get around to” aspect. To us, based on what was written, the reviewer does not give a fair representation of the main them of the book, which is the Bio-Psycho-Social concept. We start out the book by explaining the need for following a comprehensive approach if long-term success it to occur. We go on to describe the first four parts of SPEED, which are sleep, psychology, exercise, and environmental before we even get to the diet chapter. We thoroughly explain the importance of these factors and support our views with copious amounts of high-quality references. Why does the reviewer not mention anything about these very important chapters?  We are confused why the majority of what we have written was not discussed. The author spends the majority of his review critiquing the diet chapter. This brings us back to the third paragraph of the review.

We assume that the reviewer agrees that there are many potential benefits to calorie restriction (CR). We also discuss intermittent fasting (IF) which seems to have similar benefits as CR and is one method for reducing calorie intake. Additionally, there is some evidence that IF without a reduction in overall calorie intake has health benefits. Yes, CR does lower insulin levels. However, the reduction of insulin occurs with all types of macronutrient intakes (see the multiple references in the book). This means that both high carb, low fat and low carb, high fat diets BOTH have this effect. Although it is likely that a low carb diet would do this a bit better, the majority of CR research is not done with a low carb diet and the plethora of benefits are still achieved. We did not get into much detail on the carb-insulin topic. So what? As we state at the beginning of the book, our writing style for the book is based on brevity and simplicity. We are not trying to write a biochemistry textbook. We want people to get the gist of it. However, we do explain the benefits of a low GI/GL diet (pp. 91-92). We also state that a low carb diet decreases INSULIN and other markers of health (p.93). At the end of the paragraph he states “So is calorie restriction a new idea? I don’t think so.” What is the reviewers point? We didn’t say that this is a new idea. We are stating that there are multiple benefits, besides weight loss, with consuming fewer calories.

In paragraph four Mr. Boyd states “Calorie restriction has been tried from every angle for many decades now. It can give you short term results but unless you have the willpower to starve yourself for the rest of your life, those lost pounds will be back with their friends. Calorie restriction has been literally tried to death. Is the population thinner as a result? I don’t think so”. There are multiple reasons why people cannot stick to a weight loss program. This is really the main point of our book. There are biological, psychological, and social aspects that must be considered if long-term success is to occur. When it comes to diet, there is a certain way of eating, i.e., a low carb, medium protein, high fat diet, that will modify multiple hormones in a way that will make it easier, not necessarily easy, to be able to eat less on a consistent basis. We would argue that a low fat, high carb diet, the most common diet recommendation, is one of the main factors for the poor success rates. Additionally, is the reviewer saying that there is no need to cut back on intake (calories) to lose weight? If so, how does a person lose weight? Where is the evidence that a person can eat the same amount of calories and lose weight? We are well aware of the “metabolic advantage” (MA) research on low carb diets (see our references). We do feel that there is a possibility of a MA with low carb diets. However, the actual amount of weight loss that can be elicited by this effect itself is very small. Therefore, to cause a substantial amount of weight loss, which many people need, a certain amount of a calorie reduction, such as 20-40%, is needed. Another aspect is the view that calorie restriction is the same things as starvation, “starve yourself for the rest of your life”. This is done by many people including Mr. Boyd. Starvation leads to poor health and death, calorie restriction, a 20-40% reduction done properly (we cover how to do this in the book) leads to numerous health benefits. He makes another logical error. Because people are not losing weight and people are tending to get bigger does not mean that calorie reduction does not work. This is a non-sequitor argument. There are multiple reasons for the lack of success. Again, that is the main point of our book, the bio-psycho-social model of change. It is clear that the reviewer does not represent the facts well in this paragraph. On to the next paragraph.

Here is what is said in paragraph five, “Next is a discussion of low carb diets which are put in a positive light. There is some discussion about what is the right amount of protein but no mention of fat. Do they mention that a low carb diet must be a high fat diet or it is doomed to failure? I don’t think so”. No mention of fat or a high fat diet; you must be kidding! This is probably the most egregious error in the review. At this point we are feeling that the reviewer didn’t even read the book. We state multiple times that we recommended a high fat diet. The first page of the diet chapter (p.85) we state “Eat a low carbohydrate, medium protein, HIGH FAT diet” [emphasis added]. This is the second of nine bullets of the Do this… section. Does it get any clearer than that? Here are some more examples. On page 90 we state “We recommend a low carb, medium protein, high fat diet”. We then discuss the benefits and safety of ketogenic diets, which is, or should be, a high fat diet. We state “During a ketogenic diet…the body makes ketones in the liver from fats, which are a great fuel source for the muscles and the brain” (p.98). Then in the Doing SPEED chapter our example diet plans are high fat. Based on the example for calculating the macronutrient needs of a person, the resulting diet is 49% fat (p.158). For the week of example meals, the average intake has 49% fat (p.160). How does this information equate to “no mention of fat’?

Paragraph six is “The advice starts to get really dizzy after this point. The authors mention the importance of sleep prominently on the front cover and elsewhere in the book. They also say caffeine is a good way to lose weight. Do they also mention it is a good way to lose adrenal function? And sleep? I don’t think so”. What we say is that caffeine and/or coffee has the ability to decrease appetite and has thermogenic properties. There are also many other potential benefits. We also mention that there is the potential for side effects such as “difficulty falling asleep” (p.113-114). The reference to adrenal function is likely based on the work of Dr. Wilson (Adrenal Fatigue: The 21st Century Stress Syndrome). We have read this book and are aware of this “new” syndrome. The problem is that the amount of quality evidence for this new syndrome is not strong. Additionally, the evidence that the use of caffeine/coffee at reasonable dosages, such as those described in our book, actually causes adrenal fatigue is lacking. In fact, there is plenty of evidence that caffeine can lead to feeling less stressed (Weinberg et al; Smith). So if feeling stressed is a cause of the Adrenal Fatigue syndrome, then caffeine could actually help prevent it. However, there is the potential for side effects even at reasonable amounts as well as the potential for people to abuse it. These last two aspects do not diminish the fact that there is good evidence for weight and health benefits from the use of caffeine and coffee.

Here is paragraph seven, “They go on to say stevia is the best sweetener and their second choice is a good, old-fashioned, traditional. . . artificial sweetener? We are going from dizzy to scary now. We are also led to believe canola oil is a good oil. Oh, and try the Zero Impact bars too. I never heard of them so I looked them up. The listed ingredients include yummies like maltitol, glycerin, low DE corn syrup, brown rice syrup and xanthan gum. Elsewhere on the same page they say the bar has no maltitol. And the dizziness returns. Are these things components of traditional diets? I don’t think so”.

Let’s start with the sweetener aspect. First, our main recommendation on the use of sweeteners is to minimize the use of ALL of them, natural or artificial (p.87, bullet #8). Nowhere do we call splenda or any other sweeteners “good, old fashioned, traditional…”.  We actually give a fairly detailed description of artificial sweeteners (AS’s) and their connection to health and weight management. When it comes to health it seems that for most people small amounts of AS intakes will not likely cause any negative health effects. When it comes to weight loss they may help a bit. So, within the context of weight loss, which is what our book is about, the use of AS sweetened beverages instead of regular sugar based, typically HFCS, drink is a better choice. It doesn’t mean it is the best choice. But for many people the choice, particularly at first, is between a beverage or food product that has sugar or one that is similar that is sweetened with an AS. Stevia and xylitol (also erythitol) are the better sweeteners, but the use of small amounts of AS’s is likely fine and if a person loses 30, 40 or more pounds, then the overall balance of health is still with the weight loss. We are not surprised by the canola oil comment. We are aware of the WAPF position on this oil. Again, we think it is important to keep in mind that this is a weight loss book, not a “How to eat the perfect diet based on Dr Price’s work and/or paleo principles, for perfect health” book. It is a book about a comprehensive approach to achieving and maintaining a healthy weight that is likely to get a person to be much healthier than they were when they started, not eat a perfect diet. Is canola oil the best oil? Probably not, but it is better than soybean oil or the other high omega 6 oils. We clearly recommend people avoid soybean oil and the other high omega 6 oils and partially hydrogenated oils (p.159). The canola oil is recommended mainly as a type of mayo. We felt that this was a better choice than a soybean oil based mayo. We also recommended a canola based mayo because we have not found a purely olive oil or coconut oil based mayo. Again, a better choice but not the best. Also, it is not like we only recommend canola oil. We recommended many fats that anyone associated with the WAPF should fine pleasing; extra virgin olive oil, butter, cream, coconut oil, and palm oil. Therefore, the majority of fats we do recommend are very much in-line with the WAPF. Next is the discussion of Zero Impact bars. First, keep in mind the better verses best line of thinking. We are the first ones to say that these and some of the other bars we recommend are not perfect. But, due to their convenience and overall macronutrient amounts and ingredients, we think they can be a helpful ADJUCT to a WEIGHT LOSS diet.  Here is the macronutrient breakdown of the Zero Impact bar, pumpkin flavor:

Protein- 30 grams, 27% of calories

Fat- 20 grams, 41% of calories

Total Carbs- 35 grams, 32% of calories

Fiber- 5 grams

Net Carbs- 30 grams

Here is what the ingredients are (I am holding a bar in my hand): whey protein isolate, whey protein concentrate, natural almond butter, natural sunflower butter, semisweet chocolate, purified water, glycerin, brown rice syrup, erythritol, pumpkin, rolled oats, natural & artificial flavors, lecithin, potassium sorbate, salt, sweet potato, mixed tocopherols, xanthan gum. Not perfect, but not too bad either. It does NOT contain maltitol and so what if it does. Maltitol is one type of sugar alcohol, although not the type we think is best. Anyway, we are curious where we say what the specific ingredients of the Zero Impact bar are or any bar for that matter. The fact is that we do NOT mention that anywhere in the book. This is another example of factual errors. One final error before concluding; the Fucoprotein bar from Garden of Life does NOT contain any soy, see for yourself at http://fucoproteinbar.com/. Another factual error.

It is clear that Tim Boyd, the reviewer, has made many factual and contextual errors in his review. We would agree that there are a few dietary items that are not perfect, but so what. Our goal was not to get people to eat a perfect diet. Our goal is to get people to achieve and maintain a healthy weight in a way that is very likely to also increase their level of health. It seems clear to us that Mr. Boyd has never worked with real people who have struggled with their weight. This tends to lead to overly idealistic stances, which tend to get in the way of progress. Our final gripe has to do with our research skills. Mr. Boyd wrote in the final paragraph “were they Sleeping when they did their research?”  He seems to be accusing us of not doing our homework when it comes to the research for our book. Where is he getting this stuff? We obviously cannot prove that we read all of the 298 citations that we have in the book, but we did. Our book is meticulously referenced to high-quality research. A jab at our research and efforts to support our recommendations with quality evidence is clearly not justified. Do to all that we have stated above we feel that this review is shameful and it tarnishes our view of the WAPF.

References:

Smith, A. (2002). Effects of caffeine on human behavior. Food Chemical Toxicology; 40: 1243-1255.

Weinberg, B.A. & Bealer, B. (2002). The caffeine advantage. New York. Free Press.

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Filed under: Research, Uncategorized, book review, nutrition — Jeff Thiboutot M.S. @ 9:36 am



March 16, 2010

Jillian Michaels on PBS – useful information?

I was doing a bit of TV surfing last weekend and came across a PBS special called Master Your Metabolism. The talk was being given by Jillian Michaels, the famous trainer from The Biggest Loser show and author of a recent book called Master Your Metabolism. It had just started so I decided to watch the whole thing. I then went to the book store and looked through her book. Here are my thoughts on the information presented on PBS and in her book.

First, I would give an overall rating of 3.5 stars (out of a possible five) for the book/presentation. So, overall, I think the information is pretty good. Here is the list of things I liked:

  • Hormones are very important for health and weight management
  • Foods and exercise can modify hormone levels making it easier or harder to be healthy and maintain a healthy weight
  • Eat real food
  • Avoid processed foods
  • Eat more organically produced foods
  • Minimize your exposure to chemicals from personal care products and other commonly used products
  • Minimize carb intake at night so that there is a better growth hormone output while you sleep
  • Eat a good amount of protein, about 30% of your diet
  • Drinking alcoholic beverages is very counterproductive for weight loss

Okay, good so far. However, things start to fall apart.

The first problem is the lack of discussion of the psychological and social aspects of eating behavior. As Matt and I stress in SPEED, it is not just about exercise or diet and how they affect our metabolism/hormones. Her focus on the nutritional and exercise components makes this book incomplete. To be fair, most weight loss books take this same approach and look at only a single or small number of potential variables. As you know from our book, we feel that this is a major reason for the poor success rates.

There were a number of statements that were a bit bombastic. For instance, she stated that “genetics does not contribute to aging or disease” and “hormones do not naturally decrease with age” really!? I believe that both of these statements are completely false. The following are more appropriate statements; “Genetics play a part in the development of disease but lifestyle factors, such as diet, exercise, etc. can modify how the genetics are expressed” and “Hormones do decline during aging, but a good amount of that decline can be reversed by following certain lifestyle habits”. Both of the latter statements are clearly not as enticing and do not have the same WOW factor but they are much more in-line with our current knowledge of these factors.

She also said that high sodium would cause an increase in cortisol levels as well as an increase in blood sugar and make you hold onto water, i.e., make you feel bloated. First thing, there is only a small percentage of the population that is salt sensitive. This means only a small percentage of people may have a negative reaction to high salt intakes, such as an increase in blood pressure. Additionally, the reaction to higher salt intakes also depends on the intake of other minerals such as potassium and magnesium. If these are also high then it is possible that the high salt intake will not have a negative effect. Anyway, when it comes to salt intake and cortisol the evidence for this connection is weak. Like the blood pressure affect, it seems that only salt sensitive individuals may have a change in increase in cortisol levels with a high sodium intake. However, the affect in one study was very small. (Kerstens et al) Another connection I found regarding salt and adrenal function is something called adrenal fatigue. (Wilson) This condition is caused from low adrenal function (the adrenal cortex produces cortisol) resulting in many common symptoms; fatigue, poor exercise tolerance, poor sleep patterns, sugar cravings and so on. People with this condition are recommended to make sure they get enough salt in their diet. Overall, I would not worry too much about salt intake as long as you are getting plenty of real, whole foods (i.e., eggs, beef, salmon, veggies, avocados, nuts, etc.)  in your diet.

Related to the issue of cortisol and nutrition is the cortisol and exercise connection. It seems that high amounts of exercise, particularly a combination of high intensity and high duration, and coupled with unfit individuals, will cause a strong stress reaction and increase cortisol levels. Chronically elevated cortisol levels are bad for our weight and our overall well-being. Therefore, why would Jillian and the other trainers on The Biggest Loser show use this type of training? If Jillian is so concerned with high cortisol levels why would she do this to her clients? It would seem counterproductive to health. However, from the results on the show, it does not seem to inhibit weight loss. This is because there is a big caloric deficit. Certainly this strategy, in the short term, will result in weight loss, but is it good for long-term results and health? The exercise and stress/cortisol literature seems to point to shorter duration (less than 60 minutes) and relatively high intensity as the more appropriate exercise recommendations for positive hormone changes, particularly during energy restriction (i.e., reduced calorie intake).

She also states that Atkins, South Beach, no carb and no fat diets are fads and should not be followed. She, like many other people, continually refers to low carb eating plans as fads. Low carb eating is not a fad and has an abundance of clinical and epidemiological evidence to support the efficacy and safety of this type of eating style for weight management and health benefits. She also continues to perpetuate the myth that Atkins, South Beach and other low-carb eating plans tell you to eat NO carbs. The low-carb plans recommend you eat lower amount of carbs, often less than 40% of total calorie intake, not zero carb. Usually 10-30% of calories as carbs are the recommendations of many low-carb plans. But, yes, there are ketogenic food plans that do recommend very low carb intakes, 5-10% of calories, but still not zero.

The final thing that she really stressed was to never skip meals and to eat every four hours. This is apparently necessary to keep the metabolism going and to make sure that blood sugar stays at a proper level. Jillian, like many other fitness and nutrition gurus, are very concerned about eating often and not skipping meals. Why? First, eating more often does NOT speed up your metabolism. Second, from her statements about eating frequency, we can assume that she has not read the large body of research on the health benefits of intermittent fasting (eating every other day) (Johnson et al; Varady et al) or the eating frequency literature (Mattson)? Third, why 4 hours between meals? Why not 3.5 hours or 4.5 hours or 4.25 hours? There is no magic to eating every 4 hours. Third, blood sugar regulation is controlled by many mechanisms and eating frequency is just one of them. Overall, the body can go many hours, even days, without eating and maintain a healthy blood sugar level. (Mattson) For example, usually every day the body goes without food for 10 hours, the hours between your last meal and breakfast, and seems to do just fine.

I bring up this information because it bothers me when poorly supported or non-supported recommendations are given by people who should know better. Jillian and other popular exercise and nutrition experts can have a strong influence on the behavior of many people. They should realize their influencing power and make sure that what they are saying is well-supported! For those of you who are aware of Jillian’s information, please keep the information presented here in mind when you are contemplating using her recommendations.

-Jeff

References:

Kerstens, M. et al (2003). Salt loading affects cortisol metabolism in normotensive subjects: relationships with salt sensitivity. J Clinical Endocrinology; 88(9): 4180-4185.

Johnson, J. et al (2006). The effect of health of alternate day calorie restriction: Eating less and more than needed on alternate days prolongs life. Medical Hypotheses; 67: 209-211.

Mattson, M. (2005). Energy intake, meal frequency, and health: a neurobiology perspective. Annu Rev Nutr; 25: 237-260.

Varady, K. & Hellerstein, M. (2007). Alternte-day fasting and chronic disease prevention: a review of human and animal trials. Am J Clin Nutr; 86: 7-13.

Wilson, J. (2001). Adrenal fatigue: the 21st century stress syndrome. Petaluma, CA. Smart Publications.

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Filed under: Research, Uncategorized, book review, weight loss — Tags: , , — Jeff Thiboutot M.S. @ 8:15 am



September 29, 2009

What Jimmy Moore Thinks of S.P.E.E.D. – The Only Weight Loss Book Worth Reading

One of the first people we sent our book to, even before it was polished, was Jimmy Moore of Livin’ La Vida Low-Carb. We were pleased to find out he wanted to read it and even more pleased at what he had to say about it afterward:

“Get your motor running, head out on the highway, looking for adventure, and whatever comes my way! I feel the need, the need for S.P.E.E.D.! It’s not everyday you have the opportunity to get wild and enthusiastic about something like weight loss, but this book from nutrition and fitness experts Jeff Thiboutot and Matt Schoeneberger does just that. Unlike so many other diet books that are out there, this one takes into account a myriad of reasons why weight can go up and down including the biological, psychological and social issues involved. It’s a short book by design and these guys have really done their homework.

With key references from science backing up each chapter of the book, Thiboutot and Schoeneberger methodically go through what they believe are the most essential elements of attaining the weight loss goals you desire. Obvious areas like exercise and diet come into play along with adequate sleep, an environment conducive for producing weight loss, and all the mental aspects of this process that are too often ignored. And for those people who like to have things broken down for them, there’s a convenient “Do this…” section at the beginning of each chapter that outlines exactly what you need to do to implement this strategy into your life in just a few short bullet points.

My primary area of interest is on diet since I was able to shed 180 pounds in 2004 on a nutritional approach that is outside the mainstream of conventional thought, but yet it was incredibly effective for producing weight loss and outstanding health for me. Not surprisingly, I flipped over to Chapter 6 to see what the authors had to say about this and was thrilled by what I saw. They recommend eating real food that is low-carb, moderate-protein, and high-fat about 2-4 times daily or even every other day with an intermittent fasting strategy to get the weight down. The authors are fully convinced of the science behind low-carb diets and of their long-term safety based on the evidence they have seen in research studies as well as their own clients. I especially enjoyed them taking on the “high-protein” and ketosis concerns that are bantered about by the so-called health “experts” and in media reports about low-carb.

For all you lovers of conventional wisdom, be sure to check out the “Common Weight Loss Myths” chapter where Thiboutot and Schoeneberger take on some of the most embraced concepts about shedding that pounds…that are DEAD WRONG! Topics like a slow metabolism, eating lots of small meals throughout the day, eating late makes you gain weight, doing lots of cardio to lose weight, and so much more. There’s a lot of junk information floating around out there in the minds of people because they’ve been fed this garbage for many years. This book hopes to debunk much of that misinformation.

Although this book is called S.P.E.E.D., don’t think that the authors are promoting a super-duper fast weight loss plan that will shed something crazy like 30 pounds in 30 days off of your body. However, unlike the common notion that weight loss must be slow, they realize that’s not true either. Shedding 3-6 pounds a week is entirely possible on a plan like this and I saw that in my own experience when I weighed over 400 pounds. The weight will come off quickly and then slow down appropriately as your body weight drops. And that’s a beautiful thing! Don’t believe the hype of shows like “The Biggest Loser” which make you think you need to lose double-digits every single week. It’s not realistic to expect that to happen.

A full checklist of things to do is provided for you in this book, including a week’s worth of sample menus, tips, reminders, and workouts. I truly believe if you read this short and concise book (it’ll only take you a couple of hours) and implement the strategies Thiboutot and Schoeneberger share, then you will be well on your way to becoming the healthy and fit person you have always dreamed of being. Their intense focus on evidence-based solutions and not just scientific propaganda is one of the most refreshing things I’ve seen in a long time.”

- Jimmy Moore Sept 25, 2009

Please check out Jimmy’s site blog at www.livinlavidalowcarb.com/blog

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Filed under: book review — Tags: , , — Matt Schoeneberger M.S. @ 2:42 pm