Nutrition and Weight Loss Answers

What do you think about eating canned fish?

2008-05-11T18:23:00.000-07:00

I think it's great.

Canned salmon, tuna, sardines, herring and other fish like that give you just as many heart-healthy, anti-inflammatory omega-3 fats as their fresh cousins. A 2001 Italian study found that people who ate fresh or canned fish at least twice a week were 30% less likely to have had heart attacks than those who ate fish less than once a week.

Two things to remember: One, if you eat fish packed in oil, don't throw away the oil- instead use the oil, since a lot of the omega-3's from the fish are likely to drain into it. If you get fish packed in water (which is fine), the omega-3's will stay locked in the fish since oil and water don't mix.

The second thing to remember is that canned fish is only as good as it's source, just like regular fresh fish. So get wild salmon, and choose your tuna carefully.

Believe it or not, it's the more expensive albacore that has the highest mercury levels, so go with the cheaper, chunky kind. And best of all, get it from a really reputable source. My friends at Vital Source (which is linked under shopping on my website) have absolutely terrific fish, canned and frozen, and will ship it right to your door.

I've also found the canned wild salmon at Whole Foods to be outstanding.

Warmly
jb

I'm a woman and my cholesterol is 240. My doc wants to put me on a statin. What should I do?

2008-03-25T09:24:00.001-07:00

Statins lower cholesterol, but there's absolutely not a shred of evidence- anywhere- that lowering cholesterol in women extends life or protects against heart disease. (In fact, the only group statins seem to help- a little- is middle aged men who have already had a heart attack.)

The whole issue of cholesterol is one of the most widely misunderstood in the whole of medicine and nutrition, muddied up even more by the fact that statins are blockbuster drugs (the top two alone generated nearly 20 billion dollars in 2005) and there's a huge commercial pressure to get as many people on them as possible. But consider this: fully half the people with high cholesterol have no heart disease, and half the people who have heart attacks have normal cholesterol. There's a lot more to heart disease risk than just cholesterol.

Even the issue of "good" and "bad" cholesterol is turning out to be way more complicated than was first believed. We now know there are 7 types of LDL ("bad") cholesterol and about 5 types of HDL ("good") cholesterol, and they have very different effects on the body. And there's good reason to believe that the side effects and potential problems with statins are way underreported.

Remember that cholesterol is the parent molecule for vitamin D and for your sex hormones. I'm not at all sure that reducing it to the lowest possible number is a good idea for men, and I'm almost certain it's not a good idea for women.

One good thing that statins do is lower inflammation. But you can do that quite effectively with fish oil, and with the natural anti-inflammatories found in vegetables and fruits like cherries.

What's with the new FDA warning on bio-identical hormones?

2008-01-13T07:26:00.000-08:00

You're going to be reading a lot of reports about bio-identical hormones in the coming months, and, if you're like most busy people and perhaps not paying too close attention to the details, you might well come away with one troubling sound byte- "The FDA is saying they're not safe!"

Actually, that's not at all what's happening.

After a landmark 2002 Hormone Replacement Therapy study came out showing that conventional hormone replacement therapy was associated with an increased risk of heart attack or stroke, there was a huge drop in sales of drugs like Premarin. Wyeth, the big drug company that makes Premarin and Prempro saw their sales cut in half.

Women began to turn to what they perceived as safer alternatives. Integrative medicine practitioners have been using bio-identicals for years, and bio-identicals were given a huge boost after Suzanne Somers wrote a couple of books touting them. Well-known experts like respected endocrinologist Diana Schwarzbein, MD have also been proponents.

So Wyeth did what any big business would do- they ruthlessly went after the competition.

They put the full might of their company- which took in over 14 billion in gross profit in 2006- into petitioning (and lobbying) the FDA to eliminate competition from the bio-identicals. The period for comments on the petition closed on April 4, 2006. It usually takes the FDA about 18 months to act after a petition is closed for comment, and sure enough, this month (Jan 2008) they did.

The FDA has "issued warnings" to seven major compounding pharmacies.

But what you need to know is this: There has never been a complaint against the bio-identicals. This is not a case like ephedra where there are a hundred or so "suspicious" deaths that "might" be linked to the drug. Nope. Nothing. Nada. Just the Wyeth petition. And if you read the warnings and the FDA press releases, it is very clear to anyone that they are warning these pharmacies against "making claims" that have "not been proven".

The FDA is not saying bio-identicals aren't safe. Nor are they saying they have any reason to believe they're not safe. They're simply saying their safety hasn't been "proven".

Well of course they haven't been "proven". Who's going to put up 100 million dollars for research on a substance they can't patent or profit from?

And remember, there are "claims" that water puts out fire and those haven't been "proven" in double blind randomized control studies either.

The FDA warnings refer to marketing practices only. Wyeth has succeeded in getting the FDA to try to intimidate physicians and pharmacies making these safe and effective alternatives to Premarin- which is made from the urine of pregnant mares.

If you have a hormone-dependent cancer or are at high risk for one, you should of course see a doctor well versed in this stuff before using any kind of hormone replacement, artificial or bio-identical.

Just remember that there's been not a shred of evidence that the bio-identicals have any specific problems associated with them, other than the fact that they seriously cut into Wyeth's profits. As the International Academy of Compounding Pharmacists (IACP) has siad, "Under this policy, patients will suffer while Wyeth profits".

Do fat melting treatments like Lipodissolve really work?

2007-12-30T20:01:00.000-08:00

As they say in my home town of New York City, fuggedaboutit!

Lipodissolve- and other instant fat reduction treatments like it- made headlines a while back when Brittney Spears was seen entering one of their clinics in Las Vegas. It quickly became a hot topic among everyone who wants the latest "miracle breakthrough" in fat loss.

Here's the latest on "lipodissolve".

According to the New York Times, FIG- the biggest chain of cosmetic medical clinics offering the newly popular antifat injections- shut its doors last week in the wake of dozens of complaints from consumers asking for their money back.

FIG had operated 15 offices in seven states that promoted a series of injections, at a cost of about $2,000 per body part, to reduce fat deposits on areas like the thighs and abdomen.

The procedure, commonly referred to as lipodissolve, involves injections of drug compounds that have not been approved for cosmetic medical use by the Food and Drug Administration.

Since Fig., originally named Advanced LipoDissolve Center, opened its first office in 2005, its clinics performed more than 100,000 antifat treatments across the nation, the company said in an interview in September.

In the last three years, 145 clients of Fig. have filed complaints to the Better Business Bureau of Greater St. Louis citing lack of results and adverse reactions, including pain and swelling. In just the past week prior to the New York Times report, another 150 consumers added their complaints to the list.

My comment: Always remember two things:

1) If it sounds too good to be true, it probably is.

2) If best strongest scientific endorsement for a procedure or a pill is the fact that Brittney Spears uses it, you might want to think twice about signing up.

Do Low Carb Diets Cause Depression?

2007-10-02T15:47:00.000-07:00

There's been a persistent myth about low-carb diets making people depressed and foggy-brained, and up to now, not a whole lot of research on it.

But in a study just published in the September issue of the American Journal of Clinical Nutrition, researchers from Australia decided to investigate diet and mood. They put 93 overweight or obese men and women on one of two diets- high-carb low- fat, or low-carb high-fat. The diets ranged from 1400-1700 calories a day, approximately 30% less than what the participants were used to. The study lasted 8 weeks.

At the beginning of the study- and for every 2 weeks afterwards-- participants were weighed, and also tested on three different standardized assessments of mood. They were also tested on memory and "Speed of cognitive processing", a measure of how quickly they could perform simple mental tasks.

Here's what the researchers found: Not surprisingly, the low-carb group lost significantly more weight. But everyone in both diet groups improved in mood, with no significant differences seen between the two groups. Memory was also the same in both groups, and both groups improved in "speed of cognitive processing" though the low carb group improved slightly less. (The researchers admitted that more studies were needed to see if that minor finding would be replicated.)

So do low carb diets make people depressed? The answer- like most answers- is "it depends". Any diet can affect mood, (in some people more than others), and the exact outcome will depend on a host of circumstances way too complex and intertwined to reduce to a single simplistic statement. Plus, how you feel the first two days of a diet isn't necessarily how you feel two weeks into it. That said, the current study gives the lie to the myth that "low carb diets causing bad moods". This study showed quite the opposite.

The low carb group improved in mood and overall well-being and lost more weight on top of it!

Can Omega-3's improve my sex life?

2007-08-08T19:31:00.000-07:00

There are two routes by which omega-3's might help your sex life. The first has to do with circulation, the second has to do with mood.

If circulation is compromised, that means blood has trouble getting both to your heart and to your nether regions. That's why there's such a well-known connection between erectile dysfunction and heart disease. The connecting link is circulation.

Omega-3's can improve circulation. And while all sexual symptoms are obviously not caused by circulatory problems alone, they may be a big part of sexual problems for a lot of people, so omega-3's are definitely a "pro-sex" supplement!

Then there's mood, where the connection to good sex is even more dramatic. Omega-3 levels are seriously depressed (forgive the pun) in depressed people and population studies show that people eating large amounts of fish (omega-3's) have low rates of major depression. Omega-3 fats are an absolutely critical part of the structure of the brain, and the brain requires them to function well. French scientists have demonstrated that rats who don't have enough omega-3 fatty acids have brain chemistry consistent with human models of depression. Omega-3's are incorporated into the cell membranes, making it easier for feel good neurotransmitters like serotonin and dopamine to get in. And fish oil has been shown in research to significantly help the depressive symptoms in bipolar patients.

It's pretty hard to be orgasmic if you’re depressed, doubly so if you’re suffering from poor circulation. Since both these conditions can be helped by omega-3’s- it makes sense that they could improve your sex life. (For my favorite brands of omega-3 supplements, see the SHOPPING link for vitamins and supplements at the top of my website)

While you're at it, you might want to increase your protein, zinc and magnesium (increases free testosterone), and score some high-cocoa dark chocolate. Chocolate contains PEA (phenethylamine) also known as the "love chemical" because it releases endorphins in the brain. It also raises dopamine, a neurochemical known to be elevated when you're in love.

And don't forget the greatest aphrodisiac of all- a loving partner who you’re crazy about.

It helps if she or he also thinks you're the hottest thing on the planet.

Does it matter what I eat as long as it is under my calorie count for the day?

2007-07-31T10:00:00.000-07:00

This is the question that has generated a raging controversy in nutrition for years. The short answer is that yes, it absolutely matters. But that doesn’t mean you can ignore where they come from.

As far back as 1957, two researchers named Kekwick and Pawan investigated the question “is it what you eat?” or “is it how much you eat?” They put volunteers on a carefully controlled diet of 1000 calories a day, but 1/3 of the subjects ate 90% protein, 1/3 ate 90% fat and 1/3 ate 90% carbohydrates. The results were interesting and counter-intuitive: Those on the 90% protein diet lost .6 pounds a day, those on the 90% fat diet lost .9 pounds a day. And those on the 90% carb diet actually gained a little. Though the research findings are not all in agreement, enough studies now exist for us to be pretty sure that it’s easier to lose weight (especially body fat) with more protein and fat and less carbs in the diet, even when calories are kept the same.

But this has often been wrongly interpreted to mean that calories don’t count. I frequently hear from people who think they’re “doing Atkins” by eating unlimited amounts of fatty meat and cheese- sometimes thousands of calories a day worth- and are wondering why they aren’t losing.

Fact is, calories most definitely do count- but they’re not the whole story. For the best results, keep your calories relatively low—goal weight times 10 is a good starting place- but also pay attention to where those calories come from. Clean quality protein, good fat, unlimited vegetables and as little sugar as you can manage. Get the white stuff out and concentrate on “Paleolithic” food- stuff your ancestors could have hunted, fished for, gathered, plucked or grown. Stuff your great grandmother would recognize as food.

The bottom line: calories really do matter, but if you concentrate on eating real food- and less of it- you may not have to count calories as carefully.