Eat more veggies, exercise, and prevent diabetes…
By Dr John Ellis MD // Leave a comment
One of my veggie dishes. I eat 1 lb of green veggies at lunch and dinner, plus sweet potatoes or brown rice, and steamed fish or lean poultry (Greens, plus balsamic vinegar, teaspoon olive oil, dried onion, Costco no-salt seasoning)
…especially in the African American/black community. Approximately 40% of people with diabetes don’t know it; the percentage is higher for African-Americans. A new study, “Vegetarian diets and incidence of diabetes in the Adventist Health Study-2“ by Loma Linda University School of Public Health looks at the incidence of type 2 diabetes among the African American/Black community in light of dietary factors – vegan v. vegetarian v. non-vegetarian. The study focused on black members of the Adventist Church (since they are encouraged to have a vegetarian diet, avoid smoking and alcohol consumption as part of their faith) and compared the risk/prevalence of type 2 diabetes in this population to that of a general African American/black community. They found that
only vegan and lacto ovo vegetarian diets were associated with a decreased risk of diabetes…the protection [against type 2 diabetes] afforded by vegan diets … was 70% and by lacto ovo vegetarian diets…50% suggesting that a vegetarian-type diet may be a way to counteract the increased diabetes risk for Blacks.
the Black/African American population carries an increased risk of diabetes, and could potentially benefit from a vegetarian diet …Higher income and increased exercise as well as vegan and lacto ovo vegetarian diets were protective against diabetes
There is a common misconception among the black American community that general health recommendations do not apply to them, but they do! The study in general saw that black folks (and everyone else!) are protected by eating more veggies and getting more exercise. This protection isn’t just restricted to diabetes, but eating more veggies could reduce breast cancer risks, which are more aggressive in African American women. African American women are also more likely to be obese than white women, and this consequently increases mortality in black women.
Eating more veggies, more exercise, and basically adopting a healthier lifestyle will protect against many life threatening diseases.
Weight training for women… Video of cancer survivor and her “exercise prescription”
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The lady in this video below is not overweight. But we know that obesity is associated with increased risk of breast and other cancers.
Weight training can help women surviving cancer recover and live better. And I think it’s fun, too! Watch her working out starting at 2:14
Does sitting lead to cancer?
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Beware of the couch! Sitting for too long might cause cancer. Christine Friedenreich, an epidemiologist, studied the link between physical inactivity and cancer. Her study is highlighted in a USA Today article.
More than 90,000 new cancer cases a year in the United States may be due to physical inactivity and prolonged periods of sitting…
“A brisk daily walk of at least 30 minutes could lower a person’s risk over time for breast cancer and colon cancer,”
Friedenreich…found convincing evidence that regular physical activity reduces the risk of breast cancer, colon cancer and endometrial cancer by 25% to 30%. There’s some evidence that regular exercise also reduces the risk of lung, prostate and ovarian cancer
the more time people spent sitting, the higher their risk of dying early. “Even among individuals who were regularly active, the risk of dying prematurely was higher among those who spent more time sitting,”
More jobs require us to sit behind a desk for prolonged periods of time, relying on technology to carry out the simplest of tasks. You can avoid becoming a “victim” of this system by increasing your daily activity at work. Try to incorporate as much exercise into your day as possible: take the stairs whenever you can, stand more/longer, and spend more time outdoors!
Many people disagree, but I weight myself everyday.
By Dr John Ellis MD // 1 Comment
I weigh myself almost everyday. This was especially important at the beginning of my weight loss journey. My weight loss trajectory:
I recently came across Amelia Greene’s weight loss presentation below (see video). A former typical college student (eating unhealthy college meal plans), she lost 40lbs over 5 years, mostly by keeping daily track of her weight to see what was working for her; and what lifestyle changes she needed to make. She was losing 0.2 lbs a day (slow progress!) which you typically won’t notice over a short period of time, but keeping track of this made the changes visible, and kept her motivated. Her dad followed suit, and lost weight faster than she did. See, healthy habits do rub off, it really became a family affair! You can easily do your record keeping online, as she describes in the video, no excuses!
Amelia Greenhall (Seattle): Weigh Everyday = Understanding from David Reeves on Vimeo.
The lifestyle changes she made include biking to vegetable market; driving less (rarely now), learning to cook, having a weekly dinner club etc. She also spent more time journaling (a long time hobby of hers), less time watching TV, and less time on AIM. This completely revitalized her – e.g. it made her spend money on things that make her happy (meaning more $ on healthy food 
).
I identify with a lot of the things she says, things I continually blog about. It is useful to have another success story from someone who underwent a lifestyle change.
U.S. 2010 Dietary Guidelines: conflicts of interest
By Dr John Ellis MD // Leave a comment
The New England Journal of Medicine recently published a review of the U.S. 2010 Dietary Guidelines, which were published earlier this year. These guidelines are evidently written with conflicting interests in mind, giving almost equal weight to the welfare of the U.S. public and the welfare of businesses. The guidelines are significant to both parties.
Although the guidelines’ direct educational influence is modest, they have major impact on Americans’ diets, because federal food policies, including standards for schools, and many federal food-assistance programs must comply with them. The guidelines’ development was carefully watched by agro-industrial interests that stand to gain or lose from their implementation.
Even with conflicting interests in mind, the guidelines have some improvements.
The original Food Guide Pyramid, which encouraged substituting grain products for dietary fat (irrespective of their nutritional quality), may have inadvertently contributed to epidemics of metabolic syndrome and related chronic diseases by increasing refined-starch consumption. The 2005 version, MyPyramid, conveyed little interpretable guidance about healthful food choices. The current administration, motivated by First Lady Michelle Obama’s campaign against childhood obesity, has replaced MyPyramid with MyPlate. This image improves on its immediate predecessors, especially with advice to cover half the plate with vegetables and fruits.
Some of the “lost opportunities” (the review critiques) include the lack of attention given to explaining important nutritional information like distinguishing between carbohydrates.
the quality of carbohydrates, as characterized by their glycemic index, is dismissed as unimportant, whereas we believe the evidence strongly suggests the opposite.
The guidelines seem to be tip-toeing around obvious dietary issues and recommendations that are scientific facts. It also appears that the report avoids requesting the elimination of harmful products from the American diet in an attempt to remain sensitive to specific industries.
A clearer message would have been that Americans must reduce consumption of red meat, cheese, butter, and sugar, but that message would have offended powerful industries. Deep in the guidelines, diligent readers can find a recommendation to limit sugar-sweetened beverages, but these products deserve front-page attention as the single-greatest source of calories in the U.S. diet and an important contributor to obesity, diabetes, heart disease, gout, and dental caries.
There was a disheartening post I wrote a while back on how the government promoted an increased use of cheese. Cutting cheese out of my diet (I loved cheese!) was a significant factor to my weight loss.
The guidelines require you to “read between the lines” and figure out what specific products you need to cut out of your diet.
Obese folks more susceptible to catching the flu
By Dr John Ellis MD // Leave a comment
I got my flu shot last week with flu season around the corner. I recently read an interesting study called “Obesity is associated with impaired immune response to influenza vaccination in humans”, published in the International Journal of Obesity. A United Press International article neatly summarizes the main points of the study, which concludes that obese people are at a higher risk of catching the flu after being exposed to the flu virus; obese individuals do not react as effectively as healthy individuals of average weight. This is because
Influenza vaccine antibody levels decline significantly in obese people compared to healthy weight individuals and a type of white blood cell are defective in heavier people.
Although obese, overweight and healthy weight individuals all developed antibodies to flu viruses within the first month after vaccination, the antibody levels in the blood declined more rapidly in obese and overweight individuals, the study said.
This may be why, with the previous H1N1 flu strain, obese people tended to do worse. Early vaccination may help prevent this.
Losing weight and keeping healthy certainly makes you less vulnerable to certain diseases. Now that we know it influences how you react to the flu shot, exercising and eating healthy are important — with the flu season just around the corner…
Go get your flu shot. Folks over 65 should also get a pneumonia shot. Please ask your doctor how best you can protect yourself.
Breast reduction plastic surgery
By Dr John Ellis MD // Leave a comment
Women may have breast reduction to lessen back pain or improve how they see themselves. Women who have breast reduction surgery AND gastric bypass surgery (not at the same time!) are more satisfied if they have the gastric bypass surgery first.
However, removing that amount of fatty tissue doesn’t produce other health benefits; neither does liposuction. Now, a UPI article summarizes “The Impact of Obesity on Breast Surgery Complications” study published in the November issue of Plastic and Reconstructive Surgery. The study links obesity to an increased risk of breast plastic surgery complications.
obesity is a major risk factor for complications following elective breast procedures…based on our study, it increases the odds of experiencing any complication within a 30-day postoperative period by 11.8-fold.
I can confirm this data as well from my professional experience as an anesthesiologist. In my experience, the most common complication in this surgery is wound infection.
There are certainly some links between obesity and higher risks for certain surgeries and procedures. Obesity also increases risks associated with child birth.
“You are where you live”
By Dr John Ellis MD // Leave a comment
It certainly makes sense that being well off gives you more access to healthy foods (that are typically more pricey) and more health quirks. It turns out that the neighborhood you live in actually influences weight gain and loss - a 2010 study reported that BMI (body mass index) tends to increase in lower-income neighborhoods. A recent Reuters article reports the results of a study which ties better neighborhoods to less diabetes.
Moving to neighborhoods with less poverty could provide easier access to health care and supermarkets with healthy food, relieve everyday stress that can affect eating habits, and make it easier to find a safe place to exercise
“Given that diabetes and obesity are associated with a large number of health complications and higher cost for medical care, the findings from this study suggest that improving the environments of low-income urban neighborhoods might improve the duration and quality of life for the residents and lower health care expenditures”
I featured an NY Times article a while back on malnutrition in inner city neighborhoods, despite an overabundance of calories. These linkages are extremely disheartening.
I would suggest eating lower cost but healthy foods like sweet potatoes and beans if you don’t have immediate access to healthy foods that are more pricey.
U.S. life expectancy is low due to high level of obesity
By Dr John Ellis MD // Leave a comment
Researchers at the University of Pennsylvania conclude that life expectancy in the U.S. is lower than those of other high-income countries due to the U.S. high obesity rate. A detailed report can be found in their research paper, “Contribution of Obesity to International Differences in Life Expectancy“.
…obesity reduced longevity in all countries ranging from half a year for females in Switzerland to more than a year and a half for US males. These effects have been more severe in the United States than in other countries. Two key features of the US distribution of BMI that distinguish it from comparison countries include an unusually high rate of obesity in younger age groups and significantly higher rates of severe obesity. High levels of obesity in the United States appear to be strongly implicated in its relatively low level of longevity. We believe that this demonstration should add urgency to public health efforts aimed at achieving healthier weights for Americans.
This is further proof that the obesity epidemic isn’t a myth. The American lifestyle consists of fast food diets, addiction to junk and fattening foods, eating out, and high dependence on the wrong types of technology (like TV) that reduce our levels of activity. These traits seem to be increasingly more pronounced in children. The study specifically pointed out that the U.S. has “an unusually high rate of obesity in younger age groups.”
I suggest a lifestyle change – a lifestyle that includes the exact opposite of things we are currently doing to add to the U.S. obesity level. Eliminate unhealthy habits; avoid junk and fast food by cooking and eating in; spend more time outdoors walking and running errands; and especially encourage your children to exercise – perform fun activities like dance. Join them too!
A number of health challenges in my 40s got me fearing an early death and motivated me to change my habits.
Do hormones doom weight loss?
By Dr John Ellis MD // 2 Comments
There are a ton of news reports about a new study showing that a year after losing 10% body weight, people have hormonal changes that promote greater hunger. One such hormone is leptin. These articles then argue for the existence of a “set-point” that our body will vigorously defend. The only problem is: why has this “set point” increased so much in only a few decades???
I read the study in detail. The people were starved for 8 weeks, losing about 3.5 lbs/wk – too much, too fast! I am almost certain that these folks lost muscle. We’ve previously noted that this is catostrophic, and contributes to weight regain. Loss of muscle is called sarcopenia, and may contribute to diabetes even more than obesity.
I do not go hungry! I believe there are a number of reasons my weight has been stable at approximately 212 lbs for 2 years now (down from 337 lbs):
- Resistance training to maintain and even build muscle while losing weight. Studies in women show that strength training reduces one of the “culprit” hormones, leptin.
- Protein intake to build muscle and keep satisfied longer.
- Aerobic exercise (walking, treadmill, elliptical, swimming) to burn more calories.
- More (much more!) consumption of green vegetables and fiber. A low glycemic diet rich in beans has been shown to reduce that “culprit” hormones, leptin. Elevated leptin levels have been described in the news reports as one of the reasons people “can’t help but regain weight.”
An animal study has also shown that after weight loss:
During weight maintenance, regular exercise reduced the biological drive to eat …
Don’t believe the hype! Weight loss can be maintained with the suggestions I’ve listed.
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