The Elixir of Exercise

The next 3 blog entries will be about exercise--importance, amount, benefits--all in an effort to convince and motivate you to make physical activity a consistent part of your lifestyle.  It would be impossible to overstate the importance of exercise.

First of all, you cannot experience optimal health without activity/exercise in your life.  Physical activity increases physical and emotional well-being, prevents a long list of diseases, and seems to slow down the very process of aging itself.  Do you know someone who seems to stay perennially “young” looking?  Inevitably they exercise, regularly.   There’s a lot of talk about the anti-aging properties of foods, but hardly a mention about exercise.

Ironically, you will have more energy if you exercise.  I know, it doesn’t make sense.  We have more energy when we spend more energy?  Yup.  I do realize the huge time obstacle most people face—we are maxed out to the limit with a weakening economy and ever-increasing demands on our time, but the truth is you don’t have the time (or money, considering the cost of healthcare) to not exercise.  Improvement in energy translates into feeling better and being more productive with the time you have, not to mention preventing illness, a huge component of our economic well-being, both individual and collective.  Few of us really “have time” to exercise, but I wish my uncles, who all died in their 40’s and 50’s of heart disease, would have taken the time to exercise then--we would have more time with them now.

Then there is prevention of lifestyle disease.  You name the disease, exercise makes it better.  Most people are aware that exercise reduces the major risk factors for heart disease, but let’s strengthen the case and look at each of the individual risk factors for cardiovascular disease.  Exercise reduces “bad” LDL cholesterol, increases “good” HDL cholesterol, reduces triglycerides, reduces high blood pressure, reduces stress, reduces overweight/obesity, and even has anti-inflammatory properties (C-reactive protein, a measure of inflammation in the body, is reduced).  Why do we spend so much more of our resources in the continual search and development of drugs to “help” reduce cardiovascular disease when we rarely tap into the much more effective no-cost exercise?  Many physicians are much quicker to put patients on a drug treatment program than on an exercise program, and we should be asking why.

But the positive effect of exercise does not stop with heart disease.  Exercise has an extremely positive impact on diabetes, obesity, cancer, intestinal disorders (including constipation, diverticulosis, irritable bowel syndrome and Crohn’s disease), alzheimer’s, depression, PMS, osteoporosis, and (perhaps counterintuitively) arthritis.  Exercise even improves sleep!  In fact exercise is SO important to your health that you would very likely be healthier to be a junk food addict who exercises than if you become a “health food nut” in a health food store who does no exercise—and that’s from a dietitian!  That’s how important exercise is.  (Note: I do not condone junk food addict exercisers—that is the addictive cycle of bondage to an eating/body image disorder that ate up 15-20 years of my life).

 

And there simply is no successful weight-management or weight-loss without exercise. . .  

HDL Cholesterol

Recall from the blog entry “Is a Low-Fat Diet Healthiest?” that a low-fat diet is not necessarily the best diet to prevent heart disease because

·        triglycerides increase

·        HDL’s decrease, and

·        insulin-resistance gets worse! 

In previous blogs I discussed insulin-resistance and triglycerides, but what exactly are HDL’s? 

HDL ("high-density lipoprotein") is affectionately known as the "good cholesterol".  Cholesterol is a waxy steroid of fat, and HDL is one of 5 forms of lipoprotein which carry cholesterol in the blood

Triglycerides

In the last blog entry I shared a counterintuitive finding—a relatively "high" (40%) fat diet lowers triglycerides (fat in the blood)!  The key: eat predominately plant and fish fat.

Triglycerides consist of three fatty acids (“tri”) attached to a glycerol molecule (“glycerides”).  Triglycerides are one of the components of the atherosclerotic plaque which leads to cardiovascular disease. Triglycerides may be just as important as cholesterol, if not more important, in the progression of cardiovascular disease.   

Know your triglycerides! 

A serum triglyceride level of 150 milligrams/deciliter or higher is cause for concern and dietary (and exercise) modification.  The American Heart Association recently published a statement recommending that a new “optimal” fasting triglyceride level be defined as 100 mg/dL (Triglycerides and Cardiovascular Disease : A Scientific Statement From the American Heart Association, April 18, 2011 in Circulation).

Our body fat is composed largely of triglycerides.  When excess fat is present in our bodies, the serum triglyceride (blood fat) level may increase.  In fact waist circumference (belly storage fat) is a better predictor of cardiovascular disease and diabetes risk than body weight.  A waist circumference of 35” in women, or 40” in men, will put you at significantly higher risk for cardiovascular disease and diabetes. 

Recommendations for Lowering Triglycerides:

The dietary/lifestyle recommendations for lowering triglycerides are similar to those for lowering cholesterol, with the additional focus on reducing simple carbohydrates and alcohol:

·        ¯ Animal/Saturated Fat

               

·    ¯ Simple Carbohydrates. In “insulin resistant” individuals, eating refined carbohydrates can lead to hyperinsulinemia and high triglycerides.  It is the simple carbohydrates which Americans consume in excess that are known to affect insulin--there is no evidence that complex carbohydrates are to blame.  Research on healthy cultures around the world indicate that an optimal diet (consumed in a variety of ways) is based on 90% plant and 10% animal food based on 50% whole grains, beans, nuts and seeds, 30% vegetables, and 10% fruit, a large carbohydrate intake to be sure, but very different from the largely refined carbohydrates upon which Americans base their Standard American Diet.

·        ¯ Alcohol.  Alcohol contributes 7 calories/gram and virtually no nutrition.  When we consume alcohol it is not immediately burned for calories, but first converted to fatty acids in the liver (cirrhosis of the liver in alcoholics = fatty livers which scar and burst), then the fatty acids are burned for energy secondary to available carbohydrates.  The beer-belly softball player doesn’t burn the beer for energy first, but the hot dog bun instead!  More often the fatty acids are stored.

·        Exercise.  Consistent exercise is very helpful in controlling serum triglyceride levels.

So to lower your triglycerides reduce animal protein, simple (refined) carbohydrates and alcohol, and eat whole grains, beans, nuts and seeds, vegetables, fruit, fish and plant oils with moderate amounts of lean meat and dairy (think Mediterranean).  Remember, counterintuitively, a seemingly "high" 40% fat diet based predominately on plant (especially monounsaturated fat, olive oil) and fish fat lowers triglycerides, likely due to an indirect affect of eating less simple carbohydrates and animal protein.  Finally, consistent exercise can have a major positive effect on your triglycerides, and on your risk for cardiovascular disease and diabetes.

Know your triglycerides.

Eat right, exercise, enjoy!

Diane Preves, M.S., R.D.

Note:  it is not uncommon to see a transient rise in triglycerides during weight-loss (it usually resolves within 6-12 months).

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Is a Low-Fat Diet Healthiest?

In the last two blogs I tried to correct the (dangerous) misunderstanding many Americans have regarding high-protein diets.  Today I focus on the confusion many people have about low-fat diets.

Americans have focused ad nauseam on low-fat diets.  Now overwhelming evidence indicates that it is the type of fat that matters, not the amount.  Traditional Greeks, arguably the healthiest people on the planet measured by low rates of premature mortality, ate a 40% fat diet based predominantly on olive oil.  Americans are shocked to hear that such a “high” fat diet actually lowers triglycerides.  In recent years the American Heart Association has “tweaked” its recommendation upwards from 20 to 30% fat.  The National Cholesterol Education Program’s cholesterol-lowering diet (p. V-2) has been revised to 25-35% fat with an emphasis on plant fat.

Yet due to decades of low-fat recommendations based on nutrition research which at first glance seemed to indicate that a low-fat diet would prevent cardiovascular disease, and due to the plethora of low-fat products which subsequently flooded the market with their “nutrition education” influence on the American public, many Americans still think that eating a low-fat diet is the “healthiest” way to live.  However, overwhelming evidence indicates that a moderate fat diet is much healthier.  Actually, a diet that would be considered high-fat (40%) in comparison to previous recommendations (20%) actually reduces the incidence of cardiovascular disease.  The 7 Countries Study performed way back in the 1960’s by T. Ancel Keys found that the diet eaten by the Greeks on the island of Crete was one of the highest fat diets at 40% fat, low in saturated (or animal) fat and high in monounsaturated fat (from plants), but the Greeks eating it came out with some of the lowest rates of cardiovascular disease and all-cause mortality and had the longest life expectancies in the world at that time.  The diet, now fondly called the “Mediterranean Diet” is high in vegetables (about 2-3 cups/day), especially green leafy types, high in fruits (2-3 /day), high in wholegrain carbohydrates (equivalent to 8 servings/day), high in legumes and nuts, moderate in fish and alcohol, low in meat and fermented milk products.  The diet is also low in animal and saturated fat but high in total fat (40%) with 4 Tbsp. olive oil/day. 

So how was it that American nutrition experts originally came to the low-fat conclusion? 

The Harms of a High (Animal) Protein Diet: Part 2

The Problems with High Animal Protein Diets

Continuing from the previous blog, recall that a three-pronged approach to prevent the metabolic syndrome seems prudent—weight-loss, exercise, and incorporating anti-inflammatory foods in a plant and fish based diet.  Recall also that there is more harm than good in trying to follow the weight-loss recommendation with a high-protein diet.  To continue the list of harms:

·   In the American diet, animal protein (but not plant) is usually linked with saturated fat and cholesterol, which increases LDL-cholesterol (an effect that is compounded when high-carbohydrate, high-fiber plant foods are limited).  It is generally recommended that 10% or less of your total daily calorie intake come from saturated fat, whereas a high-protein diet can have as much as 25% saturated fat.

·   Increased homocysteine levels in blood (a by-product of animal protein breakdown) have been associated with increased risk for cardiovascular disease.  Hospitals now routinely test for homocysteine.

·   Excess animal protein (but not plant) can crowd out a sufficient intake of protective fruits, vegetables, whole grains, beans, nuts and seeds.  High-protein diets are carbo-phobic.  Many high-protein diets intentionally restrict fruit, vegees, beans and whole grains, further reducing your intake of health-supporting, disease-preventing phytochemicals.  Most high-protein diets are based on 30-40% calories from carbohydrates whereas a healthy diet is based on 45-65% calories from nutrient-rich, fiber-rich carbohydrate foods. 

· High-animal-protein diets are low in fiber which can cause constipation and diverticulitis.

·  A high animal protein intake usually means a lower carbohydrate intake.  Since carbohydrates are the “high energy nutrient”, the first source of energy the body uses for fuel, high-protein (low carb) diets often result in fatigue, and sometimes headaches (due to low blood sugar and/or dehydration).

·   Dietary animal protein sources are usually expensive.

·   A high-carbohydrate diet including fruit, vegees, whole grains, and nonfat dairy products has been shown to decrease blood pressure.  Limiting these foods may increase blood pressure as potassium, calcium, and magnesium are decreased and sodium is increased. 

·   Strong evidence has accumulated indicating harmful “meat factors” promote cancer.  Restricting fruit, vegees, beans and whole grains reduces your intake of health-supporting, disease-preventing phytochemicals which further increases your risk of cancer.

·   High animal protein diets (but not plant) increase urinary calcium losses, contributing to osteoporosis and kidney stones.

·   High-protein foods such as meat, poultry, seafood, eggs, seeds and nuts are high in purines.  An excess of purines may cause gout in susceptible individuals.

·   People with liver or kidney disease are at increased risk on high-protein diets.  High-protein diets can increase your chances of developing kidney disease, especially in diabetics, because of the high level of protein which puts a strain on the kidneys.  A very high-protein diet, even for short lengths of time, can speed progression of diabetic renal disease.

·   High-protein diets can result in a dangerous metabolic condition called ketosis.  The body normally   burns carbohydrates first for energy.  High-protein diets that are low in carbohydrates force the body to burn fat for energy instead.  The by-product of fat breakdown are substances called ketones.  The very low-carbohydrate intake required in the first “phase” or weeks of many high-protein diets leads to a state of ketosis in which a large amount ketones accumulate in the body.  Ketosis occurs in uncontrolled diabetes (as when a diabetic does not have the necessary insulin), which can lead to coma and death, and in eating disorders (as a result of starvation).  High-protein diets put individuals in a similarly "sickened" state.

·   A high-protein diet can lead to or exacerbate dehydration.  Protein has nitrogen, which breaks down to ammonia, and must be diluted by the body.  Additional water is necessary to remove nitrogen from the body via urine. 

Is it any wonder high-protein diets cause health problems?  Yet even given all of these facts, and the physiological problems and recidivism rate of these popular diets, the high-protein diets continue to be popular because they “tickle the ears” of an American public wanting a quick fix to their problems without making real change.  Americans typically eat 2 1/2 times the amount of protein physiologically necessary.  The message of the high-protein diet authors to Americans—you can have your steak and eat it too.  Sorry, but some things really are too good to be true. 

The fact is despite the reported physical harm and weight-regain experienced by high-protein dieters, because of the insane popularization of the high-protein diets in the media (and I include food product advertising in that) many people now think that a high-protein (carbo-phobic) diet is the best way, even a healthy way, to lose weight.  The recommendation to lose weight to resolve the metabolic syndrome which 1 out of 3 Americans now suffer will likely result in masses of well-intentioned people going on high-protein diets, which will make their metabolic problems (and America’s already epidemic health crisis) worse.  Many Americans will unknowingly be led to slaughter even more willingly because many of the diet books give mention to the metabolic syndrome (often with interesting but not completely correct discussions about insulin and blood sugar) to support their dietary claims. 

The combination of the power of the media to promote high-protein diets and the “success” of quick visible weight-loss on high-protein diets has convinced many Americans that they are healthy.  A big part of the problem is the incessant value we put on weight-loss in America so that we have fallen for yet another false solution.  The bottom line is the public needs to be aware that there are two ways to lose weight—healthy and unhealthy—and wellness professionals need to be careful to not indiscriminately promote treatment for the metabolic syndrome with “weight-loss and exercise” without explaining that vital distinction clearly to patients. 

Let’s do this right,

Diane Preves, M.S., R.D.

N.E.W. LIFE I/ copyright 2013

Thank you for sharing this post with others who might benefit from the information shared herein.