The JAMA study
Regina Wilshire recently reviewed a JAMA study (published a year ago) that compared the Atkins, Ornish, Weight Watchers, and Zone diets.
The study authors summarized their study conclusions this way (emphasis mine):
In fact, none of the groups got the macronutrient ratios of their diets right. Those on Ornish and Zone ate way too much fat for their diet; those on Weight Watchers ate too much fat with too little carbohydrate; and those on Atkins ate too much carbohydrate with too little protein.
I’ve done a masters thesis, so I understand a bit about research protocol, and so am sympathetic to the researchers desire to eliminate variables. Hence the random assigning of participants to diet.
But what can you conclude from a study with randomized participants and low compliance?
When I commented on Health magazine’s diet face-off (which did something similar to the JAMA study), I called the results “questionable.”
Regina takes it a step further and suggests that this kind of research is “nothing more than a waste of research dollars.”
Well, I would certainly hope that any researchers who looked at the JAMA or Health projects would conclude that the critical piece to all this is the issue of compliance!
Interestingly, today’s LA Times has a story about using drugs to curb compulsive gambling. Slate, which points to this www.jasminlive.mobi article, sugggests that the psychiatric spin to this is:
This proves again that what we used to call moral problems are really biological problems.
So how are the two related? Perhaps like compulsive gamblers, people who overeat may be doing so because of drives they aren’t consciously aware of. Missing the connections between compliance, environment, and human biology will doom us to decades more of trying to figure out why us fat people just won’t eat less and exercise more like “they” think we should.
Courtesy of an Amazonn “if you liked this, you’ll like…” link, I’ve come across a book called The Pleasure Trap. The book’s a bit out there (ends with a chapter on the benefits of water fasting), but well worth a read if you, like me, find the argument that it isn’t all about personal failure a compelling one. For more, see the National Health Association’s published review of this book.
Off to Florida
Things will be quiet here as I head off to Florida for some fun in the sun. The bummer is that no one here is jealous; it was 66 degrees today in the nation’s capital!
Look for an apres-vacation post next weekend sometime. I am not planning on weighing myself until the 19th (barring any serious slip-sliding), but if nothing else, I certainly hope to comment on what a difference a year makes. Last time I visited my aunt in Orlando, I had to book two seats to fly, and I had to hang out while the family did anything physical (like a walk on the beach).
Tomorrow’s adventure begins when I see whether I’ve lost enough to say “bye-bye” to the seat extender. Probably not, but heck, asking for that was always trivial to me. My bigger anxiety was whether I’d be seated next to someone who’d be fussy about the fat chick next to him/her.
See ya in a week. Go Steelers!
Managing carbs
Well, it’s 12:35, and it’s looking a lot like I’m going to skip our company’s holiday party (which started at noon and goes til 3PM). I mostly think this is a good thing. I had a great night last night (had brown rice California roll and a salad from Whole Foods) and a pretty good breakfast this morning (a breakfast sandwhich with just half the english muffin and fruit).
But I don’t know that I’m on track enough to deal with the holiday buffet at the Grand Hyatt. I actually haven’t attended this party for years, so it’s not like it’s a big problem to skip it again.
Anyways, I digress. I really wanted to point folks to an interesting series of articles over at Weight of the Evidence. Regina Wilshire (who is apparently a neighbor of mine) is promoting controlled-carbohydrate nutrition, a concept I like a lot.
On Wednesday, she started a series of posts looking at the question: what is a healthy diet?
I agree wholeheartedly with her idea that our diets are (typically) terrible when it comes to nutrition. In part 1, she writes:
I think this is critical. What if our cravings for food are simply the body’s attempt to get nutrients? And yet, most of us stuff ourselves with foods that are either practically nutrient-free, or worse, are downright harmful–full of trans fats, high fructose corn syrup, saturated fats, etc.
But in part 2, she makes a point I hadn’t really considered: how many nutrients we give up when we eat “doctored” foods (e.g., low-fat cheeses). She writes:
Very interesting. Cheese may or may not be the best example (there are lots of folks who don’t have cheese as a healthy food for a variety of reasons), but it really does make a clear case that processed foods shouldn’t be the foundation of a healthy diet.
You’ll probably notice that I titled this post “managing carbs.” I’m convinced that there is a carb connection to compulsive overeating. And I think the idea of a “low-carb diet” is not only valuable, but a really humane way for some to approach their weight issues. But there’s some baggage with the concept of “low carbs” that I think causes people to throw the out with the bath water. More about adult cams one of these days.
But I sure like the idea of a nutrient-rich diet. I was doing really well when I was focusing on whole foods and nutrients (doing more from SuperFoods Rx for example). Now to get back there…it’s a great place to be!
Back and on track!
Well, technically I’ve been back for over a week now (got back into town on the 10th). I did go off-track while I was on vacation, but not in a binge-eating way, mostly in a “I don’t normally eat this” kinda way.
And then once I got back, I did do the one more day thing for nearly a week. This time, I managed to mostly get back on track on my own…no raging fever required.
So I’ve got just under one week of being mostly on track (I’ve done a bit of takeout Chinese this week that doesn’t really qualify as truly on track). I’ve decided to give myself two full weeks of being on track before stepping on the scale again, so the next planned weigh-in will be March 5th.
All in all, the time away was a big win. The flights down and back were way more bumpy than I prefer, but both planes were only half full, and my friend and I had the row to ourselves on both flights.
The plane was a new model (one of those Airbus something or others), but alas, I’m not yet free of the seatbelt extender. But asking for that has never been a big issue for me…being asked to buy two seats has been (I watch way too much Airline).
I didn’t figure that would be a problem this trip; we weren’t flying an airline known to be hard-ass about that, and I was flying with a friend, so I didn’t need to worry about an annoyed passenger next to me.
Anyways, so the flight (aside from the turbulence) was pretty uneventful. The rest of the trip was spent doing touristy things and mostly eating out. I didn’t go nuts, but nor did I try and do my on-track eating.
So for example, we wound up doing breakfast at a place like Denny’s one morning. While I did order an egg-white omelet with veggies and fruit instead of home fries, I also had one pancake with butter and syrup. Gotta love moderation!
That said, once I got back home, it was very easy to slip back into my old jasminelive.online patterns, which weren’t at all moderate, and included inhaling a bottle of wine and then chowing down way too much of unhealthy Chinese food (General Tso’s chicken really must be the Chinese equivalent of the Big Mac).
I’m not sure how I got myself back on track this time. One of these days I’ll have to get over the embarassment of “failing” and actually blog this stuff as it’s happening live. But I must say that Krisanne does a really great job of describing the anatomy of a binge:
My version of this looked like this: Okay, the plane landed late on Thursday afternoon, so what the heck, let me just do Chinese for dinner tonight and I can go shopping tomorrow.
And then you go shopping, but boy, maybe one more night of overeating wouldn’t be that bad, and you’ll have the whole weekend to get back on track. And you make a really healthy pilaf of beans, rice, tomatoes, and spinach to pump up the nutrients.
But then Saturday something else comes up and the pilaf sits in the fridge in a bowl and it’s another call to the Chinese takeout. Ditto Sunday. But hey, we’ll just start fresh on Monday, right?
Well no. And then Tuesday is Valentine’s Day and what the heck, you’re alone and it’s depressing so one more night, okay?
You make plans for Wednesday night in order to try and break the pattern. But when push comes to shove, you just decide that driving all the way for a concert isn’t what you want to do.
And then, on Thursday, something finally clicks, and you get through one night on track. Hallelujah!
Curiously, though the temptation is back the next day, it’s not as strong. Then again, maybe it’s the fact that you have to schedule surgery for your fibroids that helps. Or maybe, it’s the fact that you go and buy a new laptop and commit that you’ll stay on track until you pay off your credit card bill :).
Anyways, I did come up with one interesting theory while going through this. One of the supposed truisms about compulsive overeating is that we’re going for the serotonin and/or dopamine and/or beta endorphin rush. And that the problem is that it takes twenty minutes to go from stomach to brain. Alas, the amount of food you can stuff in in those twenty minutes. :(
But what if that isn’t it? What if we’ve trained ourselves that we need to eat to the point of pain?
Obviously that’s not the only issue; people aren’t stuffing themselves on carrots. But while eating the stuff we eat surely has a physiological effect, maybe the whole point of the binge eating until stuffed is simply a way of stopping the anxiety faster. Waiting twenty minutes for the digestion to do its job becomes less and less tolerable.
What’s really interesting to me about Krisanne’s story is how much it’s like mine after vacation, and how much it’s like Adriette Ward’s story in O magazine: it starts innocently enough, and then before you know it, you’ve slip-slided your way into gaining back some (scary) number of pounds.
It seems that there are four possible ways of dealing with this:
It will be a happy day if I can ever do #4 consistently!
Healthy food find
I had one of those weird serendipity-like moments during my recent vacation to Florida. On the drive from Miami to Orlando, we pulled off the turnpike to do a loo break. We pulled up to Mickey D’s, only to find that the interior was being refurbed. So we wound up going to a place called Camille’s sidewalk cafe.
Now, there has been a Camille’s in my neighborhood for a couple of years now. But the place and the name made me think it was a Starbuck’s variant or like the cafes in Barnes and Noble, and since I don’t drink coffee (and don’t need sugary pastries), I never checked it out.
So here I was, a thousand miles from home, and I’m finally stopping in. Shocker…they have a really interesting menu!
According to their website, Camille is a real person, and she and her husband had the idea to go healthy at the mall:
Anyways, if you’re like me and have avoided Camille’s thinking there’s nothing there for you, consider stopping by (they have a locator you can use to see if there’s one near you). Encouraging healthier fast food is, to paraphrase Martha, “a good thing” :).
Leaning over the wagon’s edge…
So I’m still on track to weigh in a week from now. But boy, I’m not as on track as I really should be. I’ve not fallen off the wagon, but I’m sure hanging over the edge!
What probably isn’t helping me is that I added cereal to my diet last week. If you’re new to Act Boldly, you might not know I’ve been dealing with fibroids for nearly 10 months now, and because of that, I’ve been seriously anemic. [Sidebar: check out this post on weight loss and estrogen over at Jimmy Moore’s.]
I’ve been on Lupron since October to deal with the bleeding, and until January, it was working great. But it was almost like I didn’t get my January shot.
Anyways, the February shot seems to have “kicked in” and I’m back to a trickle rather than a flow. But although I’m on major horse pills of iron, I wanted to try and get more in my diet. I won’t eat liver. But some of the fortified cereals (like Total) have a lot of iron in them, so I’ve been doing them for weekend breakfasts and evening snacks.
I suspect that this kind of eating is what’s keeping me from being back to being totally on track. And I should know better. I had been doing the individual servings of Smart Start from our cafeteria until I realized that was over 20g of sugar per serving! Total isn’t quite as bad, but boy, cereal is not a volumetrics food…a little tiny bit is sure a gigantic amount of calories!
So in this state, I found myself at my nieces’ birthday party yesterday. They like Chinese, so their parents did take-out Chinese. And not only did I eat too much of the Sesame Chicken (if General Tso’s is the Chinese Big Mac, Sesame Chicken is the Quarter Pounder with Cheese :), I wound up eating birthday cake and ice cream.
What’s bizarre is that I don’t even care for angel food cake or for vanilla, but I had both.
Ah well, I’m back on track today…so far. And I am committed to weighing in next week. I also want to do well, as my UAE procedure is scheduled for late April. The more I lose, the easier I think my recovery will be.
Both butterstick and Sheryl have recently posted about life on the edge (which I talked about more last week).
It’s scary how much these stories sound alike. I’m about a third of the way through The Hungry Years, William Leith’s story of food addiction. I guess guys can go through it too.
My current theory is that healthy eating gives you a measure of protection (a la immunity) against these kinds of cravings and binges. And while it’s probably not an issue of morality in the concept of good foods and bad foods, there may well be good and bad foods from a physiology perspective. A piece of angel food cake is not going to derail me. But if I chain a few of these meals together, wham-o, it’s back to craving city. So as of today, I’m back to being really on track. No more cereal. And on Wednesday (March 1st), I’m back to skipping the Diet Coke during the week.
I’m speculating that the way I want to go is essentially to stay on track most of the time, and then go off-track on holidays and vacation. But that’s only if I figure out how to get back on track easily.
Of course, all this would be much easer if we didn’t have the low-fat and low-carb camps acting like the Hatfields and the McCoys. But more on that later.