Thoughts related to nutrition

For those of you who don't know, I veritable font of knowledge and wisdom when it comes to food and nutrition. Although I am not formally schooled in the topic, it is something that I have spent a lot of time learning about in the last decade.

I have looked at nutrition from the perspective of weight loss, athletic performance, and also from a culinary perspective (as someone who likes to cook). I coached DI track and field for 6 years while I was in Albany NY which required coaching not just training and technique, but also lifestyle, including nutrition. I worked closely with a registered dietician for three years while I was in New York I was also married to a biological anthropologist who studied childhood obesity and exercise physiology among other things. She was also my assistant coach for three years.

Recently I was involved in a discussion in an obscure corner of Facebook (i.e., comments that were attached to a photo) with a former HS classmate (MM) of mine about the merits of a "detox" juicing diet. A few days prior to this discussion a registered nutritionist came to work to give a presentation. She confirmed many of my suspicions about this kind of "detoxing" diet, and motivated me to contribute. I'm putting the discussion here (with some minor revisions and additions) because these were my racing thoughts for the last week.

The photo was a screen shot of an iPhone app that tracked weighloss and BMI relative to some goal. The caption by MM read:

MM: Watched the "Fat, Sick, and Nearly Dead" documentary and decided to try the juice "reboot" for 10 days. 5 days in, I've lost 8 lbs., I have way more energy, and just generally feel pretty great. No real cravings, but I miss cooking.

(Note: I'm not capturing all the responses in this post, just the ones that are relevant to subsequent discussions).

JN: ten pounds in a week? Starving yourself to lose weight'll cause you to gain it right back when you start eating again. Careful!

MM: @JN - I'm still getting plenty of calories - probably about 1,600/day. It's mostly water weight at this point. Haven't really been hungry at all. I hear you, though. It's not a long-term weight loss solution, just a kick-start to my plan to eat clean and get back in fighting shape.

KH: I did the same thing for 12 days and lost 16 pounds. I was also working out at the same time. In the 5 days since adding other vegan foods into my diet I gained back 4 pounds. Overall I was pretty pleased with the whole process. I still have more fat to lose to be really healthy.

NS (This is me) Juicing is a gimmick. Masticating is not a sin. Cooking applies heat to break down the cell walls of fruits and vegetables, where as a juicer tears them apart mechanically. The net result is similar, food which is better tasting and easier to digest.

The people who benefit most from juice diets, as a concept, are the people who make juicers.

Dramatically cutting calories is a sure fire strategy to lose weight in the short term, but cutting too many calories from your diet can also do damage to your metabolism (i.e., your basal metabolic rate). Eat low-caloric density, high-nutritional density foods, and do it in such a way that your inputs are slightly less than your output.

If you are unhappy with your lifestyle, make a sustainable and enduring change, and do it today. Avoid the fads, avoid the hype, and avoid the gimmicks. This is about you being happy with yourself for the next 50 years, not just for the next 50 days.

MM: @NS- See my comment above to Jeff. I know it's not a long-term solution. In three days I'll be eating a mostly vegetarian diet, low in simple carbs and red meat, high in veggies and legumes. Just cleaning out and starting from scratch right now.

KN: @NS - what is your opinion about the angles that (a) juicing removes the fibrous material from the nutrients allowing the juicer to consume more nutrients through juice than they could through cooking and (b) cooking destroys the enzymes promoted by raw-dieters?

NS: @KH: Those are really great questions. First, I would direct you to this article about the many known benefits of dietary fiber. http://www.ext.colostate.edu/pubs/foodnut/09333.html. Juicing (as opposed to blending or pureeing) removes dietary fiber which in turns reduces the overall nutritional value.

Second, cooking does change fruits and vegetables at a molecular level. Harold McGee dedicates about 7 pages to the topic in "On Food and Cooking" (p278-85). He closes the section by noting that some nutritional value is lost by cooking (especially water-soluable nutrients such as minerals and B and C vitamins when "boiling" is the chosen vehicle for transferring heat). But there are also benefits to cooking such as the elimination of harmful microbes, and improving the availability of some nutrients (e.g., starches and fat-soluable beta-carotines).

He recommends including both raw and cooked fruits and vegetables in our daily diet. The reason that I called juicing a "gimmick" is because you don't have to juice Kale to make it healthy, but if juicing is the only way you will eat certain things then go for it. You just don't need a $$$ machine to reap the benefits.

Third, the issue of nutritional density (i.e., "consume more nutrients through juice than they could through cooking") is more complex. On the one hand, there is a potential benefit in that juicing allows you to blend together a bunch of fruits and vegetables that you wouldn't normally eat in a day. On the other hand, many nutrients (especially fat soluble nutrients) remain in the pulp. For this reason eating an apple or an orange is healthier than drinking an equivalent quantity of juice. What does get squeezed out of fruit especially is the simple carbohydrates (i.e., the sugar fructose) which is why many forms of vegetable juice are tastier than vegetables.

However, this is somewhat of a red herring because the body can only process a certain amount of nutrients in a given day. Exceeding this amount doesn't make you healthier. Water-soluable nutrients (like the red betains found in beets) are processed out through the kidneys and liver (which puts unneeded stress on those organs), and fat-soluable nutrients build up in the liver (which in high doses can become toxic).

It wasn't the juicing per say that caused the people in the documentary to lose weight, it was the net calorie deficit that was facilitated by juicing. If they would have eaten the same amount of calories instead of drinking it, they would have seen similar weight loss.

The question should always be whether or not the change is sustainable as a new habit. To MM's point above, Juicing is not a sustainable habit, but a juicer is a sustainable piece of single-purpose hardware that is now cluttering your kitchen.

MM: @NS - Let me address a couple of these concerns. While juicing isn't an ideal diet, I'd argue that it's a great improvement from SAD (the standard American diet).

Re: Insufficient calories to maintain metabolism. I added up the fruit and vegetable juice and soy milk that I'm consuming every day, and it totals approximately 1,450 calories, about a 1,000 calorie deficit from what I normally eat (and a 1,400 deficit from SAD), but not so low as to affect my metabolism. On the contrary, many of the vegetables I eat, as well as a healthy dose of ginger, horseradish, and chili peppers, have been shown to increase metabolic rate.

Re: Fiber. The juice yielded from raw fruits/vegetables is pretty fibrous/pulpy. It's a bit more fibrous than, say V8, which has 8% of the USRDA of fiber per 8 oz. I'm drinking about 88 oz. of juice per day, so I'm likely getting at least 88% of the USRDA of fiber, much much more than the typical 30ish% in SAD.

Re: Nutrient overload. This is unlikely if you get a good mix of fruits and vegetables. A few need to be watched - seriously overdoing beets can dump too many toxins in the liver, and lots of grapefruit juice can interfere with prescription drugs - but in moderation this isn't a concern.

Re: Juicing for weight loss long-term. I agree that juicing definitely isn't an ideal long-term solution for weight loss or maintenance. It's just so damn BORING. I also love masticating and would never give it up for a diet. :) I agree that a low calorie-dense, high fiber diet with moderate intake of meat and dairy and lots of fruit and veggies is the way to go, and that's normally what I strive for.

Nevertheless, compared to SAD, juice cleansing/fasting/detoxing/rebooting/whatever is much lower in fat and calories, and higher in nutrients, water, and fiber. Throw in a few scoops of soy protein and make sure to take a multivitamin, and it's not too far from what I'd call a good diet. Just really, really boring and unrealistic for the long term.

NS: @MM: Re: Fiber. Duly noted. I wasn't certain how much was being passed through or processed out. Likely depends on the juicer.

Re: Nutrient overload, agreed. The point I was trying to make was that most vegetables retain much nutrition than they lose during cooking.

Re: Calorie deficit. Going from one extreme (SAD) to another (excessive calorie restriction) is simply a different flavor of the American tendency toward excess that gets us to SAD in the first place. It places an additional and mostly unnecessary stress on one's body and mind. You can do it, but the question is why?

To quote one registered dietician and nutritionist I spoke to in the last week "It took X years to put the weight on, why would you expect to take it off in a month?"

"As a guide to minimum calorie intake, the American College of Sports Medicine (ACSM) recommends that calorie levels never drop below 1200 calories per day for women or 1800 calories per day for men. Even these calorie levels are quite low. If you want to lose fat, a useful guideline for lowering your calorie intake is to reduce your calories by at least 500, but not more than 1000 below your maintenance level. For people with only a small amount of weight to lose, 1000 calories will be too much of a deficit. "

One of the points I was trying to make by provocatively labeling juicing as a "gimmick" was the recognition that it is possible to skip the fast and jump straight to establishing healthier habits and better relationships with food.

Here are some articles that talk about the relationship between extreme calorie deficits and decreasing basal metabolic rate.

http://fampra.oxfordjournals.org/content/16/2/196.full

KH: @NS, while I've got your attention here... do you have an opinion on Paleo vs Vegan for a sustainable diet? The China Study suggests that vegan may have dramatic impacts on cancer and heart disease rates. I am also susceptible to the theoretical underpinnings of the paleo diet.

MM: @NS - Interesting article. I also hadn't heard the guideline about consuming at least 1,800 calories for males. Nevertheless, the studies found drops in metabolic rates on the order of 10% after 10+ weeks of 800-1200 calorie diets. This is a 10-day, 1,400+ calorie diet. It's unlikely that it will effect my BMR at all, and certainly won't long-term.

@KH - I just read an interesting rating by US News and World Report. They have a panel of experts review popular diets and rate them on several factors. In their study, vegan beats paleo for both general nutrition and weight loss, but both are beat by more balanced diets like Weight Watchers in both regards (no argument from me there). The paleo diet also made intuitive sense to me until I read a journal article by some anthropologists responding to the paleo craze who said that humans have, in fact, evolved in thousands of measurable ways since the advent of agriculture.

MM: Sorry - Here's the link to the diet ratings. Can't remember where I read the anthro article, though.

http://health.usnews.com/best-diet

NS: I think the paleo diet takes some sound basic principles and wraps them into an unnecessary and fallacious historical narrative to sell books.

The good.

1. Focus on Output > Input. Paleo diet notes that paleo man was not a desk jockey. He put on lots of miles solving the Omnivore's Dilemma.

2. Focus on Relatively low-energy density food. Many of the ways we process food in our industrialized system packs large amounts of calories in small packages. A half-cup of ice cream can have upwards of 200 calories. A half-cup of broccoli has 25 calories.

3. Focus on High nutritional density: Emphasizes foods that give you lots of micronutrients per calorie.

4. Encourages more sustainable farming (i.e., wild or grass fed proteins, farming whole foods (i.e., nuts, berries, fruits) instead of commodities (i.e., corn, soybeans, wheat).

But this is like the Barnum effect for dieting. These things are generally true for all healthy diets.

The less good.

One of the claims of the paleo diet evangelicals is that paleo man was much healthier than modern man, and did not suffer from diseases of excess such as cancer, obesity, diabetes, etc.

That is in part because paleolithic peoples had a life expectancy of about 33 years. It is a hard argument to swallow that modern man is doing so many things wrong relative to paleo man, but has double the life-expectancy. The paleo responds to this criticism with a bait-and-switch, talking about the lifestyles of modern hunter-gatherer societies. To which I say it's not the food, it's the exercise stupid.

The paleo diet commits the same sin that many diets commit by being prescriptive about the appropriate ratio of macro (protein, carbs, and fat) nutrients. The truth is that there is individual variability in the required portions, and a good nutritionist will talk about ways to find your optimal combination of protein, fat, and carbs.

So I wouldn't think about paleo as a lifestyle choice, but instead a meal choice. A few times a week, it would probably do all of us all some good to build a meal around lean protein, lightly cooked or raw vegetables, and fruits and nuts.

MM: Yesterday was day 10, and this morning I broke my fast (appropriately, at breakfast) with some steel-cut oatmeal with fruit, yogurt, and coffee. In the end I lost 10.5 lbs and felt like a million bucks. It got really boring days 7-10, so I think in the future I'll keep it to a week.

WM: Interesting thread MM. @NS- you clearly are very well informed. As a proponent and adopter of the Paleo lifestyle for about 6 months now, I agree with much of what you say about the Paleo Diet. My primary push back is that I haven't run into a prescription for macronutrients. That's more of what I see in the Zone Diet. It's about eating the right stuff more than in the right amounts Paleo is about eating natural, unprocessed foods, with an emphasis on lean, grass fed/wild caught meats, lots of nutrient rich foods to provide glucose (veggies) without spiking Insulin levels, nuts/seeds/oils to get good fats, and small amounts of fruits (mostly berries). The goal is to (a) manage insulin levels to ensure that the primary source of energy for the body is derived by metabolizing fat, instead of loading up on glucose, which, in excess, is stored as trigylcerides in fat cells and (b) reducing the inflammatory impacts of grains, wheat, sugar, flour, et al. Further, there is lots of anthropological evidence that the Paleolithic era people that didn't die of viruses/bacterias, injury, or other trauma, were much healthier than people today by many metrics (bone density, tooth enamel density, brain size, etc.) And lastly, I would challenge the conventional wisdom about losing weight being a "thermodynamics problem" (i.e., calories in have to be less than calories out). 2,000 of calories heavy in carbs has a much different impact on a body's metabolism than 2,000 calories of lean meats, good fats, low(ish) carbs, especially non-wheat, sugar, etc. All that aside, hard-core Paleo people can be really annoying and holier than thou, like anyone who is deeply committed to a lifestyle/point of view.

WM: One other thing. I'd strongly recommend a few books: (a) Why We Get Fat and What To Do About It by Gary Taubes; (b) Wheat Belly by William Davis (c) Primal Blueprint by Mark Sissson and for really scientifically inclined (d) Primal Body, Primal Mind by Nora G..

CD: I promise I'm not a holier than thou Paleoid!!! It's right for some, not all. Plus there's SO. MUCH. BACON.

‎NS: @WM: "Further, there is lots of anthropological evidence that the Paleolithic era people that didn't die of viruses/bacterias, injury, or other trauma, were much healthier than people today by many metrics (bone density, tooth enamel density, brain size, etc.)" --- I take issue with this statement (fyi: I was married to a biological anthropologist for a while) because simply put there isn't a lot of evidence about Paleolithic era people period. We have a few bones, some stone tools, and almost no soft tissue has survived. It makes sense, when you think about the environmental forces that work against things surviving for 10,000+ years that the fragments that did survive were the heaviest and densest. But what people ate in the Paleolithic era is greatly debated by anthropologists. It's interesting to note that the Paleo diet was not even created by an anthropologist, but a gastroenterologist based on his interaction with unhealthy people with unhealthy diets. From his perspective (seeing the worst of the worst) people who have a lot of gastrointestinal problems will benefit from eating healthier in general. But that in and of itself does not demonstrate the veracity of the many statements about paleo diets.

The diverse and distributed nature of hominids who lived during the "paleo" period means that we will probably never really know what they ate, how long they lived, and whether or not they were actually healthy. That's fine, because it will give anthropologists things to argue about long into the future.

You are right that not all calories are created equally. For example, the body has a very hard time storing protein and/or converting it into fat. Consuming more protein than they body needs generally results in expensive urine. But it is a hard sell to say that a person who takes in 2,000 calories of mixed macro-nutrients, but only burns 1,990 calories is going to lose weight. Even if they are eating "paleo" to improve metabolism, they will be gaining weight until their calorie burn exceeds their caloric intake. All the research I have read demonstrates the importance of a calorie deficit for weight loss. Recent research is adding two more important factors, hydration and sleep. People who drink adequate amounts of water and get enough rest do better at losing weight than those who don't. Who knew?

Lastly, amen to the last point and thanks for contributing to the discussion as an insider.

WM@NS- concur with everything you say about things we don't know and aren't ever going to likely know re: the Paleolithic hominids/era...and defer to anyone on this issue married to a biological anthropologist. :-) In regards to caloric deficit being essential, Gary Taubes' book has a good run down on some strong, though certainly not anywhere close to conclusive, evidence (both from a biochemistry and anthropological perspective) that the composition of the macronutrients is a driver of obesity. The basic thesis is that once a society radically increases their wheat/sugar based carb intake as the US has done since the 70s and 80s, you see a concomitant increase in obesity. Really encourage all that have interest in the topic to read it. WRT to sleep, totally consistent with what I have read as well, largely, from what I understand, as a means to reduce inflammation derived from stress of not sleeping. Most of the Paleo/Primal gurus (Wolf, Cordain, Sisson) are big proponents of getting more sleep because it's consistent with our evolutionary background. The other thing that is interesting is the extent to which the vast changes that wheat and other crops have undergone vast genetic modifications and whether or not that has impacted our ability to process them. The wheat we eat today is barely even recognizable when compared to the wheat of the early 20th century. Same with the corn. This could be contributing to all sorts of "civilized diseases" that have low levels of persistent systemic inflammation as their base potentially.

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And this is where the discussion sits.

And to all of those who think I have to have the last word?

I guess I just did.