Appropriate For Starting Off The New Year- “How Not To Diet”

I have mixed feelings about New Year’s resolutions. I think it’s a great idea to take stock and think about what’s working and what’s not, and what we could change to make our lives better. But the stereotypical approach is too drastic- start another diet, or restart the last one but “try harder” this time, and join a gym, or dust off our old membership, or take the pile of clothes off the exercise bike in the corner and resolve to “try harder” . Or better still buy a new one! Maybe an elliptical trainer will work better than the bike. And now there are lots of ways to get online classes so you can have someone shouting “you can do it!” at you in the comfort of your own home. As for diet, the drastic approach is to get lured into a fad diet that flies in the face of mainstream nutritional wisdom. Many people see short-term weight loss this way, but sustaining it is another matter.

Trying to eat better and get more physical activity are of course laudable goals. My birthday is January 12th, so usually by about the end of October I’m thinking of how I can get on a streak of doing better in time to give that to myself as a birthday present. It’s the drastic approach that’s wrong. Statistics show the vast majority of diets are going to flop within a few weeks, and as any regular gym goer can tell you, the gyms are going to be crowded in January but it’s all going to fizzle out in February. It brings to mind the saying “insanity is doing what you have always done and expecting a different result”. There’s a variation I learned from my brother that resonates with me: “whatever you’ve been doing up till now isn’t working”. He told me that once when I was going through a bad time in my life and it really helped.

Dr. Michael Greger’s book How Not To Diet is timely because it goes in detail into what the scientific evidence shows on the proper way to eat for health and sustainable weight loss.

Dr. Greger is one of my go-to sources for evidenced-based nutrition information. I’ve previously mentioned his site www.nutritionfacts.org. His first book, the New York Times bestseller How Not To Die, was full of information about the relation between nutrition and the top chronic diseases that plague modern society. Dr. Greger is an advocate of whole-food plant based eating because in his opinion the preponderance of scientific evidence support that.

Now in his new book he has tackled the subject of weight loss. His objective is to find the most effective method, based on the scientific evidence, for achieving long-term sustainable weight loss and maintenance for health reasons.

I was not surprised to find that the evidence shows whole-food plant based eating is the overall winner for weight loss as well as health. This is because, as Dr Greger and other author’s have pointed out, whole plant foods are nutritious but not calorically dense. It takes a lot of broccoli to match the calories in a slice of pizza. Whole plant foods fill you up with fewer calories. leading to weight loss without feeling hungry. As I’ve emphasized before, this does not necessarily mean becoming vegan, but cutting back on animal foods and replacing them with minimally-processed plant foods. Dr Greger also stresses throughout the book that it is not “all or nothing”. You don’t have to buy all your food at a farmer’s market. Less meat, more beans. More fruits and veggies. It doesn’t work, however if you replace meat or dairy with low-fat cookies.

I’ve discussed the Community Health Improvement Program developed by Dr. Hans Diehl previously. This is a highly effective program, based on the whole food plant-based diet, for improving heath and alleviating chronic disease. In Dr. Greger’s new book he points out that this program has proven highly effective for weight loss as well.

Other popular weight loss approaches like low-carb were covered in the book. The scientific evidence clearly shows that while this may lead to effective weight loss, it actually leads to slower fat loss, which means more loss of lean tissue, like muscle, which is precisely what we don’t want, especially while aging. This was a surprising result to me, especially for the ketogenic diet, because ketosis is supposed to prevent loss of muscle. I had covered this in a previous post, but there is additional information about it in the book. Low-carb approaches are popular because initial weight loss in often fast, and the authors promise to turn you into a “fat burning machine” or “fat burning beast”. Your body does indeed become adept at burning fat- but it’s mostly the fat you are eating that is burned. Unfortunately it actually burns the fat from your body, which is what you really want, about twice as slowly.

The other result I was unaware of is that low-carb high fat eating actually makes insulin resistance worse. Various authors have promoted it as a remedy for type II diabetes [1], because even though your body cannot handle carbs well, you are eating so few of them that your blood sugar remains under control. But if you ever go off low-carb, your symptoms will come roaring back because your insulin resistance is worse than it was before. There was a lot of information on insulin resistance and diet in Dr. Greger’s new book, since this is strongly related to both health and weight loss. I’ll cover this at greater length in my next post.

Fasting was another popular weight loss approach discussed in the book. Various versions of fasting and intermittent fasting were discussed. This may be a good short-term strategy for purposes like “plateau busting”, and intermittent fasting in particular has been claimed to have health benefits [2]. But fasting does not seem to show any advantages long term for weight loss. One exception is the “narrow eating window” technique which is often promoted as a type of intermittent fasting. For example, if you eat breakfast at 8 AM and finish dinner by 6 PM, and don’t have any evening snacks, your “eating window” is 10 hours and you fast in the evening and overnight for 14 hours. This is a sustainable approach to weight loss as an adjunct to a healthy diet . It is what I practice and I find I feel a lot better doing this. As I nice side effect, I used to have problems with acid reflux at night which are now completely gone.

After covering the main issues of nutrition and its effect on weight loss, Dr Greger discusses a lot of dietary “tweaks” that help with weight loss. These are similar to the “hacks” you’ll often see on the internet (“use this one weird tip to lose 10 pounds”), but there is scientific evidence to back them up. I would emphasize, as does Dr. Greger, that far and away the most important thing is a healthy way of eating. I think many people want a quick fix and try and jump to straight to the “hacks”. But the tweaks presented in the book appear useful as a supplement. An example is “front-loading” your eating. I remember a Seventh-day Adventist Cookbook I read years ago promoting “breakfast is golden, lunch is silver, supper is lead” [3]. Dr Greger discusses a similar maxim “eat breakfast like a king, lunch like a prince, supper like a pauper”. It turns out there is evidence to support this. There are a lot of other tips such as spices that boost metabolism. You can read about them in the book and they are also included in “Dr Greger’s daily dozen” app from www.nutritionfacts.org.

I’m not in agreement with everything in the book. For example, he recommends weighing yourself twice a day because there is some evidence from the national weight control registry that people who do that manage their weight better. This is potentially problematic. Your body can easily exhibit daily fluctuations of a couple of pounds just due to water loss or water retention. For many it can be discouraging to see your weight bounce up and down like the stock market. But if you can gut that out, and graph your weight loss over time, it can work. I once weighed myself daily for 16 weeks. That’s 112 weigh-ins. I gritted my teeth when it went up and resolved to just look at the graph at the end of each week. It worked, I gradually lost 16 pounds, But the graph was, to put it mildly, not smooth. I now weigh myself at most once a week. I try to make conditions “reproducible”, as us techies say, by eating a similar meal the night before and doing the exact same workout on “weigh day”. That works out better for me. The danger in weighing too seldom is you can start to drift up without noticing it, so I think once a week is a good compromise. It also prevents you from focussing on weight too much when health is the top priority.

You can also drive yourself crazy trying to follow all 21 tweaks. But you don’t have to- Dr Greger emphasizes that. Just pick the ones that make the most sense to you for starters. Drinking enough water is an easy and obvious one on the list.

So I wish everyone the best starting off the New Year. Here’s to sustainable changes in healthy eating, and finding fun physical activities.

References

1. Pinney, S, and Volek, J, The Art and Science of Low Carbohydrate Living, Beyond Obesity LLC , 2011.
2. Schofield, G, Zinn, C, Rodger, C, What The Fast?, Blackwell and Ruth, 2018.
3. Hurd, R, Ten Talents Cookbook, Brigham Distributing , 2012.