Mike Eades on How To Start or Restart

The surest road to failure in the first few days of low-carb dieting is to listen to your body.  The whole notion of listening to your body is one of my major pet peeves.  In fact, just hearing those words makes me want to puke.  In my experience, they are usually uttered by females with moist, dreamy looks in their eyes, but not always.  I just read a ton of comments in recent Paleo blog post in which vastly more males than females actually wrote this drivel.

Listening to your body is giving the elephant free rein. If you’re three days into your stop-smoking program, and you listen to your body, you’re screwed.  If you’re in drug rehab, and you listen to your body, you’re screwed.  If you’re trying to give up booze, and you listen to your body, you’re screwed.  And if you’re a week into you’re low-carb diet, and you listen to your body, you’re screwed.  Actually, it’s okay to listen to it, I suppose, just don’t do what it’s telling you to do because if you do, you’re screwed.

http://www.proteinpower.com/drmike/ketones-and-ketosis/tips-tricks-for-starting-or-restarting-low-carb-pt-i/

The period of low-carb adaptation is that time between starting a low-carb diet and feeling great on a low-carb diet.  It can take anywhere from just a day or so to two or three weeks.  During this adaptation period people tend to fatigue easily, experience a slight lack of mental clarity and be tormented off and on by the unbidden lust for carbs that seems to rise up out of nowhere.  

So what does this 30 year veteran coach of low carb initiators advise?

Don’t be a wuss when you start your low-carb way of eating.  Keep the carbs cut to the minimum and load up on the fat. Eat fatty cuts of meat, cooked in butter or lard if you want, and force your body over to using the fats and ketones for energy as nature intended. I mean, don’t try to be noble by eating boneless, skinless chicken breasts – instead insert some pats of butter under the skin of a chicken leg and thigh before cooking, and wolf them with your fingers while the fat drips down your arms.  Do not trim the fat from your steaks – eat them from the fat side in.  If you leave anything on your plate, make sure it’s the meat and not the fat.  If you don’t already, learn to love bacon, and don’t cook it ‘til the fat is all gone: eat it wobbly.  And whatever you do, for God’s sake, don’t listen to your body during this adaptation period or you’ll never cross the chasm between fat and miserable on your high-carb diet and slim, happy, energetic and low-carb adapted on the other side.
NOTE:  Although the Eades are missing out on the Paleo boom because their book titles don't say "Paleo", their approach has been significantly paleo from the beginning, many years ago.  Robb Wolf has blessed their Protein Power Lifeplan as a favorite many times.  

Kresser: Perfect Health

Kresser - 9 Steps To Perfect Health

Imagine a world where:

• diabetes, heart diseases, autoimmunity and other modern diseases are rare or don’t exist at all
• we are naturally lean and fit
• we are fertile throughout our childbearing years
• we sleep peacefully and deeply
• we age gracefully without degenerative diseases like Alzheimer’s and osteoporosis

While this might sound like pure fantasy today, anthropological evidence suggests that this is exactly how human beings lived for the vast majority of our evolutionary history.

Today, most people accept diseases like obesity, diabetes, infertility and Alzheimer’s as “normal”. But while these diseases may now be common, they’re anything but normal. Humans evolved roughly 2.5 million years ago, and for roughly 84,000 generations we were naturally free of the modern diseases which kill millions of people each year and make countless others miserable. In fact, the world I asked you to imagine above – which may seem preposterous and unattainable today – was the natural human state for our entire history on this planet up until a couple hundred years ago.

What's Kresser's Rx for "perfect health?"

What was responsible for the change? What transformed us from naturally healthy and vital people free of degenerative disease into a world of sick, fat, infertile and unhappy people?

In a word? The modern lifestyle. And though there are several aspects of our current lifestyle that contribute to disease, the widespread consumption of food toxins is by far the greatest offender. Specifically, the following four dietary toxins are to blame:

• Cereal grains (especially refined flour)
• Omega-6 industrial seed oils (corn, cottonseed, safflower, soybean, etc.)
• Sugar (especially high-fructose corn syrup)
• Processed soy (soy milk, soy protein, soy flour, etc.)

Friday I discussed how difficult it is to know whether an intervention is working or not.  Tomorrow, I'll cover the one sure measure of improved health, with a bit of discussion about how we might have some confidence of being on the right track.

Magic Pills? Not Really

Niacin Doesn't Improve Mortality
This study examined the effect of taking a dose of niacin, to raise HDL, with a statin, which lowers LDL.  It proved to be more dangerous than not taking the niacin, even though the two drugs had the expected effects of raising/lowering HDL/LDL respectively.  The doctors and scientists reportedly said about this - "We don't know why." 

Consider this perspective.  If you have LDL levels outside of the so called norms, and take a statin to lower the LDL, you get largely a tradeoff between risk of cardiovascular death and other deaths - but mortality is about the same, unless you've already had a heart attack and you are under the age of 65.  In the later case, your all cause mortality is improved by taking the statin. 

If you take a statin with another compound that lowers LDL by an independent mechanism (the combined drug was called Vytorin), you get a massively reduced LDL number but no improvement in mortality.

If you reduce triglycerides by taking a spoonful of oil after each meal, you change the triglycerides but don't appear to get a better mortality rate.

If you eat a low fat diet, you can reduce your cholesterol numbers - but you can't improve your mortality.

In short, you can manipulate the biomarker, but doing so does not interrupt the disease process.

In other words, there does not seem to be a causal connection between the discrete levels of these markers in the blood and the damage that is recognized as heart disease, CVD, etc.  Having high triglycerides, low HDL and high LDL is recognizable as a pattern of markers that indicates a greater liklihood of future illness and reduced longevity.  However, ttreatments aimed at manipulating these easy and cheap to measure bio markers do not restore health, or interrupt disease processes.

So if you are thinking, "If high levels of these biomarkers do not cause disease, what does?!?"  you are onto the million dollar question.  The short answer is, if you eat the neolithic agents of disease - excessive carbohydrate/fructose intake and imbalanced intake of omega 3 and omega 6 fatty acids, resulting in metabolic derrangement (excess blood glucose) and imbalanced inflammatory response - you create the underlying disease states that result in all of the manifestations of the "Diseases of the West": cancer, heart disease, gout, diabetes (type II, and probably type I), hypertension, obesity, osteoporosis, tooth and gum disease, Parkinson's, Alzheimer's, ALS, etc (some of which are caused by others on the list).  The underlying disease processes are well understood in the case of gout, for example, but not as well for others.

If you are eating a paleo diet, most or all of your bio markers will improve.  It's a reasonable assumption that you are dodging the bullets we know as "Diseases of the West."  There's no doubt in my mind eating some version of the Paleo diet is your best bet on wellness.  But the frustrating truth is - it is still just a well informed risk/reward curve we're living on, we don't know for sure what the outcomes for longevity will be.  Therefore, seems like we should chase a version of the Paleo diet that makes our lives better here and now, that aligns with living a life of activity and enjoyment and accomplishment.  The OCD perfect Paleo diet with no joy and no fun and no love misses the point.

Cardiologist - It Is Not About Cholesterol

It's Not About Cholesterol

The idea that cholesterol causes disease comes from a set of closely related theories known as the Lipid Hypothesis, the Cholesterol Theory, and the Diet-Heart Theory. These theories claim that too much cholesterol in the blood is the major causative factor in atherosclerosis, also known as hardening of the arteries. The Diet-Heart Theory maintains that too much saturated fat and cholesterol in the diet raises the cholesterol level, causing atherosclerosis and leading to the two most dreaded complications of atherosclerosis--heart attack and stroke.


Actually, the process is initiated by a proliferation of smooth muscle cells from the middle layer of the wall of the artery. These sheets of cell form a firm plaque which rigidifies that portion of the arterial wall. Nothing is deposited upon or sticking to the inner lining of the artery. Some have hypothesized that the breakdown of cells within plaque gives rise to the cholesterol that is often found there, which is to say that cholesterol is a result of the plaque, and not the cause.

“If one takes the occurrence of heart attacks and strokes as an index of the severity of atherosclerosis then there are some statistics that argue strongly against a role for cholesterol. For example, men suffer heart attacks at a rate 3-5 times that for women. Yet women on average have higher cholesterol levels than men. If you examine the statistics closely you will see that the incidence of heart attacks is spread pretty evenly throughout the entire range of cholesterol levels.”

Dr. Curtis’ book, "The Cholesterol Delusion", traces the development of the Cholesterol Theory from its origins and shows how each step in its evolution used dubious data and statistics, unscientific reasoning, and statistical manipulation to promulgate a fallacious theory that supports cholesterol as a deleterious element in the body.  http://www.cholesteroldelusion.com/.

I've gotten to the point now that I'm a little stunned when I hear of a medical professional that still believes in the delusions of cholesterol.  Nonetheless, it is the dominant paradigm and it will be interesting to see how long until it is not news for a heart doctor to say otherwise.

It's A Different Kind of Fitness

One of the high points and low points of my trip to Iraq in 2006 was finding a group training in mixed martial arts.  I joined the class and promptly dislocated three fingers.  So, I didn't learn a lot about mixed martial arts except - don't spar with a huge 22 year old on your first class.

But while I was there, visiting with the instructor, we stumbled across the remarkably different experience of work one feels when fighting.  You can run, lift, hit a bag, but when you start rolling, with the kind of inexperienced exuberance most beginners have, the metabolic impact is severe and rapid.  In no time, one feels weak like a kitten.  As the instructor said, "It's a different kind of fitness."

It sure is.

Mostly, what's different about it is the glycolytic energy pathway.  Glycolysis allows your body to generate a large percentage of the maximal force it can generate - but for much, much longer than it can generate maximal force.  In most sport, glycolysis carries the day - with the exception of those sports dedicated to not working very hard for a long, long time, such as marathoning.

Of course after my experiment in MMA went south, I found CrossFit.  CF is about maximizing fitness via full court press of glycolytic workouts.  Most of you are doing CF or would be if you could by now.  So what do you do if you can't do CF just yet, but still want fitness?

The short answer is - work extremely hard, for extremely short durations.  Pull a sled, do pushups, repeat for 5 minutes.  When you can repeat with 50% more reps, increase the time limit until you can hold the pace for 10 minutes.  Do 20 air squats, pick up a rock or a sandbag and run across the lawn and back.  Repeat for 7 rounds, and note how long it took.  Try and do it faster the next time.  Deadlift the heavy sandbag 15 reps, run a half mile.  Repeat three times and note the total time.  Do faster next time.

There's no limit to the number of the simple, intense workouts that could be dreamed up.  Dream a few and see what you can do with glycolysis.

More On Why You Want To Be A Fat Burner

     A Metabolic Paradigm Shift, or Why Fat is the Preferred Fuel for Human Metabolism    
Mark goes on a bit in this post, but it's worth the read.  The highpoints:
-a great summary of just how goofy the "eat a bunch of small meals" concept is (but if it works for you, don't read this part)
-Why it will feel better to live as a fatburner vice a sugar burner

A bit from Mark's explanation of the "carb paradigm":
The basic underlying assumption is that glucose is the preferred fuel of most cells; BUT, because we can’t store very much glucose (as glycogen in liver and muscles), we need to provide a continuous source of glucose in the form of exogenous carbohydrate (high carb meals) to keep the brain, blood, and certain organs humming along and the muscles primed for activity. AND, if we don’t feed ourselves enough carbohydrate every few hours, our blood sugar will drop and we’ll go into “starvation mode” and cannibalize our precious muscle tissue. AND any lack of regular glucose refilling (i.e. skipping a meal or fasting) will causecortisol to rise, which will have additional deleterious effects. FURTHERMORE, an excess of glucose in the bloodstream is known to raise insulin and will predispose excess calories (from all sources) to be stored as fat. THEREFORE, we should also be doing a lot of moderate-to-heavy cardio or lifting activity most days to burn off this excess stored body fat. HOWEVER, if we want to be ready and able to exercise frequently and strenuously to burn off our stored fat, we need to eat lots of complex carbohydrates between workouts to refill our glycogen stores. And ULTIMATELY, the only way to lose weight is to restrict calories (calories in
He continues:
... unless you love to work out incessantly and have really lucky familial genes, the Carb Paradigm is an unsustainable and ridiculous literal and figurative treadmill, a self-fulfilling prophecy for most people who tend to gain weight steadily and insidiously over the years and wonder why.

High Fat Heart Benefit

It's only a rat study, but still ... high saturated fat levels help your heart work better when under duress?  Sure does sound like saturated fat is supposed to be part of your diet.  Interestingly, the heart reportedly runs very efficiently on ketones, also, which the body produces in abundance on ... a high fat diet.

Now take a look at this published summary - no mention of saturated fats at all, and instead they say the study: suggests that for a damaged heart, a balanced diet that includes mono- and polyunsaturated fats, and which replaces simple sugars (sucrose and fructose) with complex carbohydrates, may be beneficial.
How could this oversight be explained?  I think it is cognitive dissonance - when one has come to believe deeply that saturated fat is the enemy, one can not process the evidence that it is not.  In any event, polyunsaturated fats are not what I would take for health, nor would I bank on "complex" carbohydrates - and I would not trust anyone that even uses that term as many complex carbohydrates have the same powerful, negative metabolic impact as table sugar, if not worse. 

As Kurt Harris has said, saturated fat is like grade A diesel, it is a premium fuel for nearly all the body's cells.  It's what we were build to burn as the "normal" fuel.

Abstract

Impaired myocardial contractile function is a hallmark of heart failure (HF), which may present under resting conditions and/or during physiological stress. Previous studies have reported that high fat feeding in mild to moderate HF/left ventricular (LV) dysfunction is associated with improved contractile function at baseline. The goal of this study was to determine whether myocardial function is compromised in response to physiological stress and to evaluate the global gene expression profile of rats fed high dietary fat after infarction. Male Wistar rats underwent ligation or sham surgery and were fed normal chow (NC; 10% kcal fat; Sham + NC and HF + NC groups) or high-fat chow (SAT; 60% kcal saturated fat; Sham + SAT and HF + SAT groups) for 8 wk. Myocardial contractile function was assessed using a Millar pressure-volume conductance catheter at baseline and during inferior vena caval occlusions and dobutamine stress. Steady-state indexes of systolic function, LV +dP/dt_max, stroke work, and maximal power were increased in the HF + SAT group versus the HF + NC group and reduced in the HF + NC group versus the Sham + NC group. Preload recruitable measures of contractility were decreased in HF + NC group but not in the HF + SAT group. β-Adrenergic responsiveness [change in LV +dP/dt_max and change in cardiac output with dobutamine (0–10 μg·kg⁻¹·min⁻¹)] was reduced in HF, but high fat feeding did not further impact the contractile reserve in HF. The contractile reserve was reduced by the high-fat diet in the Sham + SAT group. Microarray gene expression analysis revealed that the majority of significantly altered pathways identified contained multiple gene targets correspond to cell signaling pathways and energy metabolism. These findings suggest that high saturated fat improves myocardial function at rest and during physiological stress in infarcted hearts but may negatively impact the contractile reserve under nonpathological conditions. Furthermore, high fat feeding-induced alterations in gene expression related to energy metabolism and specific signaling pathways revealed promising targets through which high saturated fat potentially mediates cardioprotection in mild to moderate HF/LV dysfunction.

http://ajpheart.physiology.org/content/299/2/H410.abstract

More Talking Mummies

Mummy Says Sat Fat OK
In “Mummy Says Princess Had Coronary Disease,” scientists who performed a CT scan on a 3,500-year-old Egyptian mummy express their puzzlement that this ancient princess had advanced atherosclerosis (hardened arteries) despite her civilization’s “healthy” diet that included wheat, barley, bread and beer—and only small amounts of meat.
Atherosclerosis is linked to high blood levels of triglycerides (a type of fat molecule) and low levels of HDL cholesterol, the “good” cholesterol. Eating a lot of carbohydrates (such as wheat, barley, bread and beer) is well known to raise triglycerides and lower HDL. Eating fat (such as found in meat) counteracts these effects, raising HDL and lowering triglyceride levels. The Egyptian princess’s diet, therefore, is the perfect recipe for high triglycerides and low HDL—and for atherosclerosis.

These facts about diet and blood lipid levels are not controversial—they have been known for decades and verified repeatedly by scores of studies. So why were the anthropologists surprised by the mummy’s atherosclerosis? And why is Horgan resistant to the idea that carbohydrates cause obesity and desease?

The "mummy as proof of causality" narrative isn't convincing to me, because it isn't provable what amount of meat, fat, or sugar these folks ate.  It's entirely possible that some degree or even a lot of atherosclerosis is normal, but it's the combination of athersclerosis plus a highly inflammatory diet that is the cause of accelerated rates of death/CVD/stroke/cancern in western cultures.  On the other hand, if mummies from Egypt had great ooking arteries, when it is well known that the Egyptians ate large quantities of wheat, THAT would be significant but not a stake in the heart of the carbohydrate hypothesis.

I agree with the author on one point - there's just no doubt that high triglycerides in combination with low HDL provides the means to predict greater liklihood of disease, and carbohydrate consumption does in fact elevate triglycerides, while low saturated fat consumption lowers HDL levels.  It is also a fact that high carbohydrate consumption, and in particular high fructose consumption via sugar/HFCS, drives non-alcoholic fatty liver disease (among other potential causes).  It is also easy to correct metabolic syndrome through carb restriction.  In short, we don't need mummies to know that excessive carb consumption has a negative effect on your health.

What's Going to Happen?

What's going to happen if you follow this prescription to the "T"?  You will lose a lot of weight, quickly, without hunger or a sense of deprivation - because you will be eating a lot of food.  Your health will benefit within weeks - the damage your high carb life has been causing will be measurably reversed.  Your belly will get smaller, quickly.  Muscle loss will be minimal.  Long bouts of cardio won't be easy in the beginning, but they are not necessary either (lift weights, and if you like cardio, stick to short sessions of the most intense ten minutes worth of work you can stand - or try 30s sprint, 30s recover, for 5 minutes and build up to ten over a few days).

How do you know if it is going well?  All you have to know is that your belly's getting smaller and the scale starts to show progress.  You may lose a quick five pounds of water weight - which is great for both your health and the pressure against your belt.  Abdominal circumference is as good a measure of health risk as any blood test - your belly getting smaller while eating the rich diet I describe above is an unquestionable measure of improving health.  

In the next few days, we'll cover what lies ahead, including what to do to ease out of ketogenic metabolism when you approach your goal weight, and how to look at eating for the rest of your life.  

Many people feel nearly euphoric when they are over the 3 week transition, and their body starts shedding weight -  enjoy it, it doesn't last but it's great when it happens.  Celebrate your victories, and hopefully your family will too.  This is nothing less than a fight for your life.  3, 2, 1 go ...

From What To Eat, To Why

What's the point of all the directions from the previous post?  You are starting the process of developing the ability to run your body using stored fat.  To jump start that, you will use the process that made Dr. Atkins wealthy and famous - ketogenic metabolism.  When carbohydrate intake is restricted to below 25g/day for a few days, the body becomes adept at processing stored body fat in such a way that a by product of the fat metabolism is a ketone body.  Ketones are part of the body's fasting response system - in other words, a normal metabolic process that 'normal' people would use over night.  In our high quantity high carb food world, many of us never get ketogenic, but that seems to be to our detriment.   Continuous feeding to support glucose metabolism is not the way we were designed to run. 

While many have wailed about the dangers of ketogenic metabolism over the years, the sensible folks finally did the necessary experiments and have proved that there's no risk associated with ketogenic metabolism - and what's more, there are recent studies showing positive results for diabetics and even folks with kidney disease.  In short, ketogenic metabolism is a miracle for those who are chronically over-carbed, which is virtually every American.

There's only one long term problem with ketogenic metabolism - it's hard to sustain it in a normal life (there's also the bad breath).   In the short term, be warned - it can be a tough few weeks to essentially detox from carbohydrates.  Until your body regenerates enough fat burning enzymes, your cells cannot run well on fat, and you won't have enough glucose to support anything but your brain.  The glutamine powder will help, as will drinking water consistently through the day.  If you find constipation is a problem, increase the intake of water, magnesium and 5% vegetables.

Next - what's going to happen to me?

Getting Started

So, you know you need to lose weight.  Your health may be at stake, your career might be at stake in some cases, and certainly your enjoyment of life is at stake.  It's decision time - you are ready to commit - what to do?

1.  First, eliminate high density carbohydrates - bread, pasta, any liquid calories (milk, gatorade, cola/dr. pepper/mt. dew), and most non-whole foods (potato chips, fries, food bars, and most anything in a wrapper, especially if the product boasts a "healthy" label).  Quinoa, rice, potatoes - for now, these too are out.  If I didn't mention cake and ice cream and such, I hope you would still realize those are not on the menu for now.  For now, fruit is also a 'no go'.  Beer?  Not if you want to get over your health/body fat/living well hurdle.  If proceeding without some form of booze for a month is not appealing, try Robb Wolf's NORCAL Margarita:  shot of tequila or gin, with a whole lemon or lime's worth of juice, over ice with a bit of carbonated water.

Bread is the enemy - if you are already overweight and starting to show the signs of metabolic syndrome, and can't get used to the idea that the industrial food product known as "bread" is not really suitable for human consumption, you will die fat and sick.  Sugar - same thing.

2.  Get some fish oil, and get a gram of DHA/EPA down the hatch daily.

3.  Supplement with 2-6000iu of vitamin d gel caps.  If you are in the sun routinely and have been for most of your life, you may still make vitamin d; 90% of us reportedly do not.  Make a guess where you fall on the "always sunbathing" to "never see the light of day scale" and supplement vitamin d accordingly.  There are few things that will make a more palpable impact on your health or how you feel than restoring normal vitamin d levels.

4.  Eat good veggies if you like them.  Broccoli, cauliflower, lettuce, mushrooms, radish, peppers, spinach - what they used to call the "5% vegetables" for their low percentage of carbohydrate content.  Dress these veggies with butter, olive oil, vinegar, and/or real blue cheese dressing.  You don't need to be concerned with calories per se during this period.

5.  Make a plan to get 100g of protein (that's about 15 ounces of meat, but you can also use hard cheese) down the hatch per day.

6.  When you get hungry, you may add coconut oil, coconut cream, or coconut pieces to satiety.  You can also eat nuts, but don't get crazy with nuts - munch on two or three at a time, not handfuls.  Don't count the protein in the nuts as part of your 100g.  Macadamia nuts are primo - walnuts, pecans and almonds are ok.  Stay away from the cashews for now; they are high in starch.  Some folks also really enjoy pork rinds - just keep the water handy!  If you put stuff in your coffee - stop, and start using only heavy whipping cream.  Trust me, you'll thank me for this later.

7.  Additional supplementation to work into your program over the next week or two:
-Magnesium - not much.  You know you've had too much when you get the trots.  Start out with a tablet or a half spoonful of a powder like Natural Calm, and work your way up from there.
-Glutamine powder - available as a recovery powder at Wal Mart.  Helps in the 1-3 week adaptation period.
-ALA - alpha lipoic acid is a potent anti oxidant and worth experimenting with when you are putting yourself through the relative metabolic stress of shifting from being a sugar burner to being a fat burner.

In part 2, we'll switch from the what to the why.

Eades On Taubes

Eades About Taubes' Why We Get Fat

This post by Mike Eades is long and is a good example of Dr. Eades at his best.  I recommend that you read it in full if you groove on understanding how human metabolism works, and why we get fat. 

Here's what he covers:
1.  We get fat from eating more calories in food than we dispose of as calories and waste, but that doesn't tell us anymore than it does to know that a restaurant if full sometimes, and not others, because people come in faster than they can be served, eat, and leave.  IOW - if you want to adequately staff a restaurant, you need to know more than "we have more people we can serve right now."  You need to know why a bunch of people decided to walk in so that you can better plan for the next time.  If you want to eat less than you need to know why you get hungry in order to eat for reduced hunger and therefore less caloric intake and greater energy expended.  In other words, you need to know what foods cause energy imbalance and why.
2.  For many people, the unproved but oft repeated assumption that we just 'eat less and exercise more' becomes worse than not true, because it reinforces choices that will doom almost all the overweight to future failure in weight loss.  A life of trying to restrict ourselves from hunger satisfaction, whilst burning up prodigeous amounts of time working at minimally effective fitness regimes, is at LEAST not optimal.  At worst is a farce, and a special kind of torture for the obese, leaving them feeling as though they are morally inferior and the cause of their own suffering.  Mike Eades reminds us of the old saw "it's what we know that just ain't so" that hurts us the most.  The "calories in calories out" model is a perfect example of that instance.
3.  "Science must be a simple as possible, but no simpler" is a rough quote of a noted philosopher of science which Taubes notes in his incredible survey of the science of diet, "Good Calories Bad Calories."  The calories in calories out model is an example of simplicity gone too far.

An excerpt from Eades' post:
Why can some people eat like crazy and not get fat?  Perhaps because they develop insulin resistance in their fat cells just as they do in their liver cells.  They don’t get fat, but they typically have all the other insulin-driven problems of the obese: high blood pressure, elevated triglycerides, increased risk for heart disease, etc.  And all while staying skinny.
How about morbid obesity?  Easy.  Those people don’t develop insulin resistance in their fat cells until late in the game, if ever.  They continue to push fat into the fat cells and become more and more obese until they weight 400-500 pounds or even more.  The average person will finally develop fat cell insulin resistance before the morbid obesity stage.  When this happens, weight and level of obesity stabilize and stay the same, almost irrespective of how much is eaten.
We now know why we get fat.  Excess insulin drives fat into the fat cells increasing the fat cell mass, ultimately leading to the state we call obesity. If we keep walking this progression back, the next question has to be, Why do we make too much insulin?
We make too much insulin because we eat too many carbohydrates, especially sugar and other refined carbohydrates.  With that statement, we’re starting to edge into controversial territory, but it’s only territory populated by the ignorant.  The hard science is emphatic that carbs are a pure insulin play.  Eat them and your insulin goes up.
Some people with a little learning may be quick to point out that protein drives insulin up as well.  This is true, but with a catch.  Protein drives both insulin and glucagon up, so you don’t have the pure insulin effect.  Only carbs will give you that.  With carbs, insulin goes up while glucagon goes down.  With meat and other proteins, the effects of the elevated insulin are muted by the concomitant rise in glucagon. (Glucagon isn’t called insulin’s counter-regulatory hormone for nothing.)

Boiling this down:  You can't eat enough fat and protein to get morbidly obese, but you can easily eat enough carbohydrate, especially carbohydrate and fat, and triple especially carbohydrate and polyunsaturated (aka man-made vegetable fat) oils to get as fat as you want to.  That is, by the way, how they do things in the world of sumo wrestling, in which they average 4000 to 5000 calories per day on a low fat diet (~16% fat). 

As I've heard and blogged many a time, you cannot out train a bad diet. 

If you don't want to be obese and sick (or lean and sick for that matter), eat meat, vegetables, some nuts and seeds, little fruit and starch, and no wheat or sugar.  Work out to cultivate desirable physical capacities like strength, speed, power, coordination, balance, accuracy, agility, flexibility, endurance and stamina.  Keep your workouts short and intense.  Walk for pleasure and relaxation and the inordinate wellness walking seems to deliver.  Learn and play sports.  Don't let your pursuit of the above prevent your full embrace of the zest of life, whatever that may be for you.

Worms For Health?

Human trials (of intestinal parasite infestation) have been much more limited. Two small groups of adults — one whose members had colitis, and the other made up of those with Crohn’s disease — experienced reduced symptoms after being treated with whipworm for multiple weeks by University of Iowa researchers. But human research has stalled in the United States since the Food and Drug Administration classified parasitic worms as a drug in November 2009. Today, drug companies are working to create parasites that the FDA would approve for inflammatory bowel disease, according to Joel Weinstock, the Tufts University gastroenterologist who is a leading researcher in the field.

http://www.thesmartset.com/article/article05061101.aspx

Our guts of course are loaded with and depend upon many bugs of various sorts to work right.  I don't think many folks thought, however, that worm infestation might at some dosage or level be good for us.  I'm not going to volunteer as  test subject, but I am interested to see what they think they can learn with further FDA approved worm tests!

Say What?

Last week, discussing the Federal Trade Commission's call for slashing the sodium content of food marketed to children, I noted that the scientific case for population-wide reductions in salt consumption is pretty shaky. A new study in The Journal of the American Medical Association reinforces that point. The researchers, led by Jan Staessen, a professor of medicine at the University of Leuven in Belgium, tracked 3,681 middle-aged Europeans for an average of eight years, measuring their daily sodium intake through urine collected at the beginning and the end of the study. None of the subjects had high blood pressure or cardiovascular disease at the outset. But over the course of the study, those who consumed less salt were more likely to die of heart disease: There were 50 such deaths in the lowest third, compared to 24 in the middle third and 10 in the highest third. The subjects who consumed more salt did have slightly higher blood pressure, but they were no more likely to develop hypertension. "If the goal is to prevent hypertension" by reducing sodium consumption, Staessen told The New York Times, "this study shows it does not work."
http://reason.com/blog/2011/05/05/could-eating-less-salt-be-dead

This is the next boondoggle from "public health authorities."  What are public health authorities?  Folks who's job it is to think of ways that they can use the coercive power of the government to enforce their will upon you for your own good.  These people need pets and children, vice jobs in the government. 

As regards salt, there's little doubt that coercive government interference in salt intakes will not help most of us live longer or better; the science on the topic is at best unclear, and if anything, the science shows that salt does not cause disease, though it can exacerbate disease in those that already have given themselves high blood pressure.  Shaky science didn't stop the saturated fat fiasco, so I don't expect that it will stop the salt nazis either.

Michael Alderman, who edits the American Journal of Hypertension, also worries that sharply reducing sodium intake, while good advice for people with high blood pressure, could raise the risk of cardiovascular disease in the rest of the population, perhaps by increasing insulin resistance. His own research has generated  results similar to Staessen's. "Diet is a complicated business," he told the Times. "There are going to be unintended consequences."

This is why the standards for government intervention as regards diet should be very, very high.  A government bureaucrat with good intentions and half baked science should not have the power to dictate anything to anyone, nor to issue dietary guidelines that government agencies are bound by.

Original Equipment or Rebuild?

http://online.wsj.com/article/SB10001424052748704004004576270844211718806.html?mod=WSJ_article_RecentColumns_HealthJournal
I get excited reading these kinds of articles.  I hope it'll be another 15 years until I "have" to get something done for my knee, but fortunately for me, there are enough folks out there with wrecked knees and insurance (or cash) that the market for rebuilding joints is driving innovation and better solutions seemingly by the year.

One thing all these folks would benefit from both before and after surgery is to work on functional movements, learning and re-learning how to feel and utilize their musculature in ways they may not have since their injury.  Runners in particular are notoriously deficient in range of motion and hip/hamstring/glute development - this is not a good thing.  One friend I know who trains in a unique but intense and functional ways commented on finding his hamstrings after years of atrophe.  After a knee replacement surgery, this former D1 football player said "I felt my hamstrings firing for the first time in years!"  I think that bodes well for his future.


Joint-replacement patients these days are younger and more active than ever before. More than half of all hip-replacement surgeries performed this year are expected to be on people under 65, with the same percentage projected for knee replacements by 2016. The fastest-growing group is patients 46 to 64, according to the American Academy of Orthopaedic Surgery.
Many active middle-agers are wearing out their joints with marathons, triathlons, basketball and tennis and suffering osteoarthritis years earlier than previous generations. They're also determined to stay active for many more years and not let pain or disability make them sedentary.
To accommodate them, implant makers are working to build joints with longer-wearing materials, and surgeons are offering more options like partial knee replacements, hip resurfacing and minimally invasive procedures.
More younger people also need joint-replacement surgery due to obesity, and some orthopedists refer them for weight-loss surgery first to reduce complications later.
Even the most fit patients face a long period of rehabilitation after surgery and may not be able to resume high-impact activities.
"There is, to be honest, some irrational exuberance out there," says Daniel Berry, chief of orthopedic surgery at the Mayo Clinic in Rochester, Minn., and president of the American Academy of Orthopedic Surgeons. "People may be overly optimistic about what joint replacement can do for them."

Athletes and Statins, Problems

http://healthydietsandscience.blogspot.com/2010/04/statins-and-muscle-problems-in-athletes.html?spref=tw
Bottom line for me is I wouldn't consider doing statins unless I have a heart issue.  There's good reason to believe almost anyone can avoid having to use these things if they don't eat like a USDA food-pyramid-moron.  This study shows what one would think it would show - if you take a powerful medicine that affects cellular energy production and short circuits your body's ability to operate normally, it's no free lunch.  The embedded video is also worth looking at.

I see Lipitor commercials frequently as we track the Grizzly's through the NBA tournament - this is a novel experience for me, by the way, as I've never watched an NBA game before - and the language is remarkably and deliberately vague.  They go way out of their way to avoid making detailed claims, and rely heavily on innuendo like "80% of people who die from heart disease have high cholesterol."  That makes me go "hmmmm."  Why not say "people who take our medicine get well" or "people who use statins, even young, lean and fit people without currently diagnosed heart disease (like the model on this commercial), show a reduction in all cause mortality"?  There's a reason they don't say things like that, and I'm sure you can figure it out.

I also have to let out a moan when the commercial protagonist complains that "diet and exercise didn't do it for me."  Well, if you eat the moron low fat USDA food pyramid junk with 11 servings of whole grains daily, that's not going to help you, your family or me stay off of statins either.  If that's your plan, skip all the agony of eating that nonsense and just get the statin Rx filled.  Better yet - eat meat, vegetables, some nuts and seeds, little fruit or starch, and no sugar/wheat and be healthy.

Beans for Health?

Eat Poison To Lower Cholesterol
If it is a stretch to say that eating beans is "eating poison to lower cholesterol", still it's only a little bit of a stretch (HT: @dreades).  Humankind's love affair with beans is mostly based on humankind's commonly experienced poverty and hunger since subjecting itself to the vagaries of agriculture.  Not to over-romanticize the hunter-gatherer lifestyle, as I'm sure there were issues, but with floods, storms, and other variants of pestilence, the adaptation of the agrarian life brought a new meaning to the word feast or famine.  For one, there was the sheer dependence of one group of humans - city dwellers - on those actually growing the food.  Two, there was the fact that if in any year the crops went bad, the recourses were few for that year.  All of a sudden, what affected one group of humans affected many, many more.  Three, agriculture brought a significantly increased birth rate, thus, more people to be affected by whatever went wrong.

From the article:
Red kidney beans has the highest concentration of the toxic agent Phytohaemagglutinin (PHA). It is a lectin (sugar binding protein in beans) which causes food poisoning when red beans are consumed in it's raw, soaked or under cooked form. The FDA measures the unit of toxin, hemagglutinating unit (hau) to be from 20,000 to 70,000 hau in raw kidney beans while the fully cooked beans contain from 200 to 400 hau.
Continue reading on Examiner.com: The truth about red kidney beans - Toronto Fresh Foods | Examiner.com http://www.examiner.com/fresh-foods-in-toronto/how-to-cook-with-kidney-beans#ixzz1LrdutRZn
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"If you eat like crap, beans might be an upgrade."
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So, soak 'em well and cook them thoroughly or enjoy that food poisoning, which is apparently not unheard of but is difficult to diagnose and therefore not widely known, per the article.

Outbreaks were reported in the UK in the 1970s and 80s, with clusters in US and Canada. This does not mean that people do not fall ill after consuming raw or undercooked beans, but it just indicates that identification or isolation of the source of the food poisoning can be cumbersome due to their generic symptoms.

Nutritionally, red kidney beans or red beans or rather Phaseolus vulgaris is a high fiber legume with many beneficial properties. Red kidney beans offers 333 calories, 23.58g of protein, and 24.9g of fiber per 100g or approximately ½ cup of dry beans. For detailed nutritional analysis, click here. It's high fiber content makes it an excellent candidate in aiding in cholesterol reduction, and glucose management in diabetics. Red kidney beans is also high in iron and folate, both equally important for pregnant women.  In short, enjoy their immense health benefits by cooking them right.

"Immense health benefits."  Ahem.  In other words, if you are eating a diet which is poor in iron and folate, you can avoid deficiencies by eating beans.  If you are eating an unnatural diet, with sugar and wheat, and need fiber to be "regular", eat beans.  If you vastly overconsume sugars and grains, and therefore have abnormal glycemic control reflecting your abnormal dietary intake of sugars and grains, eat beans so that you can get more carbohydrate, but slowly (just what you need, eh).  If you over-consume carbohydrate and believe the latest fads about low fat and low cholesterol leading to improved health, eat some beans.  Oh yes, if you are unable to get real protein from animals, beans do have a jolt of low quality protein, which you can mix with rice or meat to make a complete protein (so hopefully you have rice or meat to go with your "high in protein" beans). 

In other words, the case for the 'immense' benefits of bean consumption boils down to "if you eat like crap, beans might be an upgrade."  I freely admit that beans are better than starvation, and they won't kill you outright (assuming you prepare them correctly).

Or, you could just eat beans because you've learned to enjoy them and if so - bon appetite.  My comments are aimed at liberating you or your loved ones from any mis-impression that your health will be better served by consumption of beans, as there is virtually no case in which that will be true.  Health is the human birthright, not the result of any magical foods.  Lack of health is the evidence of a poor diet.  We cannot gain health by eating magical foods, but we can live with the health our genome was designed for if we eat the foods our genome was designed for - this is the essense of the paleolithic model of nutrition.
(edited for style 1248 CDT)

Wendler Wisdom

http://articles.elitefts.com/articles/training-articles/10-nuggets-of-wisdom/

Every time I get a wild hair up my ass to do some assistance work, I pluck it out. Best be wary of the dingleberry. Training templates are fine but they should always fluid. Make the big exercises matter. Jim Wendler


Wendler's interesting in the ways he differs from Westside, but perhaps because he's no longer lifting as a competitor, and is just lifting because he likes to be strong without spending all his days in the gym. Speculating - but I like these ideas!

Women Need Strength More Than Men

This lady has a way with words! I like her message and how she presents it.  A martial arts instructor that  I trained with in the 80s said "Too much work makes you sick, too little work makes you weak."  The commonest of common sense, but how many of us, or our friends, do anything to solve the obvious problems of physical frailty?  So something!  If you can't get yourself to CrossFit, lift weights at a real gym.  If that's not an option, work on body weight circuits.  Try P90X.  If all of that's out of the question, jog two days a week and run sprints two days a week (kids love to race!).  
More options: Get a sandbag and work with it.  Tie a rope to something heavy and drag it.  Set up a cheap pullup bar and do a pullup each time you walk under it; or buy a set of rings and hang them for pullups and dips.  Mix your sprints, sand bag drags/carrying and pullups with different reps and durations and time your workouts and you are doing CrossFit without knowing it.  The amount of progress you can make with 10 minutes of warm up and skill work and ten minutes of blood sweat and tears doing workouts like these will change your life.


OK, so the point of what follows is how essential strength training is for ladies, but it ain't going to do gents any less good.


Increased self-esteem and decreased depression - Studies show that women who engage in a regular resistance training program report feeling confident and capable as a result of their training. Additionally, a Harvard study found that 10 weeks of strength training reduced clinical depression symptoms more successfully than standard counseling.

Women have 10-30 times less of the hormones that affect muscle-building. If it were that easy to get huge every guy on the beach would have massive biceps. But you don't see that. You see skinny dudes, fat guys and the men that you can tell lift hard, eat well and put in the years of hard work that goes into getting and maintaining a built physique. Getting stronger will make your life easier; picking up your children, putting heavy boxes in the attic, carrying your luggage, and even lugging laundry baskets up and down stairs. Life just gets easier when you're stronger. Start opening pickle jars for him.

Improved performance - You can use your imagination here. You are more ready willing and able for everything when you are stronger and in better overall shape. Whether you love to run with your dog, ski, surf, hike, golf, swim or have rowdy sex, performance increases relative with your strength and fitness.

http://articles.elitefts.com/articles/training-articles/what-women-should-never-do-but-often-do-while-trying-to-get-in-shape-part-1-of-6/comment-page-1/#comment-44048

Decreased risk of injury and chronic muscle aches - The best treatment for injury is prevention. Strength training not only builds lean muscle but also develops stronger connective tissue and increased joint stability. Get stronger throughout your whole body and enjoy the energy, balance and coordination that come with it. I can't tell you how many times I've worked with women and men that described themselves as having bad backs, knees, shoulders etc.and chalked it up to old injuries, pregnancy, and new strains that just won't go away.  The differences were always dramatic and even life changing. Get mobile, get stronger and get back to me.

Classic Quotes, EFS

"I dubbed this one the Prowler Marathon because it’s simply a test of guts and stupidity – the two great values of a strong man." 
http://www.elitefts.com/documents/prowler_challenge.htm

It's arguable that you could get more useful physical capacity from all the games you could play with a Prowler than with any other single piece of fitness/strengh gear available.  Add some pullups, a couple unweighted sprints, and perhaps a cheap set of plates/bar for deadlifting and you could be ready for nearly anything.  The link above gives an idea of how you could begin your transformation.

Marathon for Health?

http://www.marksdailyapple.com/marathon-heart-damage/
This is just a good read to reinforce what you likely already know - marathoning is about preparation, devotion, and guts.  It's a test.  It's a chance to feel something you don't always feel.  Marathoning for health?  No.

Beginners should probably not be running marathons. Truth is, I don’t even think experienced endurance athletes should be running marathons as often as some do (I keep tabs on all my old elite runner/triathlete friends who have had serious heart problems – or died – and it’s at a significant number now). But good luck getting that across. They – we – can be a stubborn bunch. If you want to get fit and you’re starting from scratch, lifting heavy things, engaging in slow steady movement often, and getting your diet in order are the most reliable, safest steps toward that goal. Running a marathon sounds badass and impressive, but remember – the first marathoner dropped dead after completing it.

Fish For Omega 3

Fish for 3
Great article, key points are:
Sure, flax seed and walnuts and a few other sources have "omega 3 fatty acids", and these short chain omega 3s and ALA can be converted to long, branched chain omega 3 fatty acids (DHA and EPA), but the conversion rates are very low.  Rates are decreased if serum levels of zinc, iron and pyridoxine are low, which they often are in vegans.  Thus: 
Studies have shown that ALA supplements (like flax oil) are unable to raise plasma DHA levels in vegans, despite low DHA levels at baseline. So unless they are supplementing with an algae-derived source of DHA, it is likely that most vegetarians and vegans are deficient.
The bioavailability of iron in plant sources is poor compared to animal sources, so iron deficiency is common in vegans and vegetarians. This is another reason why they tend to be poor converters of ALA to DHA.
DHA status in newborns is much lower in those receiving formula with LA and ALA, than in those receiving milk or formula with pre-formed DHA
DHA, vice EPA, is the essential form of omega 3 fatty acids - EPA seems to interfere with the action of arachadonic acid, providing a healthy inflammatory response, but DHA is a higher impact player.  Bottom line:  health demands that you eat DHA AS DHA, vice as a plant and hoping for a conversion.  This wasn't a problem when virtually the entire population ate grass fed animals and commonly ate organ meats.

Countless studies show that this deficiency is at least in part to blame for the rising incidence of cardiovascular disease, inflammatory disease, mental and psychiatric disorders and suboptimal neurodevelopment.
I don't trust anyone who cites "countless studies", but in this case, there's no down side to DHA supplementation, and a very good reason to think there's a serious downside.

DHA is likely to be the primary reason why populations that eat fish on a regular basis have consistently been shown to healthier than those that don’t. 
Wild caught salmon if you can get it fresh, or perhaps sardines if you can't get the salmon, are probably the closest most of us can come to getting this "essential" nutrient as we were meant to get it - although I'm doing my best to think of ways that I can use the liver of any deer I kill from now on.  Short of that, I recommend Green Pastures products for fish oil.  The Eades (http://www.proteinpower.com/) have recommended krill oil, also.  At a minimum, get some fish oil, note the DHA content, and shoot for a gram or so per day.

Marathon Risk? Compared to What?

Marathon Risk Perspective
Dr. Redelmeier, who has run a marathon, said he began his study out of annoyance with the enormous attention given to each death in a marathon — often even greater, he added, than the attention paid to the winner. When someone died in the Toronto Marathon, he said, there were immediate calls to close it down.
“It has a chilling effect,” he said, “and becomes one more excuse not to exercise.”
So he and his colleagues decided to examine data from 26 American marathons over 30 years. They included results from 3,292,268 runners on 750 race days and 14 million hours of running. For comparison, they also examined national data on traffic fatalities, estimating how many would be expected to occur in the area on marathon day and comparing that with the number that did occur.
Fewer than 1 in 100,000 people died while running a marathon, Dr. Redelmeier and his colleagues reported. The chance that a middle-aged man — the typical marathon fatality — would die while running a marathon was about the same as the chance a middle-aged man would suddenly die anyway.
Dr. Thompson, the Hartford cardiologist, said there was another way of making the comparison. He noted that middle-aged men who run marathons are not typical of men their age. He said their risk of dying while running a marathon, while low, was nonetheless about seven times their risk of dying at other times.
Dr. Redelmeier also said his results did not depend on the marathon — some, like the one in Boston, have rigorous entry criteria for most runners and so tend to have a fitter group of athletes. Some are run in the heat, others in the cold. On some the course is flat, and on others it is hilly. The death rate, on average, was the same low number.
The study also found that half the people who died in a marathon did so while running the last mile and almost no deaths occurred in the first 13 miles.

I like this article for the way it contextualizes risk - is it sad when a person dies while marathoning?  Yes, but that doesn't mean that someone wouldn't have died from something else were the marathoning stopped.  IOW - virtually every risk is a trade off for other risks. 

I wish the article had covered cause of death - dehydration, hyponatremia, rhabdomyolosis, or over heating seem to be the most likely causes.

What they didn't answer but should have was whether the risk of a bunch of folks traveling to Boston, for example, is riskier than running the marathon - it might be!  Another example of the same concept - a small child or baby was killed in an aborted takeoff.  It was determined that the life may have been saved if the child were required to be in its own seat with a 'carseat' type restraint vice its mother's arms.  Would lives be saved if it was a requirement to have a paid airline seat for all children regardless of age?  Not necessarily - because some would not be able to afford the extra seat and might choose to travel by auto, which is statistically riskier.  IOW - the law to require all ages of children to travel in a paid for seat in a child restraint might result in MORE deaths, vice fewer.

In fitness generally, there is a lack of clarity in thinking as regards injury.  Sports of any kind are riskier than virtually any training in weights or 'cardio' - basketball, jogging, softball, or soccer, each is far more risky than virtually any weight training regimen.  But mainstream fitness has been 'dumbed down' so far that there's no risk and virtually no reward. 

More to follow on this topic, generally, but specifically, what risks would you be willing to face in order to gain your desired level of fitness? 

Low(er) Carb Beats High Fiber

Nutrition Journal Randomized Trial

It would be interesting to know if the participants were rated for appetite during the study.  Otherwise, results are as would be expected.  Interesting to note that carbs were not particularly low on this study - 40% of caloric intake, with 30% of intake as protein, in other words, Zone Diet proportions - nor was protein "high" except as relative to other diets. 

Dr. Robert Lustig, of "Sugar:  The Bitter Truth" YouTube fame (which is a long, but fascinating video), likes to say something along the lines of "it's either fat or fart."  It's a bit of an awkward attempt, but he's trying to articulate his deep conviction that eating high fiber foods is the be all end all for weight loss and health.  He's right - if you MUST eat carbs, eating high fiber carbs is better than otherwise.  If you eat enough insoluble fiber, some will survive the trip through the gut to the "back end" of the digestion process before being broken down, leading to some 'noxious emissions' (not yet controlled by the EPA, but perhaps that's in our zero emissions future).

I recommend just saying no to the current "the more the better" attitude towards fiber.  I've yet to see significant evidence that fiber does anything more than make you 'noxious.'  If you are eating meat, vegetables, nuts and seeds, some fruit, little starch and no sugar/wheat, you don't need "more fiber."  I'm pretty sure the human genome didn't evolve to make you dependent on copious fiber consumption day in a nd day out, and it's becoming more and more clear that the folks that fell in love with the idea of fiber will not be able to demonstrate that the object of their affection is actually beneficial. 

Background

Studies have suggested that moderately high protein diets may be more appropriate than conventional low-fat high carbohydrate diets for individuals at risk of developing the metabolic syndrome and type 2 diabetes. However in most such studies sources of dietary carbohydrate may not have been appropriate and protein intakes may have been excessively high. Thus, in a proof-of-concept study we compared two relatively low-fat weight loss diets - one high in protein and the other high in fiber-rich, minimally processed cereals and legumes - to determine whether a relatively high protein diet has the potential to confer greater benefits.

Methods

Eighty-three overweight or obese women, 18-65 years, were randomized to either a moderately high protein (30% protein, 40% carbohydrate) diet (HP) or to a high fiber, relatively high carbohydrate (50% carbohydrate, >35g total dietary fiber, 20% protein) diet (HFib) for 8 weeks. Energy intakes were reduced by 2000 - 4000 kJ per day in order to achieve weight loss of between 0.5 and 1 kg per week.

Results

Participants on both diets lost weight (HP: -4.5 kg [95% confidence interval (CI):-3.7, -5.4 kg] and HFib: -3.3 kg [95% CI: -4.2, -2.4 kg]), and reduced total body fat (HP: -4.0 kg [5% CI:-4.6, -3.4 kg] and HFib: -2.5 kg [95% CI: -3.5, -1.6 kg]), and waist circumference (HP: -5.4 cm [95% CI: -6.3, -4.5 cm] and HFib: -4.7 cm [95% CI: -5.8, -3.6 cm]), as well as total and LDL cholesterol, triglycerides, fasting plasma glucose and blood pressure. However participants on HP lost more body weight (-1.3 kg [95% CI: -2.5, -0.1 kg; p=0.039]) and total body fat (-1.3 kg [95% CI: -2.4, -0.1; p=0.029]). Diastolic blood pressure decreased more on HP (-3.7 mm Hg [95% CI: -6.2, -1.1; p=0.005]).

Conclusions

A realistic high protein weight-reducing diet was associated with greater fat loss and lower blood pressure when compared with a high carbohydrate, high fiber diet in high risk overweight and obese women.