LiveLongAgeWell

This article is dedicated to the many people who seem to get enough aerobic exercise, and eat a reasonable diet, but still have problems with excess fat. It will give you something else that might help your situation; something basic and super simple…

Have you observed that as far as general activity level is concerned, people tend to fall into one of two big categories: the people who tend to be “couch potatoes”, and those who are constantly moving? The first group just doesn’t seem to want to move much. They would rather wait for the elevator than take the stairs, even for one floor, and if they are sitting watching TV or at the computer, rather than jumping up and getting something they need from another room, they will call for help or at least just sit and wait until they have more motivation to actually get up and move.

Now the other group, we might call the “movers” or maybe “people who putter”, seem to be constantly moving, almost in a nervous way. But take a look at the body shapes of these two groups, and you might notice a pattern—the movers tend to be a lot trimmer than the people who don’t like to move. It makes a lot of sense, and now we have good scientific evidence that the movers are both thinner and healthier than the sedate group, but the reasons for this are a lot more complex than what you might think.

Studies comparing people in occupations requiring lots of sitting (such as bus drivers) with those who stand much of the day (for example train conductors), have shown a much higher rate of cardiovascular disease and fatal heart attack in those who sit most of the day.  Experimental studies have recently demonstrated that sitting a lot, even a few hours straight, lowers the activity of the enzyme lipoprotein lipase, which normally works to decrease the fat content in your blood. So even a few hours of sitting seems to alter your very fat metabolism.

A study of otherwise healthy men who became incapacitated and confined to bed rest showed that three weeks of bed rest had a bigger negative impact on their physical work capacity than 30 years of aging. Scientists (“inactivity physiologists”) are now more closely studying the physical changes during our “inactive” periods, but while we await more research, it seems clear that people who sit too much during the day face a host of problems, and to cut your risk of obesity, diabetes, and of heart attack, you need to, basically, “get off your butt” and move around more. For some people, even a good program of  regular aerobic exercise, combined with a reasonable diet, may not be enough to keep your weight under control if you sit much of the day.

•    Avoid sitting too long. You are at higher risk of serious metabolic problems if you spend hours watching TV or sitting in front of the computer at work or during your free time. As much as you can, just get up and walk or move around, if only for a minute or two at a time, that’s fine. If you can’t get up, at least shift in your chair regularly, and maybe shake/stretch your arms and legs occasionally. Try to change your mindset so that when you need something from another room, you see that as a good thing, not an irritation.

•    If you like video games, consider as an alternative to the standard (sitting) game something more active like the Nintendo Wii, which will get you up and moving, and allows you to play too. It’s great for both your body and your mind.

•    People who sit for long periods, for example on an airplane, suffer a higher risk of DVT or “deep vein thrombosis” a potentially life-threatening condition in which the blood stagnates in the deep veins in your legs to the point that a clot forms which breaks off and travels through to your lungs. Basic prevention involves getting up and moving around the plane occasionally, and flexing your calf muscles while seated to get the blood moving in your legs. Drinking water also helps to keep your blood from getting too thick and prone to clotting.

For those of you with dreams of life extension, there was good news last week. It has been known for many years (since the 1930s), from fruit fly, worm, and mice studies, that long-term calorie restriction extends  life spans in many of these animals. Some mice, who from birth have been fed 30% fewer calories than normal mice, have had their life spans increased by up to 30- or 40%. But before you go on a radical diet (or worse, put your kids on such a diet), be aware that many strains of mice and rats do WORSE on such a diet. Still, the fact that many animals aged so much better has tickled the fancy of anti-aging researchers.

A big step up from rodent studies, and before human trials, is primate research. Monkey studies are very expensive to carry out, and life span research, as you might imagine, take many years to complete. Still, twenty years ago, a long-term rhesus study was started at the University of Wisconsin, and now there are preliminary results supporting the value of calorie restriction in suppressing diseases. The rate of tumors and cardiovascular disease was cut by half for the calorie-restricted monkeys, and none of the these monkeys developed any signs of diabetes (which affected about 40% of the normally-fed monkeys). Further, the calorie-restricted monkeys had less muscle and brain shrinkage, and also looked younger than the normally-fed group.

Identical ages; one on right fed long-term low calorie diet.

Since these monkeys normally live about 27 years (and up to 40 in some cases), this 20-year-old study is only about half-way completed, and life span comparisons will take some time yet. But (and here’s your chance again to be part of a research study if you live in the Eastern United States), the so-called CALERIE study is beginning in several U.S. medical centers, which attempts to see if a 25% reduced calorie diet (of course nutritionally balanced) will show positive changes in humans.

Scientists don’t know why calorie-restriction diets might work. Of course if we have lower cholesterol levels, lower blood pressure, fewer cancers, less diabetes and so forth, it’s not so hard to imagine a longer life span, but other factors are also suspected. It is thought that semi-starvation shuts off some of our genes that are directed towards reproduction, and turns on genes that promote better maintenance of our current bodies (our organism senses there is not enough food to share with other, new people, so to best preserve the species, our bodies work harder to preserve our own bodies).

Realistically, a calorie-restricted diet on a long-term basis is not easy to maintain, so many biotech researchers are trying to mimic this semi-starvation effect through medication. Many of the efforts involve resveratrol, an “anti-aging” component found in red wine. This sort of medication would have an incredible market potential as you can imagine, and I believe that within ten years we will a FDA-approved pill we can take that will replicate this semi-starved state.

But for now, I think anyone interested in trying a severely calorie-restricted diet should talk to their regular physician, as well as to an endocrinologist and a nutritionist to see if it’s a good idea, as there are risks. These potential, yet unknown risks and a constant feeling of deprivation might not be worth it, and you might well wait for more human trial results or some proven pill to be released. Failing that, there are studies showing that periodic short fasts—by stressing your body much as exercise stresses your muscles, yet makes you stronger—might offer some of the same benefits. It may be that some form of alternate-day fasting may be as good as full-time calorie restriction. Again, talk it over with your doctors, and if you decide to try something like this, get regular blood tests and physical exam monitoring to see how you are doing.

Finally…..I want to mention to my subscribers that only about 1/2 of the LLAW posts are sent out (I know there is too much mail)…but if you care to read other posts, on other topics, you need to go the the LLAW website itself. Thanks for your interest.

One of the hottest topics in medical research regarding aging is that many problems—from some cancers to atherosclerosis to Alzheimer’s disease and even some aspects of aging itself—can be in part caused by inflammation, which we might describe as a low-grade infection in the body over many years. This chronic irritation gradually results in damage to various organs such as the brain and the lining of our blood vessels, and might be one of the major factors in determining who among us will lose our mental capacity as we get older…the more the chronic inflammation, the greater the long-term damage, the higher the risk for dementia.

So for the past several years at least, the conventional wisdom has been that drugs that decrease inflammation also lower the risk of dementia, and much hope has been directed towards the non-steroidal anti-inflammatory drugs (NSAIDs) such as over-the-counter ibuprofen and naproxen (U.S. trade names like Aleve, Advil, Motrin).

Indeed, it was almost exactly one year ago that the esteemed journal Neurology published a huge study of veterans (about 250,000 people) over the age of 55, and found that during a five-year period, NSAID use appeared to lower the risk of developing Alzheimer’s by 24-40%. Considering the grand theory of inflammation, this all made sense. But now a University of Washington study, spanning 12 years, showed the opposite result—those who used NSAIDs most heavily (which, we would think, should markedly cut the inflammatory effect), had a 66% higher risk of developing Alzheimer’s than those who didn’t use NSAIDs.

The authors of this new study suspect the reason for this contradiction is that the earlier research studied younger people, and the latest study looked at people over 75. So perhaps NSAIDs only have the protective effect for younger people, and if you are above 75, NSAIDs markedly raise your risk? Is it perhaps that NSAID use by younger people delays the onset of Alzheimer’s, but ultimately raises the risk? This is still a very messy and complex topic, which won’t be resolved soon. What is certain is that much new research will come out over the next decade, and maybe by then the issue will be resolved.

The news about vitamin D just keeps getting better and better. In fact, it’s hard to find much news that is negative about this vitamin. The latest work comes from studying Costa Rican children with asthma, and those with the lowest vitamin D levels had a much higher risk of severe asthma.

Want to avoid diabetes? (who doesn’t?)  It seems likely that most cases of diabetes in people 65 or older are preventable… it’s not just fate, or family history. Nine out of ten cases can be avoided if you “live right”. According to a recent report in The Annals of Internal Medicine, people who follow some basic health principles regarding diet and exercise have a 89% lower risk of developing diabetes.

Here’s how to do it…see the details in MedPageToday, and of course, consult your physician for your specific situation:

1. above average physical activity
2. healthy diet regarding fat and fiber intake
3. don’t smoke, or have quit 20 or more years ago
4. light to moderate alcohol use, vs. not drinking at all
5. avoiding obesity
6. keeping your waist under 34.6 inches (88cm) for women, and under 36.2 inches (92 cm.) for men

Last Sunday I thoroughly enjoyed a dinner of the national dish of Brazil, feijoada (fehz-waada), so I was happy to see that this week the New York Times featured black beans (the principal component of feijoada), as the topic for its Recipes for Health series.

You probably know that legumes—which includes black beans as well as the color spectrum of others such as navy, red, pinto, and white—are healthy, but my guess is you don’t know how great they really are, and that the black variety is the healthiest of the lot. Some of the benefits of black beans:

1.    They are full of fiber, which naturally lowers your cholesterol absorption and production. High fiber diets have been linked with lower heart attack and stroke risk.
2.    Beans are also loaded with the best type of carbohydrates, the complex type, which are slowly absorbed and provide your body with long-lasting energy without the spikes in blood sugar seen with many carbs.  Beans are especially good for those with sugar control issues, and recently, blood sugar spikes have been implicated in long-term memory decline.
3.    Surprisingly, beans and particularly black beans are full of the same antioxidants, anthocyanins, that are found in grapes. Recent research has shown the darker the bean, the higher the antioxidant content. Black beans actually contain about the same anthocyanin content, weight-for-weight, as grapes and cranberries.
4.    They are low in calories and almost completely fat-free.
5.    Especially for a fruit/vegetable, they are full of protein…one cup provides about a third of your daily protein needs.
6.    Beans have high iron content, and are full of the wonderful trace element molybdenum, as well as heart-healthy folate (a B vitamin) and magnesium.
7.    Black beans likely have anti-cancer properties.
8.    They store well for long periods of time, and are cheap.

The downsides to beans are that they take some time to prepare and cook…the healthiest way is to cook them yourself rather than using canned beans (interestingly, in Brazil, you cannot even find or buy canned beans), and beans tend to cause gas (despite that they are considered beneficial for most people’s gastrointestinal tracts). Pre-soaking the raw hard beans in water for at least six hours makes them easier to cook and also decreases the gas problem. Then simmering beans can take an hour or two, but if cooked in a pressure cooker, it goes down to 30 minutes.

The Times mini-series details several black bean recipes, including basic simmered beans, black bean soup with spinach, and a healthy alternative to traditional fat-filled refried beans.

Real Brazilian feijoada is another matter entirely, and what’s in it depends on the region you live. The one I had last week had black beans mixed with various types of pork and sausages, potatoes, cabbage, squash, and collard greens. Here is one recipe from foodbuzz if you want to experiment. You can even find feijoada made only with chicken, or without meat, although those would not be considered true feijoadas by most (carnivorous) Brazilians.

But if you don’t want to spend the time making feijoada, try at least basic black beans from scratch. It will be worth the effort in taste and nutrition, and the more you can divorce yourself from canned food, the better! (But if you really don’t have the time or inclination to make from scratch, canned low-sodium black beans are an OK substitute.)

All in all, I would wager that black beans are the least expensive super-food we have, and these days, that is something to consider.

Based on last week’s survey results, rather than every week sending out two email updates to subscribers, I will send out one to two weekly based on the content. And as always,  three fresh posts will magically appear on the LLAW website itself every week.

I am sure that this study will not put an end to the controversies comparing various types of diets, but recent research published in the New England Journal of Medicine—coming from the Harvard School of Public Health—strongly suggests that, to achieve weight loss, it really doesn’t matter what type of diet you adopt…the important point is that you significantly reduce your caloric intake.

Most diet research involves short-term studies and a relatively small number of participants (or have many more participants of one sex like the Israeli study mentioned below), but this Harvard study went on for two years, and involved 811 participants, and each of those was randomly assigned to one of four diets:

* Low-fat, average protein: 20% of calories from fat, 15% of calories from protein, 65% of calories from carbohydrate
* Low-fat, high-protein: 20% fat, 25% protein, 55% carbohydrate
* High-fat, average protein: 40% fat, 15% protein, 45% carbohydrate
* High-fat, high-protein: 40% fat, 25% protein, 35% carbohydrate

All of the diets encouraged lots of fruits and vegetables, the participants were encouraged to do 90 minutes of moderate exercise weekly, and all underwent first individual, then later in the study, group weight-reduction counseling. All participants were encouraged to cut about 750 calories from their previous diet, but all people during the study ate at least 1200 calories per day.

The results: people in all four diet types lost an average of 13 pounds (5.9 kg.) after the first six months, and then after about a year, most people slowly gained back some of their original weight, but at two years, all four diet groups were about nine pounds (4 kg.) less than their original weights.

One important differentiating point was that those people who faithfully continued attending group-counseling sessions over the two years lost an average of 22 pounds (10 kg.) rather than nine pounds!

Now while this seems to be a good study, it isn’t perfect; for example, the study group was 62% female rather than the ideal 50%.  And an Israeli study published last year in the same journal showed that people who followed a low-carbohydrate diet for two years had a larger weight loss than those who followed a low-fat diet, but this study consisted mostly of men (86%), and the study was partially funded by the Atkins Foundation (which advocates a low-carbohydrate diet).

Without doubt, the diet wars will continue, and I will not be surprised if I report within the next two years a different large controlled study with completely different results. Still, I think we can take away a couple lessons: first, that cutting calories is the most critical factor in any diet. Daily calorie counting might well be worthwhile to make sure you keep to your daily goal. You could take this approach: choose whatever diet (Atkins, Ornish, Mediterranean, etc.) you can stick to! (Consult with your physician, and you might have to experiment with several to see which you can really follow.) Second, it’s likely that if you consistently work with group support or counseling while you diet, you will have better results.

Next post: a nutritious recipe idea from Brazil, whether you are dieting or not!

We are now (hard to believe) weeks after the New Year…yet many LLAW readers are still asking about diet and weight loss, so today I am highlighting an important recent report from the British Medical Journal. This was a so-called meta-analysis, which is a kind of super-statistical study that examines a large number of other studies done on one subject. A good meta-analysis like this one looks at how each sub-study was done, discards the sub-par research (not uncommon), and come to a grand conclusion after summing the best of the studies.

The goal of this meta-analysis was to determine: is the Mediterranean diet really as good as it’s supposed to be? Does it cut disease and make people healthier? The conclusion, after assembling over 1.5 million subjects, was that yes, the Mediterranean diet really does lead to a drop in the death rate and can help you avoid chronic nasty diseases such as Alzheimer’s.

The Mediterranean diet is also a tasty one, one that you can stick to for life, and for your life. It’s not a six-week or year-long program. It’s best forever. Named after the traditional diet of countries surrounding the Mediterranean Sea (traditionally with some of the lowest incidences of heart disease), here it is:

1. Most of your fats come from Olive Oil, and secondarily, Canola Oil (rather than butter or other oils).
2. Eat Nuts, but no more than handful per day (since they are high in calories); peanut butter, cereals, and seeds are great.
3. Lots of Fish, at least several times per week.
4. Minimal red meat, preferably a few times per month.
5. Lots of Fruits, Vegetables, Whole Grains, and Legumes. For dessert, choose fresh fruits over the typical processed sugar products.
6. Red Wine in moderation (unless you have a problem with or sensitivity to alcohol).

This is not such a difficult diet to adhere to, for one reason because it’s relatively high in fat. This fat though comes from vegetable sources (such as olives), so they are healthy monosaturated fats, rather than the saturated fats from animal sources.

The result of the BMJ meta-analysis was that those who stuck to this diet had a significant decrease in early death from all causes, and specifically a decreased risk of dying from cancer and heart disease, along with a modest (13%) diminished risk of Parkinson’s disease and Alzheimer’s.

Finally, one recent Spanish study concluded that if you stick to a Mediterranean diet, you are much less likely to be part of the group which gained an average 7.5 pounds (3.4 kilos) over a ten-year period. (Unfortunately, many young Mediterraneans have moved away from their traditional healthy diet to a Western diet full of more processed foods and saturated fats, and the rate of obesity in these countries has jumped alarmingly.)

One question that stumps U.S. public health officials is why—despite all the good health information and media attention—Americans are becoming more and more fat. It’s a question you might be asking yourself if you are trying to lose weight but having limited success, despite looking for “low fat” or “trans-fat free” food. Some nutritional researchers feel the problem, in part, could be due to the so-called “health halo” effect. Another name for this could be the “Nabisco SnackWell” effect.

Back in the 1990s, the Nabisco company made a tremendous marketing coup by introducing the SnackWell brand, the first really great-tasting fat-free cookie. The most popular flavor was the SnackWell Devil’s Food Cookie Cake. When they first came out, I tried to buy them many times, but since I usually worked late, by the time I got to the store, the SnackWells were gone. Dieters had already had emptied the shelves. Some people were almost camping at the store waiting for the SnackWell shipment to arrive. It was a crazy scene.

Fortunately (or not) about a year later I started noticing some SnackWells on the shelves, even late at night, because the mania had died down. By then, dieters realized that each little beautifully-formed chocolaty SnackWell (how could anything so small be bad?) represented 50 calories, and they added up. Some well-meaning dieters were gobbling them up by the boxful, like popcorn, because they were “fat-free”. The front of the box said nothing about calories, only that they were “fat-free”. Consumers were seduced by the label; SnackWells were protected by the “health halo”… they were fat-free, they must be healthy. Finally though people got smart and realized the little addicting devils were adding hundreds of calories to their diet each day, sales plummeted, and I was finally able to buy them.

Read this New York Times article for the full story, but basically a French nutritional researcher (the French know food much better than Americans) studied New Yorkers, and found that when they saw a “trans-fat free” label, they got reckless, and consistently under-estimated the calorie content, and ate too much of whatever it was. Interestingly, this calorie-amnesia effect was more pronounced in people who were already overweight. They just lost control.

Here is how you can guard against this happening to you:

Be cautious when you see “Non-Fat”, “Trans-Fat Free”, or even “Organic” on a label. If it doesn’t have fat, what does it have instead? “Organic” says nothing about calories. The main function of the label is to get you to buy, not to give competent nutritional information. Most important, look at the calorie count per serving.  What is the serving size for the calories quoted, and how many servings are you eating?