Diet & Weight Loss Archive

Replacing unhealthy behaviors with healthier ones usually isn’t easy, and many ambitious attempts often fall short. But you’re more likely to succeed if you start by choosing the right goal—the one you are most likely to accomplish—rather than the goal you think you should make. Breaking a goal into bite-sized pieces also helps. So does making your goal a SMART one (specific, measurable, achievable, realistic, and time-based).

Here is the problem: we Homo sapiens evolved to cope with conditions that predominated during the Paleolithic period, when humans hunted and gathered, and fat, salt, and sugar were in short supply. To ensure that we ate adequate supplies of each, we evolved a craving for them. In fact, some of the brain mechanisms involved in our pleasurable response to sugar and fat are the same as those involved in our response to opioid drugs like morphine and codeine.

But now we live in an environment that is brimming with food and drinks that satisfy these cravings — and, in the process, make us overweight, cause illness, and shorten our lives. An adult can get by on as little as 500 milligrams (mg) of sodium a day; the average American intake is about seven times that amount, or 3,400 mg. Humans can certainly live without sugar (and, in fact, without any kind of carbohydrate as long as some fat and protein are available), but Americans now consume, on average, about 20 teaspoons of added sugar daily — and that's above and beyond the sugars found naturally in fruit, vegetables, and dairy products.

It isn’t easy to get rid of a harmful habit like drinking too much, or to make healthy changes like losing weight and exercising more. Media stories often sugar-coat changes like these, making them seem easier than they really are. In a moving essay in the American Journal of Health Promotion, Michael P. O’Donnell (the journal’s editor) describes his dad’s efforts to become healthier for his sake and the sake of his family. There was no monumental struggle, no epiphany—just a regular guy doing his best each day to become healthier for his sake and for his family. It’s a truly inspiring story.

Q. I am overweight and need abdominal surgery. Does being overweight make the surgery more difficult and add to the complication rate?

A. We all have a fair amount of fatty tissue in our abdominal cavities that surgeons must deal with during abdominal operations. The more fat you have, the more difficult the operation is for the surgeon. Excessive fatty tissue impairs access to the surgical site. It can also make the surgery itself — the cutting of tissue — more complex. Operations on obese patients tend to take longer for these and other reasons.

For some time olive oil has been touted for its ability to protect the heart. Its popularity may be getting another boost — a study has linked consumption of olive oil with reduced risk of stroke. In the ongoing Three-City Study in France, participants who used olive oil for cooking as well as for dressing salads and sprinkling on grains and vegetables were 41% less likely to have had a stroke over a five-year period as those who rarely or never used olive oil (Neurology, published online June 15, 2011).

Before you rush out to stock up on olive oil, keep in mind that a study like this shows that olive oil and lowered stroke risk are associated. It wasn't a clinical trial, and so can't show that consuming olive oil prevents stroke. It is possible that people who take in more olive oil eat more vegetables and whole grains, or don't consume as much saturated fat, and it's these things that influence stroke risk, not olive oil.

These evolving guidelines continue to get better and more helpful.

Every five years, the federal government revises the Dietary Guidelines for Americans. The 2010 edition (issued a few months into 2011) was more a facelift than a makeover — a few wrinkles removed here, some definition added there.

Potato chips and potatoes (baked, boiled, and fried) were the foods most responsible for weight gained gradually over four-year periods among 120,000 healthy women and men in long-term studies. Other key contributors included sugar-sweetened beverages and red and processed meats. On the flip side, yogurt, nuts, whole grains, and fruits and vegetables were linked to weight loss or maintenance. Potatoes may be a “perfect food” for lean people who exercise a lot or who do regular manual labor. But for the rest of us, it might be safer for the waistline to view potatoes as a starch—and a fattening one at that—not as a vegetable.

With much fanfare, the USDA launched MyPlate, a replacement for the outdated and much-maligned Food Pyramid. The colorful quarters of the plate–green for vegetables, red for fruits, orange for grains, and purple for protein–are aimed at nudging Americans away from meals dominated by meat and starch and towards meals made up mostly of plant-based foods. It offers information on portion sizes and sends the message that a balanced meal should be at least half vegetables and fruits. But it ignores important issues like what are the healthiest choices for grains, protein, and fat. Nor does it counsel Americans to avoid the sugary baked goods, breakfast cereals, and drinks, and the salty processed foods and snacks, that make up a big chunk of the average American’s daily caloric intake. In spite of its shortcomings, MyPlate is better than the old pyramids–may they rest in peace. But whether MyPlate will help stem Americans’ frightful eating habits is anyone’s guess.

Two volunteers testing the new “Harvard Medical School 6-Week Plan for Healthy Eating” may have come to the end of the plan, but both are just beginning their independent journeys to a lifetime of healthy eating. Helen Hoart and Tonya Phillips talk about the goals they set for themselves, whether they achieved them, and their dietary plans for the future.

Reduce salt — get your iodine elsewhere

Markel H. "When it rains it pours": endemic goiter, iodized salt, and David Murray Cowie, MD. American Journal of Public Health 1987; 77:219-29.

Dasgupta PK, Liu Y, Dyke JV. Iodine nutrition: iodine content of iodized salt in the United States. Environmental Science and Technology 2008; 42:1315-23.