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Still counting calories? Not all calories are the same!

Fri, 03 Aug 2012 04:42:38 +0100

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Dieting? Study Challenges Notion That a Calorie Is Just a Calorie
ScienceDaily (June 26, 2012) — A new study published June 26 in the Journal of American Medical Association challenges the notion that "a calorie is a calorie." The study, led by Cara Ebbeling, PhD, associate director and David Ludwig, MD, director of the New Balance Foundation Obesity Prevention Center Boston Children's Hospital, finds diets that reduce the surge in blood sugar after a meal--either low-glycemic index or very-low carbohydrate-may be preferable to a low-fat diet for those trying to achieve lasting weight loss. Furthermore, the study finds that the low-glycemic index diet had similar metabolic benefits to the very low-carb diet without negative effects of stress and inflammation as seen by participants consuming the very low-carb diet.

Weight re-gain is often attributed to a decline in motivation or adherence to diet and exercise, but biology also plays an important role. After weight loss, the rate at which people burn calories (known as energy expenditure) decreases, reflecting slower metabolism. Lower energy expenditure adds to the difficulty of weight maintenance and helps explain why people tend to re-gain lost weight.
Prior research by Ebbeling and Ludwig has shown the advantages of a low glycemic load diet for weight loss and diabetes prevention, but the effects of these diets during weight loss maintenance has not been well studied. Research shows that only one in six overweight people will maintain even 10 percent of their weight loss long-term.
The study suggests that a low-glycemic load diet is more effective than conventional approaches at burning calories (and keeping energy expenditure) at a higher rate after weight loss. "We've found that, contrary to nutritional dogma, all calories are not created equal," says Ludwig, also director of the Optimal Weight for Life Clinic at Boston Children's Hospital. "Total calories burned plummeted by 300 calories on the low fat diet compared to the low carbohydrate diet, which would equal the number of calories typically burned in an hour of moderate-intensity physical activity," he says.
Each of the study's 21 adult participants (ages 18-40) first had to lose 10 to 15 percent of their body weight, and after weight stabilization, completed all three of the following diets in random order, each for four weeks at a time. The randomized crossover design allowed for rigorous observation of how each diet affected all participants, regardless of the order in which they were consumed:
    •    A low-fat diet,which reduces dietary fat and emphasizes whole grain products and a variety of fruits and vegetables, composed of 60 percent of daily calories from carbohydrates, 20 percent from fat and 20 percent from protein.
    •    A low-glycemic index diet made up of minimally processed grains, vegetables, healthy fats, legumes and fruits, with 40 percent of daily calories from carbohydrates, 40 percent from fat and 20 percent from protein. Low glycemic index carbohydrates digest slowly, helping to keep blood sugar and hormones stable after the meal.
    •    A low-carbohydrate diet, modeled after the Atkins diet, composed of 10 percent of daily calories from carbohydrates, 60 percent from fat and 30 percent from protein.
The study used state-of-the-art methods, such as stable isotopes to measure participants' total energy expenditure, as they followed each diet.
Each of the three diets fell within the normal healthy range of 10 to 35 percent of daily calories from protein. The very low-carbohydrate diet produced the greatest improvements in metabolism, but with an important caveat: This diet increased participants' cortisol levels, which can lead to insulin resistance and cardiovascular disease. The very low carbohydrate diet also raised C-reactive protein levels, which may also increase risk of cardiovascular disease.
Though a low-fat diet is traditionally recommended by the U.S. Government and Heart Association, it caused the greatest decrease in energy expenditure, an unhealthy lipid pattern and insulin resistance.
"In addition to the benefits noted in this study, we believe that low-glycemic-index diets are easier to stick to on a day-to-day basis, compared to low-carb and low-fat diets, which many people find limiting," says Ebbeling. "Unlike low-fat and very- low carbohydrate diets, a low-glycemic-index diet doesn't eliminate entire classes of food, likely making it easier to follow and more sustainable.
Story Source:
The above story is reprinted from materials provided by Children's Hospital Boston.
Note: Materials may be edited for content and length. For further information, please contact the source cited above.
Journal Reference:
    1.    Cara B. Ebbeling et al. Effects of Dietary Composition on Energy Expenditure During Weight-Loss Maintenance. JAMA, June 27, 2012 DOI: 10.1001/jama.2012.6607

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How Naturopathic Doctors Are Proving the Value of Integrative Medicine

Sat, 23 Jun 2012 07:49:01 +0100

By John Weeks

Publisher and Editor, 'Integrator Blog News & Reports'

Published in HuffPost Healthy Living Posted: 06/13/2012 5:11 pm

In the mid-1980s, leaders of the reemerging naturopathic medical profession faced a tough challenge. They had to make the case for a scientific basis for their field prior to any history of federal support for naturopathic research.

The naturopathic physician authors of such pioneering volumes as the Textbook of Natural Medicine and bestselling, consumer-focused counterpart the Encyclopedia of Natural Medicine searched the world's literature. They referenced diverse studies on diet, therapeutic nutrition, lifestyle, stress and exercise and profession's whole person, multi-modality, natural therapeutic-focused form of integrative medicine.

Many of these references were gleaned from conventional medical literature. Bottom line: The reemergence of naturopathic doctors (N.D.s) owed a significant debt to research of their medical doctor (M.D.) colleagues.

Now it looks like present day naturopathic researchers may be paying back this debt -- at least as far as their medical doctor colleagues in integrative medicine are concerned.

A recently-published study of naturopathic treatment for diabetes and a review of 13 outcomes studies of "whole practice" naturopathic treatment each support the value in the multiple modality, individualized approach that is also favored by integrative M.D.s.

The review was presented at the recent International Research Congress on Integrative Medicine and Health, May 15-18, 2012. The key inclusion criterion of the naturopathic research studies was that all examined the impact of care using at least two therapeutic modalities simultaneously.

A hallmark of integrative, whole person care -- whether by naturopathic doctors or integrative medical doctors -- is that doctors virtually never treat with single agents. An herb, nutrient or pharmaceutical may be a centerpiece, but this is typically prescribed in the context of a family of other treatments. These may include counseling, dietary suggestions, additional supplements, exercise, and some form of stress management. These are offered in the context of a supportive therapeutic relationship.

The poster presentation was entitled "Systematic Review of Outcomes Studies of Outcomes Studies of Whole Practice Naturopathic Medicine." The poster team, led by Erica Oberg, N.D., MPH and Carlo Calabrese, N.D., MPH, acknowledged that "formal whole practice studies in naturopathic medicine are a recent phenomenon."*

All of the naturopathic studies were on chronic conditions. "Some degree of clinical benefit" was found in each, "sometimes quite strong." Eight of the 13 used quality of life measures with all showing improvements. While noting many "methodological weaknesses," the team concluded that the review "provides evidence of effectiveness and cost savings in chronic diseases in the observed or validly-modeled practice of trained and licensed naturopathic doctors."

Such research is of most value to real world decision makers. The aim is not to show that X therapy caused Y response under controlled conditions. Rather, these help stakeholders -- whether employers, individuals, hospitals, or accountable care organization leaders -- understand what may happen if a given population of patients is cared for by a set of integrative practitioners. These specifically help answer whether naturopathic doctors will be helpful if included in care teams or benefit plans.

The prime example of this utilitarian research was a pilot project reported this spring via Group Health Research Institute and Bastyr University. The team compared adjunctive naturopathic care for 40 patients with Type II diabetes against usual care for a Group Health population.

The researchers honored the individualized philosophy of integrative medicine treatment. No protocol was required of the participating naturopathic physician clinicians. They were only told they could offer no more than eight visits during the study year. The researchers, led by Ryan Bradley, N.D., MPH and Dan Cherkin, Ph.D., found improvements in self-efficacy, mood, glucose testing and motivation to change lifestyle. Changes in hemoglobin A 1c were trending positively but not statistically significant in the small sample.

For employer or insurer decision makers concerned with cost, another signal finding was that the average number of visits was just 3.9. This was less than half of the allowable eight. These reassured that the naturopathic doctors wouldn't break the bank. Notably, the visit count to the naturopathic physicians was a fraction of that in the highly-regarded Diabetes Prevention Program.

Small as this sample of research projects may be, this baker's dozen of whole practice studies reflects a significant contribution to the body of knowledge of the outcomes of real world treatment by integrative doctors of any kind.

Ironically, the time may soon come when integrative medical doctors make use of these data on integrative naturopathic treatment for their own ends. An effort is underway to establish a new board certification for integrative medical doctors. A recent examination of M.D.-based integrative medicine was challenged for relying on hearsay claims of the integrative M.D.s. Questions about the effectiveness and cost-effectiveness will increasingly be on the table.

In search of the science to support whole person, integrative medical care, the emerging guild of board-certified integrative M.D.s may use a strategy favored by the naturopathic doctors 30 years ago. They too might find it useful to borrow useful research from across a professional aisle. In their case, they will be sampling from their naturopathic doctor colleagues who are forging the path of whole practice integrative medicine research.

*Disclosure note: I have worked with Oberg, Calabrese, Bradley, Cherkin and others from many disciplines to promote more funding of research on outcomes of whole person, integrative care.

For more by John Weeks, click here.

For more on natural health, click here.

Fibromyalgia: Is it for life?

Sat, 23 Jun 2012 06:46:19 +0100

Dr. Shanon Sidell: Posted on Sunday, June 10, 2012 1:56 PM

Are there health issues you or your loved ones would like more information about? You are welcome to ask health questions on our Facebook page. You may see your answer on this Blog!

In response to a question about Fibromyalgia:

Thank you for your question. This is a quite prominent condition in the age group you mention.

As always, the first step is to determine the cause. With that we can tailor treatment. Every person is different, however one factor that spans most everyone is that stress makes it worse, less stress or better stress management improves symptoms.

So, relaxation massage, acupuncture, getting excellent sleep, warm epsom salt baths, counseling to deal with stress, and doing mild-moderate exercise and stretching are all good starting points. Nutritional modifications, both with regard to food and to adding supplementation have been helpful.

Recently I have been using amino acid therapy with very good reports. Most importantly though, people with fibromyalgia and chronic fatigue faire best support from family and friends to help manage and move past the condition. This is where the community becomes a healing entity in itself.

Treating Food Addictions with Amino Acids

Sat, 23 Jun 2012 06:40:50 +0100

Maggie Ney: Posted on Monday, May 28, 2012 9:11 PM

June 6, 2011

This article was published in Akasha’s newsletter on “Addictions”.

Turning to food for comfort may result in an emotional high, but craving things like ice cream, cookies, pasta or cupcakes when you are down may be a sign of an underlying amino acid imbalance. Amino acids are the building blocks of protein and turn into neurotransmitters in our bodies. Neurotransmitters, like serotonin, tryptophan and tyrosine, are our brain’s hormones and affect all aspects of our bodies, including mood, energy, sleep, libido, and ability to concentrate. New research is linking amino acids to the hunger-stimulating hormone, ghrelin. High ghrelin levels (which can result from an amino acid imbalance) contribute to increased hunger and lack of satiety after meals.

Indulging your craving for carbohydrates and sugar causes a temporary boost in certain neurotransmitters, which, in turn, can leave you vulnerable to the addictive properties inherent in these foods. Literally, they act like a drug. It is rare, for example, for someone to binge on broccoli, walnuts or apples. We have receptors in our bodies that know how to release satiety signals when we eat real food. But our bodies lack receptors for yellow dye #4 and hydrogenated oils, for example. We really can’t eat one potato chip because our bodies don’t tell us we’re full and satiated after eating processed foods. We may feel sick to our stomach but our bodies don’t feel satisfied. We do, however, feel the neurotransmitter boost; so we feel better (briefly) but we want more carbs and sugar. If, however, amino acid imbalance is corrected, you might not crave that chip in the first place. You can have your amino acid levels checked through an easy saliva, urine or blood test. Treatment can be a single amino acid therapy or an individualized, costume amino acid blend based upon your unique amino acid profile.

A few examples of amino acids that can help cravings or food addictions are:

5-HTP: decreases carbohydrate cravings.
Tyrosine: decreases food cravings triggered by fatigue or inability to concentrate.
N-acetylcysteine: this amino acid turns into the neurotransmitter glutamate. Low glutamate levels have been associated with addictive behaviors and contribute to strong food and drug cravings.
GABA: decreases food cravings associated with stress or an overactive mind.
Theanine: enhances the effect of GABA and can contribute to decreasing food cravings and addictions.
Glutamine: can decrease sugar cravings almost instantly.
Tryptophan: deficiencies can lead to overeating and food addictions.