More on the Caveperson Approach to Weight Management

I’ve written some about the Primal approach to weight management as proposed by Mark Sisson, and I’ve mentioned the Paleo diet put forth by Loren Cordain. Since then I read another book in the same venue: “The New Evolution Diet: What Our Paleolithic Ancestors Can Teach Us About Weight Loss, Fitness and Aging” by Arthur De Vany, PhD. The book cover says, “Living like a caveman is good for your health.” Like Sisson, he talks about our evolutionary development lurking the in hunter-gatherer, pre-agricultural stage and recommends a diet and lifestyle that support our genetic makeup. Here’s a bit of his introduction:

“We humans evolved when food was scarce and life was full of arduous physical activity. Hence, our bodies instruct us to eat everything we can lay our hands on and to exert ourselves a little as possible....We are, in essence, hardwired to be lazy overeaters....Most diet and exercise plans ask us to move more and eat less--a direct contradiction of our genetically engineered impulses. No wonder most diets don’t work.”

He agrees with the others, and Taubes as well, saying “it is the grain-based carbohydrate in our diet that hinders our metabolism from functioning as evolution intended.” He recommends varying our activity and our mealtimes, just as our ancestors had to. He talks about skipping an occasional meal, eating a variety of food, combining low-level cardio with occasional sprints and brief, intense strengthening exercise.

These are the basic strategies of the New Evolution Diet:

“Enjoy the pleasure of food and do not restrict calories.”

“Do not starve yourself, but do go hungry episodically, for brief periods.”

“Exercise less, not more, but with greater playfulness and intensity.”

Sounds simple! Like Sisson, he’s all about living well: “The quality of your life should determine how much you eat. Instead of obsessing over how much you take in and then trying to burn it all off, you should focus on living a high-quality life and then eat to fulfill your energy demands.” I love that idea. It seems to put food into the proper perspective. And here’s one more similar quote to put exercise into the proper perspective: “So regular exercise is not just something you do to improve your health and drop a little weight....You exercise because the length and quality of your life depend on it.”

This is a very informative book, and if you want more details about the food and exercise that fits our evolution, De Vany provides plenty. If you’re only going to ever read one book on the subject, stick with Sisson’s. It’s just more fun, more accessible, and more practical. But The New Evolution Diet did a lot to confirm for me that this is the path I want to take, and while the overall message is the same, I learned a lot of new information in this book that I hadn’t run across in the others.

For the last four months, I have been avoiding grains and starches and sugars. My daughter says I am on a diet, but I am skipping the whole diet mentality. I don’t feel deprived, and I do feel healthier. I am losing weight and feeling more energetic. My mood and my energy level are more stable. I feel better in my body. Occasionally I eat something that our ancestors would not have had access to--a hot fudge sundae for example--and I usually feel lousy afterwards. I am not so strict that I can’t adapt to various social situations: for instance, if I have dinner at a friend’s house and she makes pasta, I’m not going to turn it down. But overall I am consistent; i.e., I do not feel like I’m dieting, so I don’t feel a need to binge. I find I really don’t miss the carbs, I don’t find them hard to resist at all. If I really want something, I have a little, and usually that feels like enough.

Easy-peasy! This whole approach is fun and easy, and it feels good! If you are not convinced my Sisson and me, go ahead and read De Vany!

A quote about scarcity vs. abundance

“Delusion underlies all other unhealthy states. Grasping and clinging arise from the delusion of scarcity and inability to sense our wholeness and life’s abundance.”

--Jack Kornfield, Buddhist Psychologist

Food or Money?

I recently listened to a CD by Lynne Twist called “Unleashing the Soul of Money: Find Sufficiency, Freedom and Purpose--Through Your Relationship with Money.” I was shocked by how much of what she said about money could also be applied to food. It was almost as if the two were interchangeable. See if any of what she has to say about money rings true for you when you think about food.

Twist claims our cultural approach to money rests on “The Great Lie of Scarcity” which is based on “Three Toxic Myths:”

--There is not enough

--More is better

--That’s just the way it is

Think about where in your life you experience a sense of scarcity. There’s not enough time, not enough money, not enough energy, not enough attention... Where do you hoard? I need more shoes, more food, more money, more toys, more hours in the day... And what do you leave unquestioned, assuming “that’s just the way it is”? These myths make up the consumer culture we live in, and, as Twist points out, “In a consumer culture, we race right past enough toward more.” Is that how you eat? Even the word “consumer” makes one ask, is she talking about money or food?

Twist proposes we replace “The Great Lie of Scarcity” with “The Principle of Sufficiency.” She says, “When you let go of trying to get more of what you don’t really need, oceans and oceans of energy become available to do more/make a difference with what you have.” Think about this when you eat. What is sufficiency when it comes to food? What does it feel like to have exactly enough? Why would you want more than that? What exactly does it take to satiate you? More than enough? (In my case, yes, more than enough, thank you. Why is that?) Twist challenges us: “Be in the presence of the exquisite distinction of sufficiency. You can’t do that when you are scrambling for more.”

I am fascinated by how the influence of our “consumer culture” plays out in our eating habits. No wonder we are an overweight nation. Think about what it means to eat mindfully when everything around us says “Supersize Me!” It is an act of subversion! We are bombarded by messages that more is better just as we are bombarded by the message that skinny = beautiful = happy. What are we to make of this? Even if we are trying to diet--to eat less, to lessen our size--we still feel the need to cut more calories and lose more weight and exercise more. But, as Twist points out,

“You cannot get to abundance through the door of more. The doorway of more will only bring you lack then then the longing for more again... The only route to true abundance is enough--the exquisite distinction of sufficiency, being met by the universe.” She’s talking about this in terms of money, but I think it’s a great argument for the practice of eating when you’re hungry and stopping when your body has had enough. Whether you are overeating or restricting your eating, it’s the same vicious circle.

The trick is both recognizing when you’ve had enough and then honoring it. This is not something we necessarily grow up learning how to do, whether with food or anything else. Who doesn’t want more of a good thing? “There is no room or space for the distinction of enough in our culture. Enough has a hard time holding any weight in a consumer culture that’s racing toward more. But if we let go of trying to get more...and start paying attention to what’s already there...it begins to expand into abundance.”

Twist implores us to stop and notice what we have, appreciate it. “What you appreciate appreciates. When you live in...gratitude, or when you exercise the muscle of appreciation, what you appreciate grows in the nourishment of that attention...and you realize that you live in a kind of bounty that’s been eclipsed by the chase for more. This is as much about being present and attending..to what you already have as it is about anything else.” You see? All roads lead us back to mindfulness, which turns out is the key to everything!

I realize there is some risk in using Twist’s language when we’re talking about weight issues, because if I tell a dieter to appreciate his or her body, the first thought might be, “And watch it expand into abundance? No thank you!” But let’s rise above that here and try to see what abundance might really mean for us. This reminds me of Rago’s work which I mentioned in my last post. You may remember that she organized the people she was treating for eating disorders to prepare and serve meals to the homeless community. Actually I should point out that after they served the meals, they sat down with those they had invited and ate with them. I wonder if that experience showed them what Twist calls “the profound radical truth of enough”?

In my last post, I mentioned that Rago and Archer suggest your energy might be better spent somewhere other than in the worry that your thighs are too fat. They tell us, basically, to love our bodies and eat what we want. I think Twist takes that momentum a step further by showing us HOW. Let’s go back to the Three Toxic Myths that support the Great Lie of Scarcity. Let’s start questioning ourselves when we find ourselves buying into them (no pun intended). When you find yourself feeling like there is “not enough” of something, ask yourself, is it true? When you find yourself feeling like you need more of something, ask yourself, is it true? Do I really need more pulled pork, more wine, more pairs of jeans that will fit me next year if I just lose a little more weight? Is that really just the way it is?

Before I ever listened to Twist’s CD, I walked into my closet one day and suddenly decided, “I have enough clothes.” Sure there could be a morning that I really wished I had a lightweight but long-sleeved teal blue blouse to go with those black pants, but so what? I had a closet stuffed full of clothes. That was enough. I vowed not to buy a single piece of clothing for a year, then I could reevaluate. I’m over half way through, and so far, so good. It’s actually easy and satisfying, even liberating. No more lunch hour raids on Ross to stock up on huge armfuls of clothes that I didn’t need but couldn’t resist because they were just so darn cheap. Enough can be enough. Enough food, enough clothes, enough money. We really do live in abundance, don’t we?

Cat Fight in the Diet Aisle

I have to make a confession. I actually purchased and read the book "Skinny Bitch" by Rory Freedman and Kim Barnouin. It was what you would expect from the title. I felt a little foolish for having given them my money and time. I didn't even think to mention it to you until I ran across a new book, "Shut Up, Skinny Bitches!" by Maria Rago and Greg Archer. It is basically a critique of what they call "The Skinny Bitch Mentality." Although their intentions are good--really very good--they seem to be stooping almost to Skinny Bitch lows to make their point--which you might also expect from their title. What is happening in the diet literature? Can't we at least communicate like civilized people?
So while I found "Skinny Bitch" highly dismissible at the time, I realize now that it is really quite a dangerous little book. I have to admit that I was glad when Rago and Archer called Freedman and Barnouin out on the carpet. (Is that a real expression? It sounds funny.) "Skinny Bitch" starts like this: "Are you sick and tired of being fat? Good. If you can't take one more day of self-loathing, you're ready to get skinny." So right off the bat, we are hearing the message that if we are overweight we should not only feel "sick and tired" of it, but we should hate ourselves for it. Rory and Kim go on to call the reader the following names, as pointed out in the aforementioned critique: gluttonous pig, moron, shithead, cheap asshole and pussy. Of course they are just trying to be cute, right? Trying to get our attention? Rago and Archer note that "millions of people purchased the book. They were called the names listed here, yet they kept reading." Wait a minute, I purchased the book, was called those names, and kept reading! Of course, I didn't actually do ANYthing those skinny bitches told me to, so it's not like I was taken in by them (right?), but still, I let them talk to me that way! What was I thinking? They assume everyone wants to be skinny, must be miserable if not skinny, and must follow their rigid, bitchy recommendations to achieve such skinny-ness, although they deny that they wrote a diet book. Basically they tell to you become a vegan. I decided maybe I didn't want to be skinny after all.
Rago and Archer had more to say than just how damaging books like "Skinny Bitch" can be. Their message is, "Shut Up, and Eat!" (the title of their first chapter). Actually it's much more than that. They remind us that dieting DOESN'T WORK. We know that, right? It's a dismal failure all the way around. People who diet end up gaining weight in the long run, and they are often miserable in the process. "Have you noticed chronic dieters, and otherwise erratic or restrictive eaters, are some of the most frustrated, depressed people you meet? They're always fighting themselves and their body's natural cravings. The emotional war with their bodies drains them of precious life energy." They propose that all the time we spend worrying about the shape of our bodies could be better spent: "...millions of people on the planet don't even have enough food" yet we are expending all our energy "making sure our damn thighs don't touch." Point taken.
They suggest we follow our hunger cues, exercise for fun and health, address emotional and psychological issues and generally try to have a good time. In light of aforementioned emotional and psychological issues, they delve into the realm of eating disorders. If you are dealing with an eating disorder, this book has some good advice, but for more depth you should read Geneen Roth (review of her latest book forthcoming!). They present some scary statistics: approximately 88% of females and 43% of males are dissatisfied with their bodies, and 24% of women and 17% of men are so dissatisfied that they "would be willing to trade three years of their lives to achieve their weight goals." Even more sad and shocking, one study found "21% of five-year-olds were concerned about their weight and dissatisfied with their bodies." By 3rd-5th grades it's 50%, and 30% of middle-school girls are dieting on any given day. UGH! The Skinny Bitches are getting to our children!
Maria Rago did some very compelling and successful work organizing people who were in treatment for eating disorders to prepare and serve meals for the homeless. She recommends we "spend time getting to know what hunger truly is...this will help you understand the true value of food." Imagine how an experience like that could shift one's perspective on food. What a brilliant intervention as well as just a useful thing to do.
I didn't love this book, but I do appreciate how Rago and Archer address so many larger cultural issues. I haven't talked much about body image and the impact of advertising and other cultural messages on individual's sense of beauty and self worth in this blog because, well, don't get me started! That's a whole blog in itself. Plus I am always questioning whether writing a blog about weight management is even ethical because the last thing I want to do is buy into "The Skinny Bitch Mentality." And I certainly don't want anything I write to presume that my readers should for any reason be unhappy with their body shapes and sizes. So it's a slippery slope. I admire these writers' courage in taking it on, even if it was premised on their reactions to the stupid (but dangerous!) little book, "Skinny Bitch."
"Shut Up, Skinny Bitches!" concludes with the following advice: "Let's start fighting back against our thin-obsessed culture and cultivate deeper meaning in our lives...eat well, play, feel your emotions, embrace the size you are, and best of all, spread love through doing service." As long as they don't tell me to "shut up!" one more time, I will take their advice to heart and pass it on.

More Controversy!

Here's Blakes analysis of the LA Times article I put in my last post. How are we to know what to think?:


Hey Tess... here's one of the articles alluded to in the LA times column. It's pretty interesting to look. You're probably not interested in these details, though, and if not I'm sorry, but that's where the devil is. It shows how much each study has to be stared at to make sense, and how hard it can be to make sense of unrelated studies.

I guess if nothing else, as a friend, this shows you what a drag it is to be me.

Don't bother to read on if you don't want to see my analysis...

First, the study includes a total of 40 people. That is a very small number.

Second, it's important to segregate what they say about weight loss, fats circulating in the blood, and actual adipose tissue.

The weight before was about 210 pounds (plus/minus 20 pounds) for both grups. The high fat diet end weight was 190 (plus/minus 20 pounds) while the carb diet end weight was 195 (plus/minus 20 pounds). So, really, this study isn't making a claim about weight; the errors make the differences between and before/after indistinguishable. A better number to report would probably have been the % weight loss. This might wash out the big errors (comparing someone that was 170 with someone 210 won't reveal how each individual fared). Of course, this may have looked even worse than body mass.

The body fat was actually less in the high carb group.... 36.8% vs 38.2%... though the size of their error bars (8%) actually dwarfs any difference. The carb group had more non-fat body mass, which makes them slightly heavier overall.

Where they do see something striking is in concentrations of blood lipids. A decrease in triacylglycerols of 50% (as he said in the article). The carb group also saw a decrease of 20% (not mentioned in the article), which is also really striking. The error bars in both these numbers is 25%. Caloric reduction in general is a good thing for diabetes risk.

The other thing that's striking is the shift in the insulin response. This gets to that homeostasis thing I was mentioning before... the reduced carbohydrate load allows the body to shift to a lower insulin response: there's less sugar to import, so we require a smaller insulin response. On the other hand, the difference is response is really not too surprising: the body responds to the stimulus... less carbs, less insulin required to move fewer carbs into the cell. I bet if they looked after week1 of the study, they'd have seen the same thing.

To be fair, I think the metrics of diabetes risk is what they're emphasizing (circulating lipids). So, you can still be overweight (if I lose 20 pounds, I'll still be overweight), but reduce your risk for diabetes. Which is more important? I don't know. Being overweight but diabetes free is still probably linked to self-esteem and depression issues.

So, I guess the bottom line is that it's easy to confuse weight loss and health benefits. Also, such small studies are very hard to interpret because the errors are so large. However, it is nice to know that, even if you're too fat (at 210 myself, I can say that's too fat), you can still avoid risk for diabetes!

In the end, for me, the article is about how 210 pound people go on 2000 calorie diets for 12 weeks. I wish I could do that with a house full of pumpkin pies, candied yams, mashed potatoes, fudge and rolls.

Anyway, sorry! But thanks for posting the link, it was useful and fun for me!

bg

We Have a Controversy!

My friend Blake had the following to say about carbs and cholesterol. I'm hoping he'll read the Taubes book and help us all make sense of it!

"Hey Tess, this is obviously unsolicited, so sorry and feel free to ignore. I do teach metabolism, and have thought a bit about all this, not that I'm positioning myself as an Authority. But reading your post, well it made me think. What I will say overall is that its really hard for *anyone* to look at the nutritional science of the past 10, 20, 30 years and come up with definitive conclusions. I'm pretty suspicious of attempts to do so, though obviously an Answer is what everyone is after. Not that scientists are the only ones who can/should interpret the science, either...
Anyway, as to insulin:
Insulin's job is not to store fat. Its job is really to respond to sugar concentrations in the blood, and one of its principal duties is to induce import of glucose into the cell. When there's a dietary influx of carbohydrates (like the chocolate chip cookies I've been working through), that's a signal that the 'fuel level' is high, and it's time to store it away for future use. On the one hand, insulin induces storage of carbohydrates as glycogen (particularly in the liver). On the other hand, when glycogen levels are adequate, insulin stimulation leads to synthesis of lipids. This is the trouble! Excess carbohydrate is going to be stored as fat... the simplest-to-grasp reason is that, calorie-for-calorie, fat takes up less space... fat doesn't have to be bathed in water, like carbohydrate polymers such as glyogen do... for this and other reasons, fat is a better energy storage medium. Also, the liver has limited glycogen storage capacity, whereas we have lots of adipocytes for storing fat distributed all over the body. There are other effects of insulin on gene expression, etc... In the end, insulin is part of a 'homeostasis system' that works to keep energy levels constant. Incidentally, that tendency towards homeostasis makes it hard to lose the weight we've gained.
So insulin is good! Import of carbohydrates is good! Storage of glycogen and lipids is good! Loss of sensitivity to insulin (and the resulting health problems including perhaps obesity and CHD) is most likely the result of difficulties that arise from chronic overingestion of calories (of carbohydrates perhaps most specifically, but of food in general) and concomitant underconsumption (use of) those calories in exercise.
As for the Western diet, I just wanted to say that indigenous American and Asian diets are not lacking in carbohydrates: those non-western cultures gave us corn and rice, after all! Again, my impression is that it's this over/under problem that leads to issues of obesity, and thence to the other problems... As for the refined carbohydrate thing, I tend to think of it like I do the high-fructose corn syrup thing. Fructose is fructose - it all goes into the same energy production pathway - the problem is the amount of it we ingest. All plant fuel storage carbohydrates are made of glucose, and glucose is what insulin causes to be imported into the cell, whether the grain has had the bran removed or not. We just need to eat less of them to avoid storing them as fats.
I guess I just wanted point out that it's not carbohydrates per se that lead to insulin dysfunction, but overconsumption of these and other foods. Our lives depend on carbohydrates. Too, I think (having not read the book) that statement about 'everything we believe about a healthy diet is wrong' could be a bit hyperbolic. What's really problematic, I tend to think, is the search for a diet 'Answer' other than moderate eating and exercise (this, from a fat, lazy hedonist).
The books may have covered all this stuff, and I'm just being a didact (in fact, I know I'm a didact, so f@$& me!). I have enjoyed your blog... and the Taube book's in our library, so I'll check it out... I hope you don't mind my note, though, and I won't mind if you tell me to piss off! I totally respect your quest... my own quest focuses on finding time to do anything resembling exercise. Hopefully you take or leave my input without getting to irritated with me!"

Meanwhile, here's an article from the LA Times that summarizes what I've read better than I ever could:

http://www.latimes.com/health/la-he-carbs-20101220,0,5464425.story

My Primal Inspiration

Here's a link to my friend Holly's blog: http://www.underdogdesign.net/wordpress/2010/09/10/an-archaeologist-goes-primal/
Also see her next post: Primal in Paris.
She's been on the low carb primal path for awhile and has more to say than I do, plus she's a more sophisticated writer, so you might enjoy checking out her blog as well.
Cheers!