Fat Doesn’t “Flush”!

Wouldn’t it be great if you could just “flush” your excess body fat down the toilet? Overweight people love that idea, so they’re vulnerable to anyone who promises that they can simply “flush” their fat away. The problem is that “fat flushing” doesn’t work.

Body fat isn’t waste, it’s stored energy. It’s like money in the bank. Your body doesn’t want to “flush” that away! Even if it wanted to, it couldn’t.

Your body has a limited number of ways to get rid of waste. Carbon dioxide leaves your body through your lungs. In hot weather, you can lose a lot of water and salt through your sweat glands. However, most of what we think of as waste leaves the body through either the kidneys or the liver.

You can’t flush fat from the body through the kidneys. If you could, you’d end up seeing an oil slick on top of your urine. It’s not normal to pass any significant amount of fat in the urine. The presence of even small amounts of fat in the urine is called lipiduria. It’s a sign of a serious medical condition, such as severe kidney disease or a fracture in a large bone.

The liver breaks down a lot of toxins and other substances. It can also put some waste products into a fluid called bile. The bile then passes into the small intestine. However, the intestines then reabsorb much of what the liver had put into the bile. The material that is reabsorbed then gets carried straight back to the liver.

If your liver were flushing fat out of your body, the fat would be going into your small intestine. Then it would get reabsorbed and carried straight back to the liver. If you were losing a significant amount of fat through your intestines, you would end up passing a lot of fat in your feces. So unless you are finding lots of fat in your toilet bowl, you simply aren’t “flushing” fat from your body.

One popular author of diet books promotes what she calls a “fat flush” diet. However, her diet can’t overcome the basic biology of the human body. Although that author doesn’t have the kind of scientific credentials that she pretends to have, she probably knows that you can’t flush fat from the liver. That’s why her “fat flush” regimen also includes a severely low-calorie diet. So while the dieters imagine that they are flushing their fat, they are actually losing weight the conventional way, by eating a low fewer calories than they burn up.

Bourbon and potato chips are vegan!

My Web site and blog are about healthy food. I want people to know what science really says about how diet affects human health. For example, we know that eating animal-based foods raises the risk of a whole host of diseases, including heart disease, many cancers, and autoimmune diseases. The less animal-based food you eat, the safer you can be from those diseases. So the health-optimizing diet for human beings would be free from animal products. It could therefore be classified as vegan. Although all healthy foods are vegan, not all vegan foods are healthy. For example, no one would consider bourbon and potato chips to be the basis for a healthy diet.

The first vegetarians I met were vegetarian for religious reasons. They included some Hindu people who had been born in India and some Seventh-Day Adventists from the USA. I’ve also known observant Jews who would eat in vegetarian restaurants because everything that’s vegetarian is automatically Kosher. I also know a lot of people who refuse for moral reasons to eat any products that come from animals. All of the people I’ve just described can eat at my house without violating any of their dietary laws. Since I’m allergic to wheat, everything that I cook is even kosher for Passover. However, not everything that passes muster in their dietary laws is good for them.

To be truly health-optimizing for the average person, a diet also has to be low in fat (<10% of calories) and high in fiber. Some of the foods that contain no animal products are nevertheless high in fat or low in fiber. A high-fat, low-fiber vegan diet could promote atherosclerosis, even though it doesn’t contain any cholesterol. That’s why even vegans occasionally die of heart attacks.

When I was growing up, I was taught in school that the meat group (which includes eggs and fish) and the dairy group (which includes all milk products) are an essential part of a balanced diet for human beings. However, when I grew up and started reading nutrition and medical textbooks and scientific journals, I found strong evidence that those foods are dangerous and unnecessary. So far, I haven’t found any evidence that any human beings would really benefit from adding animal-based foods to an otherwise healthy plant-based diet. I found plenty of evidence that cats need certain nutrients that occur only in animals, and are not produced by plants or bacteria. However, I’ve seen no such evidence for human nutrition. If I find it, I will report it. Then, the decision of whether to eat those foods will be a moral decision, not a health decision.

Quick, but temporary weight loss! This time from France!

I just heard about a “new” diet: the Dukan diet. It’s from France! It promises four steps to permanent weight loss! It promises that people will lose weight while eating as much as they like! The problem is that this “new” diet isn’t really new. It’s just South Beach with a French accent. The quick results from the first phase aren’t from fat loss. Nor will your weight problem be permanently cured by the end of the program, regardless of what Dr. Dukan says. It’s just more false hope for desperate people.

Like many fad diets, the Dukan diet starts with a low-carb phase. As if by magic, this phase causes people to lose several pounds very quickly. Unfortunately, the weight that people lose so quickly does not represent fat. Instead, it represents the loss of the body’s glycogen stores. Glycogen is a starch that is stored in the liver and muscles. When the body needs quick energy, the glycogen is broken down into glucose, which is a sugar that is the body’s favorite fuel.

Like other carbohydrates, glycogen provides about 4 calories per gram of dry weight. However, the glycogen in the body isn’t dry. Each gram of glycogen absorbs about 2.7 grams of water. As a result, each gram of wet glycogen in the body represents roughly 1 calorie of stored energy. If you suddenly deprive yourself of carbohydrates, your body will run through its glycogen stores very quickly, releasing water that will leave the body through the kidneys. You would have to burn up almost 9 times as many calories to lose that much weight from fat.

The rapid weight loss that results from cutting out carbohydrates may be thrilling to the frustrated dieter, but it is meaningless. Nobody is overweight from having too much glycogen, and your body will replace that glycogen and water as soon as it can. What people really want to lose is fat. Besides, losing your glycogen can make you feel crummy. When marathoners “hit the wall,” it’s typically because they’re run out of glycogen.

So the first phase of the Dukan diet or the South Beach Diet will cause a quick but temporary and meaningless weight loss that could end up zapping your energy. If the Dukan diet eventually helps you lose fat, it does so by making your body think that you are starving or seriously ill. During a sudden fast, the body’s supply of carbohydrates is cut off. The body has to rely on its fat stores and the proteins in its tissues instead. A low-carb diet mimics this condition. The body may respond to this emergency by suppressing the appetite. The person may then lose weight the old-fashioned way, by taking in fewer calories than he or she burns up.

The Dukan diet is based on a lie: that people get fat from eating a high-carb diet. In reality, fat is fattening, and starches are slimming. That’s because starch, like glycogen, holds water. It’s actually hard to fatten yourself on starches. For example, consider what happened when the head of the Washington State Potato Commission went on an all-potato diet to protest the exclusion of potatoes from the federal Women, Infants, and Children (WIC) program. He lost 21 pounds in 60 days, even though he was eating about 20 potatoes per day. He also cut his total cholesterol by over a third, and lowered his blood sugar. In other words, he also improved his health.

A starchy diet works on both sides of the weight loss equation. You end up eating fewer calories, because the starchy foods are so bulky. Boiled starches often provide only 1 calorie per gram, whereas fat provides 9 calories per gram. You also end up burning more calories on a low-fat, high-carb diet, because you become much more sensitive to insulin. If you still manage to have a few calories left over, it’s hard for your body to store them as fat. You’d lose about 30% of the calories in the conversion process, so your body just generally revs up your metabolism to burn off the excess. You may end up doing more activity, or simply generating more body heat.

Forget Dukan’s false promises. The only proven way to achieve healthy, permanent weight loss is to switch to a low-fat, high-fiber, high-carbohydrate diet. That’s because it’s the kind of diet that is appropriate to the human body. If you simply train yourself to eating the right kinds of food, you can eat as much as you like and still stay slim.

Don’t Snatch the Food out of Your Child’s Mouth!

I just read a really disturbing article on Peggy Orenstein’s Web site. In Fear of Fatness, Orenstein talks about the bias that even young children have against fat people, and the troubles that fat girls and their parents face. I was particularly horrified by the plight of one mother, who was so frustrated by her 5-year-old daughter’s fatness that she admits that she “fights the urge just to snatch the food out of the child’s mouth.” This is an unnatural problem.

No mother in nature tries to protect her offspring by snatching food out of its mouth. This unnatural problem results from the unnatural diet that is standard in the United States. Mothers are supposed to feed and nurture their children. Why are American mothers struggling to limit their children’s portions?

If the child were being fed the kinds of food that naturally slim populations eat, then the weight problem and the struggle for portion control would simply vanish. The child would also avoid early puberty and have a low risk of breast cancer in adulthood.

Orenstein mentions that the parents turned to the child’s pediatrician for dietary advice. Unfortunately, medical doctors typically know little about nutrition. Back in 1963, the American Medical Association reported that doctors weren’t learning enough about nutrition and dietetics in medical school. A few years later, their follow-up report showed that nothing had changed. Periodically, some other expert panel studies the problem and comes up with exactly the same conclusions: our doctors are not being adequately trained in nutrition and dietetics. Thus, it’s not surprising that the child’s pediatrician has given the family horrible advice that is corroding the mother-child relationship.

The pediatrician has been working with the family to control the child’s portions. No animal in nature controls its weight by eating less than it wants to eat. Nor does any animal force itself to go to step aerobics class. Wild animals rely on their appetite to regulate their weight. Appetite works well for regulating weight as long as the creature is eating the kind of food that is appropriate for its species. We have an epidemic of obesity in people in the United States because the standard American diet is far too dense in calories. It has too much fat and not enough fiber. It overfeeds us before it satisfies our appetite. When people try to “correct” this problem by limiting their portions, they end up even more unsatisfied. They end up struggling against a primal urge, and the primal urge usually wins in the end. When parents end up needlessly struggling against their children’s primal urges, their relationship with the child will suffer.

How can we tell what kind of diet is appropriate for human beings? We can rely on several kinds of evidence. First, we can use the same approach that scientists use to figure out what kind of diet a dinosaur ate. They figure that out by comparing their teeth to those of modern-day animals. If you look at human teeth, you’ll see that they look almost exactly like the teeth of chimpanzees. Chimps are classified as fruit-eaters, but they also eat a lot of leaves. So our teeth suggest that we should be eating a diet with a heavy emphasis on fruit and vegetables. Although chimpanzees do sometimes hunt and eat meat, they actually eat less meat than practically any human population.

Chimpanzees and human beings are almost completely alike genetically. Some of the key differences involve genes that control brain size and body hair. One interesting difference is in the gene for the enzyme that digests starch. Chimps have one copy, whereas humans have several copies. In other words, our genes tell us that human beings are specially adapted to a starchy diet. It’s one of the reasons why human beings are among the world’s elite long-distance runners.

Several different kinds of scientific studies have shown that human beings thrive on a diet of unrefined starches and vegetables and fruit. People who switch to that kind of diet can solve their weight problems automatically. They can also prevent or cure many of the chronic degenerative diseases that are common in the United States but rare elsewhere.

As I explain in detail here, a high-fiber, low-fat diet works on both sides of the weight equation. People end up eating fewer calories and burning more calories. In other words, a starchy diet is slimming, while a fatty diet is fattening. A low-fat, plant-based diet also helps to delay puberty.

Of course, if a family were to feed a child the low-fat, plant-based diet that would solve her weight problem, they would be bombarded with criticism from people who ask, “But where will she get her protein? Where will she get her calcium?” In response, the parents could ask, “Well, where do you think a gorilla gets its protein and its calcium?”

Gorillas don’t hunt. They don’t fish. They don’t milk cows or gather eggs. They get 99.9% of their food from vegetables, fruit, and a few nuts. Yet those foods provide enough protein and calcium to enable a silverback male gorilla to grow to be 500 pounds and become 10 times as strong as a man.

It makes sense for parents to rely on a pediatrician for medical care for their children. But for nutritional advice, parents should turn to someone who has been trained in nutrition and dietetics. A lot of people claim to be “nutritionists,” but not all of them have real training in the science and practice of nutrition and dietetics. When I had a health problem that was potentially food related, I got advice from a registered dietitian. An RD has at least a bachelor’s degree in nutrition, has completed a hands-on training program in dietetics, and has passed a national examination. To keep their registration, they have to pursue continuing professional education.

The American Dietetic Association and the Dietitians of Canada have issued a position paper that argues that a well-planned vegetarian or vegan diet is appropriate for all stages of the life cycle and provides certain advantages. If your child has a weight problem, or any problem that might be diet-related, it makes sense to talk to a registered dietitian about a plant-based diet.

The appetite for food is not the only primal urge that is creating conflicts between American children and their parents. Peggy Orenstein has pointed out in articles and books that girls are being urged to be inappropriately “sexy” at earlier and earlier ages. This trend is bad enough. What’s worse is that girls’ bodies are becoming sexually mature at inappropriately early ages. Thus, girls are being plagued by powerful primal urges long before they are emotionally mature. If you think that the dinner table wars are ugly, just wait for premature puberty. The good news is that the same kind of diet that ends the struggle over food portion size can also postpone the child’s puberty to its natural age.

Polycystic ovary syndrome: the diabetes of bearded women

Polycystic ovary syndrome is a major cause of infertility among young women in the United States. It’s also nature’s way of telling women that they’re eating the wrong kinds of food. Cutting her fat intake to 10% or less of her total calories can restore the woman’s fertility and is important for protecting her health, especially if she becomes pregnant.

A woman with polycystic ovary syndrome has irregular periods or may have stopped having menstrual periods altogether. Because she seldom ovulates, it might take a long time for her to become pregnant. Besides having irregular periods, the woman may also be overweight and have acne and facial hair. The infertility, acne, and facial hair result from an excess of male hormones, which in turn result from abnormally high levels of the hormone insulin. In other words, polycystic ovary syndrome should be viewed as a mild form of type 2 diabetes. As far back as 1921, some French researchers referred to this problem as “the diabetes of bearded women” (la diabète des femmes a barbe).

Diabetes mellitus, or sugar diabetes, means that the person tends to pass large amounts of a sugar called glucose in the urine. This happens when the amount of glucose in the bloodstream has reached toxic levels. There are several types of sugar diabetes. Since the terms that Americans use for the different kinds of diabetes are confusing, I’ll use the French terms, whose meaning is obvious.

Back in the 1870s, French researchers divided cases of sugar diabetes into two general categories: thin diabetes (diabète maigre) and fat diabetes (diabète gras). Thin diabetes was a catastrophic, incurable problem that often occurred in children and young adults. These patients wasted away and died within a few weeks, regardless of treatment. At autopsy, you could usually see that something had gone wrong with their pancreas. Eventually, some Canadian researchers figured out that the pancreas of people with thin diabetes had lost the ability to make a hormone called insulin. The Canadian researchers developed a way to isolate the insulin from animal pancreases to use as a drug for human diabetics.

The development of insulin therapy was a life-saving miracle for people with thin diabetes, often enabling them to live a near-normal lifespan. However, insulin has much less of an effect on blood sugar in people with fat diabetes. Fat diabetes is a comparatively mild condition that tends to occur in overweight, usually middle-aged to elderly people. It could be cured by weight loss and exercise. People with fat diabetes can make their own insulin. In fact, they typically have abnormally high levels of insulin in the blood. Their bodies just don’t respond normally to insulin. They have insulin resistance.

Insulin acts as a key that unlocks an important door on the surface of cells. Unless that door opens, a cell cannot take in glucose. People with thin diabetes cannot make their own insulin. Unless they take insulin by injection, their cells will starve even as those cells’ favorite fuel builds up to toxic levels all around them. Although people with fat diabetes may make excessive amounts of insulin, their cells don’t respond normally to it. It takes a huge amount of insulin to pry open the doors to let glucose into their cells.

In women, the abnormally high insulin levels cause the body to produce abnormally large amounts of male hormones. Besides causing acne and facial hair, these male hormones disrupt the development of eggs in the ovary. Normally, each egg cell develops in a tiny fluid-filled follicle, which bursts to release the egg. The release of the egg is called ovulation. If the woman doesn’t ovulate, she can’t become pregnant. If the egg follicles stop developing before ovulation, these little fluid-filled cysts build up in the ovary. You can actually see them if you look at the ovary with an ultrasound machine. That’s why the condition is called polycystic ovary syndrome.

Since women with polycystic ovary syndrome seldom ovulate, it can take a long time for them to become pregnant. Doctors typically tell women with polycystic ovary syndrome to lose weight. Doctors may also prescribe a drug called metformin, which reduces the body’s resistance to insulin. Unfortunately, the metformin doesn’t solve the problem. In the long run, it may make the problem worse, because it tends to promote weight gain!

Fat diabetes results from fat: fat in the body and fat in the diet. Scientists have known since the 1930s that eating a high-fat diet causes insulin resistance. Eating a low-fat, high-carbohydrate diet restores the body’s sensitivity to insulin. If the woman switches to a low-fat (<10% of calories), high-carbohydrate (>75% of calories), high-fiber diet, she will correct her insulin resistance and will probably lose weight while eating as much as she wants. In contrast, metformin tends to promote further weight gain, which could make the insulin resistance worse in the long run.

If a woman is infertile because of polycystic ovary syndrome, metformin could help her become pregnant. However, it will not remove the cause of the insulin resistance. If the woman becomes pregnant, her insulin resistance may get worse. She may even develop a full-blown case of gestational diabetes! In contrast, a change to a healthy diet will not only help her become pregnant, it will improve her health throughout the pregnancy and increase her chances of having a healthy baby.

Photo by WarmSleepy

The Magic Realism of a Healthy Diet

Magic Realism is a literary style that explores the seemingly magical effects of commonplace things. Consider, for example, the following scene from One Hundred Years of Solitude, by Gabriel García Marquez. Melquíades is an old gypsy who normally comes to the village once a year with a group of gypsy peddlers who sell wondrous and magical goods and services, such as magnets and magic carpet rides Melquíades looks older than his true age because he has lost his teeth to scurvy. Yet one year, Melquíades shows up with his teeth magically restored. To everyone’s amazement, he can actually take the teeth out of his mouth, along with his gums, making himself look old again. He can put the teeth back in, making himself look young again.

The reader knows that there’s nothing magical about a set of false teeth. However, the villagers have never seen anything like it before. Dentures are outside the scope of their personal experience. Therefore, the transformation produced by a set of dentures seems like magic to them. Similarly, a truly healthy diet is simply outside the scope of personal experience for the average American. As a result, we think that it’s normal for people to get fat and sick in middle age. We think that it’s normal for middle-aged and elderly people to have to take a fistful of prescription medications every day. Thus, the effects of a truly healthy diet might seem magical to us.

A truly healthy diet would represent a radical change from the way that Americans have been taught to eat. When I was in home economics in sixth and seventh grade, I was taught that people are supposed to eat two servings of meat and three servings of dairy products every day. Otherwise, we’d supposedly run a risk of protein and calcium deficiency. Even today, I still see warnings against “fad” diets, which are usually described as diets that “eliminate entire food groups.” Unfortunately, the “experts” who peddle this advice are not experts in nutrition. In contrast, the American Dietetic Association has come out with a position paper that provides support for a purely plant-based diet.

A truly healthy diet for a human being would get less than 10% of its calories from fat and would be based exclusively on high-fiber plant material. It can include plenty of unrefined starches, such as potatoes, rice, or corn. In other words, people really ought to eliminate two of the “basic food groups.” Some people also need to avoid particular plant foods. For example, people with celiac disease can’t eat wheat, rye, or barley.

To see the seemingly magical effects that this radical change in food choices can have on ordinary Americans, look at the “Star McDougallers’” page on Dr. John McDougall’s Web site. Many people show how they’ve managed to reverse supposedly incurable disease simply eliminating two of the basic food groups and cutting way back on fat. It’s not magic. It’s magic realism.

Weight and Cholesterol: When Average Is Abnormal

I just discovered that I’m normal, which means that I’m way below average. I’m 5 foot 5 inches tall and weigh about 125 pounds. That gives me a body mass index of 20.8, which is normal. Yet it also means that I’m skinnier than about 95% of the American women my age. To become officially overweight, I’d have to gain at least 25 pounds. To be as fat as the average American, I’d have to gain a total of 40 pounds. To qualify as obese, I’d have to gain a total of 50 pounds.

If you live in the United States, you have probably noticed that most of the people around you weigh more than they should. That’s because you probably know, more or less instinctively, what healthy people are supposed to look like. Unfortunately, we can’t automatically recognize that some of our other measurements, such as our total cholesterol values, are also wildly abnormal. That’s because nobody has an instinctive feel for what healthy blood values are supposed to be. It’s tempting to evaluate them by comparing them to the average values for our population, but how can we tell if the average value in our population is normal or abnormal?

The U.S. federal government’s “Healthy People 2010” guidelines regarded total cholesterol of 240 mg/dL as “high” and a level of 200 mg/dL as “desirable.” Yet people are still at risk for heart disease as long as their total cholesterol is above 150 mg/dL. The last time my blood was tested, my total cholesterol was 120 mg/dL. According to statistics from the Centers from Diseases Control and Prevention, my total cholesterol level is unusually low. More than 95% of the Americans in my age-group have a total cholesterol value that’s way higher than mine. Yet I suspect that my cholesterol levels, like my weight, are normal and healthy. It’s the average person who’s dangerously abnormal.

The numbers are staggering. People whose cholesterol level is “high” by American standards (over 240 mg/dL) have more than twice as much cholesterol in their blood as I have. The average American has a total cholesterol level of about 200 mg/dL. This means that even the average person has far more cholesterol in his or her blood than I do. No wonder their arteries are getting clogged!

My blood cholesterol level may seem amazingly low, but it’s about average for someone in rural China. In the late 1990s, the China-Cornell-Oxford Project found that the average total cholesterol level in rural Chinese people was 127 mg/dL. As a result, heart attacks were rare in China. Overall, American men were 17 times as likely as Chinese men to get a heart attack. American women were about 6 times as likely as Chinese women to get heart attacks.

In some areas of rural China, coronary artery disease was practically nonexistent. A population of a few hundred thousand people could go for a couple of years without anyone under age 65 dying of a coronary. Not one person. The study didn’t analyze the causes of death among the elderly, but there probably weren’t many coronaries among people over 65, either.

Why were cholesterol values and rates of coronary artery disease so low in China? The study showed that diet makes the difference. Overall, the Chinese were eating only about a tenth as much animal protein and three times as much fiber as Americans were eating. The less animal protein people ate, the lower their cholesterol values were, and the less likely they were to die of heart disease and various cancers. There didn’t seem to be any “safe” level of intake of animal protein. Eating even a small amount of animal protein produced a small but measurable increase in risk. On the other hand, the more vegetables people ate, the safer they were.

My cholesterol values look like those of someone from rural China because I eat no animal protein but lots of rice and other grains and vegetables and beans and fruit. Anyone who thinks that this kind of diet is boring or unsatisfying has simply never had dinner at my house.

I know from reading the scientific literature on nutrition that people in the United States could dramatically improve their health and increase their life expectancy by shifting from the standard American diet, with its heavy emphasis on animal protein and its heavy load of fat, to a diet based on unrefined plant foods. This simple correction in the diet would enable people to drop to a normal weight without counting calories or limiting their portions. It would practically eliminate heart disease and greatly reduce the risk of other diseases. So why doesn’t our government tell us about this?

Worse yet, our government is still urging people to eat animal protein. Although the Healthy People 2020 goals supposedly “reflect strong science,” their dietary advice flies in the face of what we learned from the China-Cornell-Oxford study. In particular, the healthypeople.gov Web site says the following: “Americans with a healthful diet consume a variety of nutrient-dense foods within and across the food groups, especially whole grains, fruits, vegetables, low-fat or fat-free milk or milk products, and lean meats and other protein sources.” Since we know from the China-Cornell-Oxford study that eating animal protein is the major contributing cause of our major cause of death, and that there’s no safe level of intake of such foods, why in the name of good common sense is our government saying that a diet that includes these foods is healthful?