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Weight loss is the most-frequently cited New Year's Resolution, and at this time of year I always feel as if I should write an inspirational column to help people get motivated to lose weight.
But that's not what Dr. Gourmet is about.
Yes, weight loss is an important goal for many people, but there is evidence that simply eating better food (like the Asian Lettuce Wraps pictured above) will not only help you lose weight, but can also help you be healthier and live longer without losing a single pound.
If you make a resolution this year, it should be on getting healthier and not specifically on weight loss. Don't focus only on the bathroom scale - focus on simply being healthier in 2014 and this will serve you well in years to come.
Here's a recap of this past year's research that can help guide you in the coming year.
Taking Weight-Loss Supplements Could Backfire
Losing weight is not easy. Even for those who don't have significant obstacles to weight loss, like those taking certain medications or with certain conditions, it takes a certain amount of discipline to watch portion size, make healthier choices (most of the time), and exercise faithfully. So I understand why people want to take weight-loss supplements. Unfortunately, there are no weight-loss supplements that have been clinically proven to work by being subjected to large-scale, controlled human subjects trials that have been published in peer-reviewed medical journals. (It's true that one might argue that some have: they're available by prescription only.)
The True Heart Attack Proof Diet
A couple of months ago a reader asked me for my opinion of Dr. Esselstyn's 'Heart Attack Proof' diet. This is essentially an extremely-low-fat diet that completely eliminates meat, fish, dairy, and all oils, including nuts. On the one hand, we know that extremely-low-fat diets are not the magic bullet in preventing heart disease that it once was thought to be (JAMA 2006;295:655-666). On the other, adhering to this diet is extremely difficult for most people: simply avoiding any oil whatsoever (you can't use oil in pasta sauces, breads, or salad dressings, just as a start) is pretty difficult. Most of his premise is based not on solid science but interpretations of research and what we call "cherry-picking" with selection of only research that supports his theory (and it is a theory).
Taking Vitamins to Prevent Cancer or Heart Disease
In my practice we ask our patients to bring all of the medications they are taking, including vitamins and herbs or supplements, to every office visit. This is so that if a patient is seeing more than one doctor - maybe a cardiologist in addition to visiting me, an internist - we can make sure that none of the medications they are taking will interact with each other in negative ways. (Coumadin (warfarin) users should be especially careful to do this, as many medications, vitamins, or supplements will intact with the warfarin, sometimes with serious consequences.) I discourage my patients from taking most vitamins, as the research is fairly clear that for those who are not nutrient deficient or need supplementation for some other reason (like being vegan or pregnant), getting your vitamins from foods and not pills is better for you. (Here's a link to more discussion and citations.)
One idea that is drawing attention is the notion that weight maintenance requires different skills than weight loss. A few of those skills, researchers believe, include learning how to be more active in one's daily life as well as learning how to follow a healthy diet with appropriate portion sizes - with a minimum amount of effort and without feeling deprived or inconvenienced.
Exercise and Appetite
Vigorous exercise is known to reduce appetite, at least during and immediately after exercising, but what we don't know for sure is why. Researchers have looked at various hormones (known as "gut hormones") associated with appetite regulation and there does appear to be a difference in the effects of different types of exercise on these appetite-regulating hormones. But does that actually translate to an effect on appetite, and is it different for different types of exercise?
Snacking and BMI
At nearly every lecture I give about eating healthy, somebody asks about snacks. Although there's no scientific evidence that eating more frequently speeds up one's metabolism, people seem to have bought in to the idea, and so snacking, at least among my patients, has become the norm. The problem is that it sounds plausible: if it's true that your metabolism slows when you go without food overnight (actually true), then eating more frequently would speed it up, right?
Nuts and Weight, BMI, and Waist Circumference
Eating nuts in place of other types of snacks can help you lose weight, although it's worth noting that one research article does not necessarily mean certainty. What helps is what is known as a meta-analysis, in which researchers pool the results of several well-designed studies. These meta-analyses are held to yield far stronger results than those of the smaller studies on their own.