Dispelling the Myths

The title of this post is the title of the seminar taking place next Saturday, May 19th, in Phoenix, featuring speakers Dr. Helen Hilts and Dr. Ben Bocchicchio.  For anyone in the local area or neighboring states that is interested in treating diabetes, has diabetes, is looking to lose fat, has little time for exercise, or is looking for help with dietary habits, this seminar will provide information that will help you.  Here is the text from the flyer:


Learn what your doctor doesn't know about diabetes, weight loss, exercise and diet.  Dr. Ben will explain why we get fat, why aerobic exercise can't work, how cutting fat from your diet will make you fatter and wy less exercise creates more results.

Guest speaker and recognized diabetes expert, Dr. Helen Hilts, M.D. will discuss the causes, management, and reversal of diabetes, and how diet plays a key role in fighting this disease in adults and children.


Dr. Ben Bocchicchio has two PhDs in exercise physiology and is one of the brightest minds that I have come across in the exercise field.  I have met with Dr. Hilts several times and her use of nutrition instead of medicine to treat diabetes has led her practice to become renown in the Phoenix area.

The seminar is free and will take place from 10 A.M. to 12 P.M..  The address for the lecture hall is 2398 E. Camelback Road, Phoenix, AZ 85016.  I will be introducing both speakers.  If we have not met before, please come introduce yourself to me after the lecture as I would love to meet any of you who follow Health-Actualization.

Predicting Future Disability

I cringe every time I see a senior on a scooter (such as the one above).  Some seniors are disabled to the point where a motor scooter, walker, or other travel aid is necessary, but these tools are all merely palliative; they deal with the symptoms of the problem, but they don't solve the actual problem.  Decreasing movement will not help solve the difficulties one has with moving.  While fixing the movement difficulties is a great topic in itself, let's think one step ahead: what if we could predict future disability, therefore allowing us to take preventative actions?

The Chair Stand Test

The Chair Stand Test (CST) is a simple test primarily focusing on the major muscles of the lower body: the quadriceps, hamstrings, and gluteus maximus.  It is performed by seeing how many times an individual can stand from a standard chair (perhaps the chair at your dinner table) in 30 seconds, without the use of an aid or the arms (arms should be crossed).  The muscles used in performing this test are the essentially the same muscles and muscle groups that we use to run, walk up stairs, and perform many other activities of daily living.  While this test may sound easy to you, over 20% of 1,122 seniors in their 70s were unable to stand five times [1]!

The CST is a useful because it is effective in determining risk of future disability.  One study assessed seniors four years after completing a CST [1].  When the CSTs were conducted, all subjects were free of disability.  The subjects were then broken up into four groups based on test score, with Group 1 having the poorest scores while Group 4 had the most stands.  After four years, 79% of Group 4 were disability free, as compared to 67 and 60% in groups 2 and 1.  Group 1 also had about twice the amount of mobility disorders that group 4 did.  CST scores also predicted the risk of falling in two studies [2, 3].

Use of the CST and Scores

I urge you to give the CST a try, especially if you fit into one of the age brackets below.  The test only requires effort, 30 seconds, and a chair similar to that generally found at dining room tables.  Remember to keep your arms crossed during the test, ensuring valid results.

According to the Senior Fitness Test Manual by Roberta Rikli and Jessie Jones, here are the minimum desired stands during a 30-second test (obviously you should strive to go well beyond the minimum):

60-64 years: 12 (women), 14 (men)

65-69: 11, 12

70-74: 10, 12

75-79: 10, 11

80-84: 9, 10

85-89: 8, 8

90-100: 4, 7 

Keep in mind that the CST test is an indication of risk based on associations.  The associations could be explained by those who score better having better exercise habits at the start and through the duration of the study.  Regardless, if you score poorly on the CST,  look at it as added motivation to to improve lifestyle habits, specifically through a strength training program.

Is It the Lifestyle or the Fat?

Tell me if this sounds familiar: person starts an exercise program and changes his/her diet.  After a few weeks or months, he or she loses a noticeable amount of weight.  After seeing the results of the next blood test, the doctor commends the person for major health improvements (for blood glucose, blood pressure, triglycerides, etc.).   

Sounds like a great story...but why did the health markers improve?  Does health improve because of the fat loss or the lifestyle changes (diet and exercise)? 

Obviously they can both be responsible to some extent, but let's determine what the majority cause is.  If you believe fat is the primary determinant of health change, then reducing body fat without a change in lifestyle should make noticeable improvements to health.  If you side with lifestyle, then exercise and diet without weight loss should be very effective in improving health.  I'm going to use those scenarios to answer the question.

Fat Loss Without Lifestyle Change

How does one lose fat without a change in lifestyle?  Liposuction.  An average of 22 lbs. of fat was removed from 15 obese women [1].  Seven of the women had diabetes.  The women were assessed 10-12 weeks after the procedure.

The results: at the assessment period, the non-diabetic women had 20 fewer fat lbs. than their pre-liposuction weight, while the diabetic women went on to lose another pound of fat (totaling 23 lbs. of fat lost).   Diabetic or non-diabetic, the women has no changes in insulin sensitivity, blood pressure, blood glucose, cardiovascular inflammation, or blood lipids ("cholesterol").

Lifestyle Change Without Fat Loss

In regards to exercise, many studies lasting weeks or even months have led to little or no weight loss.  One study put 58 overweight or obese men and women through twelve weeks of aerobic exercise, five times per week [2].  Using the amount of calories expended per session, the researchers predicted a specific amount of weight loss for each individual.  26 of the 58 failed to hit their weight loss predictions.  However, despite losing only about two pounds (versus an average over 10 pounds for the other 32), the 26 that fell short had greater decreases in systolic and diastolic blood pressure.  In another study, overweight women, ages 24-44, strength trained for a year and experienced no change in weight [3].  However, their arteries improved greatly in ability to dilate with increased blood flow, which translates to a decrease in risk for heart disease or stroke.  Overall, without weight loss, both aerobic exercise and resistance training can reduce blood glucose and blood pressure [4].

One study was designed to look at health changes from diet without weight loss [5].  The study examined the effects of a DASH diet on blood pressure without changes in sodium or weight.  The DASH diet stresses a high amount of fruits and vegetables and calories were increased anytime weight was lost from week-to-week.  The study lasted eight weeks and included 459 people.  At the end, subjects with high and normal blood pressures improved (-11.6 and -3.5 mmHg).

The Importance of the Distinction

Why is answering this question important?  Am I just wasting your time by arguing technicalities?  No, not at all.  This is a very important distinction because exercise and a healthy diet fail often in producing the desired amount of weight loss.  In fact, sometimes exercise without a diet change can lead to weight gain.  However, weight change and health improvement are not always linked with each other, and starting an exercise program or adopting a better diet will improve health.  For those of you who don't see the physique changes you seek with a healthier lifestyle, don't quit; you are receiving a much greater benefit: better health.  Don't stress over your weight: focus on your habits.  "Losing a few pounds" and "improving my health" are not synonymous phrases.

Nutritional Differences with Grass-Fed Meat

Back from a three-week hiatus!  Thanks for your patience.  My schedule has been demanding over the past few weeks, but you'll definite hear from me more often this summer.

Anyway, I recently heard about this story, reported by talented Arizona Republic writer Cathy Creno, about a fugitive cow in Ahwatukee, AZ during the summer of 2010.  Apparently the cow escaped from a farm in June and was able to allude potential corrallers until August.  During her independence, the cow walked around neighborhood streets, lounged under trees, drank water from a small stream in south Phoenix, and ate grass in the neighborhoods near the local mountain preserve. 

Not surprisingly, the fugitive cow survived on grass, her natural source of food.  However, the majority of red meat consumed in the US comes from cows raised on grains, soybeans, and corn.  Does it make a difference in the quality of our meat, and if so, how significant is the difference?  I'm going to break it down in segments of the differences found through research.

Total Fat and Type of Saturated Fat

For people who avoid red meat due to its high amount of calories from fat, grass-fed may be for you.  Grass-fed red meat has less total fat than cows raised on grains [1].  The amount of saturated fat is the same.  However, the type of saturated fat isn't the same, and the difference is critical.  Grass-fed saturated fat has more stearic acid and less palmitic acid [2].  If that means absolutely nothing to you, then allow me to explain.  

All fat is made up of fatty acids, much like protein is made up of amino acids.  Fatty acids vary in composition and effect on the body.  Palmitic acid, which is found less in grass-fed meat, is known to increase blood cholesterol [1].  On the other hand, stearic acid has no effect on blood cholesterol levels.  Therefore, grass-fed red meat is a better choice for people trying to limit their total fat or who are worried about increasing cholesterol.

Omega-6 to Omega-3 Ratio

If you take a fish oil pill, then you are trying to improve your omega-6 to omega-3 ratio.  As I have said before, omega-6 fatty acids aren't inherently bad and omega-3s aren't inherently good [3].  The problem is that people generally eat so many omega-6s and so few omega-3s that the ratio is poor and leads to blood clots and a higher risk of heart disease and some cancers [4].  Also, low omega-3 intake is linked to high rates of depression and suicide.  Grass-fed meat offers an average ratio of 1.5:1, whereas grain-fed meat features a ratio over 7.5:1 [1]!

A Healthy Trans Fat

Yes, there is a healthy trans fat.  Trans vaccenic acid is a fatty acid found in monounsaturated fat.  Unlike the trans fat you see in many peanut butters, baked goods, and other processed foods, trans vaccenic acid is not chemically altered and does not increase risk for cardiovascular disease [2].  Trans vaccenic acid is used in the body to create conjugated linoleic acid (CLA), which decreases the development of cancer cells, arterial plaque, and diabetes [1].  Grass-fed red meat has more trans vaccenic acid and two-to-three times more CLA than conventionally-fed cows.

Other Benefits

In addition to less total fat, healthier saturated fatty acids, a much better omega-6: omega-3 ratio, more trans vaccenic acid, and more CLA, grass-fed red meat has over four times more vitamin A and at least double the vitamin E of that found in grain-fed meat [1].  Also, fat from grass-fed meat is more resistant to oxidizing, meaning the fat has a higher resistance to becoming toxic and dangerous to cardiovascular health [4].

 Final Thoughts

There are clearly a number of benefits to eating grass-fed meat.  So the question is, why wouldn't you purchase it?  I can come up with three reasons: more expensive, harder to find, and taste.  In regards to price, ground grass-fed meat is much more affordable than buying steaks and is around $6/pound in Arizona.  A few national and regional chains carry grass-fed meat, including Whole Foods, Sprouts, Trader Joe's, Fairway, and Fresh and Easy.  Regardless of where you are, you can order from U.S. Wellness Meats and have it sent to you.  

As far as taste goes, some have said that grass-fed meat has a hint yellow to it, perhaps making it slightly less appetizing.  The yellowish color is due to the higher content of vitamin E [1].  Also, a few have said that it is a little tougher to chew.  Buying ground meat is an obvious and easy way to circumvent this problem.

For those of who you haven't tried grass-fed meat, I recommend giving it at least one shot.  Buy a steak or a pound of ground meat and prepare it as you would with any red meat.  If you care about your health and diet, then grass-fed meat is a far superior option.  For those of you who have tried it, feel free to leave a comment with your own experiences.

Using Protein for Weight Loss and Muscular Improvement

In my last blog, I mentioned that the tail end of my weight loss was partly due to increasing protein intake [1].  This idea came from the results of a few studies I reviewed recently.  As most people would guess, protein helps improve muscle mass, but it also has key effects on fat loss.  Exactly what does the protein do?  How much should you consume?  Keep reading.

Effects of a High Protein Diet

1. Higher Total Weight/Fat Loss: Subjects who strength trained and ate one-third of their calories from protein lost 12.7% of their total body weight and about 25 lbs. of fat in a 16-week study [2]. In the same study, subjects who strength trained and ate about one-fifth of their calories from protein lost 10% and about 18 lbs.  Both groups were on a low calorie diet and consumed about the same total amount.  Another study compared a carbohydrate:protein ratio of 1:1 versus a ratio of 3:1 (more carbs, less protein) in combination with a circuit training routine of strength and aerobic exercises for obese/overweight women over 12 weeks [3].  All diets were designed to create a 500 calorie deficit.  The group that ate more protein and less carbohydrates lost over 15 lbs. vs. 8.8 for the lower protein/higher carb group.  A third study, this one also with obese women, looked at an exercise routine of walking and strength training in combination with differing amounts of protein and carbohydrates[4].  The high protein group (102 grams of protein and 127 grams of carbs per day) vs. a high carb group (57 and 202).  The amount of calories and fat consumed were very similar.  The high protein group lost the most weight and, by far, the most fat (about 19 lbs).  (Note: the studies mentioned in this paragraph mainly involve differing amounts of protein.  However, carbohydrates and fat vary in each of the studies to ensure equal caloric intakes, so it cannot be said with certainty that protein is mainly responsible for the changes discussed).
2. Optimal Muscle Growth: This may be obvious, but protein allows for your muscles to grow to their optimal level.  If you are not consuming enough protein to meet your needs, muscle growth in response to strength training will be limited [5].  
3. Muscle Retention During Weight Loss: Not only does a higher protein intake lead to greater weight loss, but it also leads to better retention of lean mass (i.e. muscle) [4,5].  Think of this in terms of your own weight loss goal (if this is a goal of yours): do you want to lose both muscle and fat, so you'll be leaner but with the same muscle "tone" that you currently have?  Or...do you want to retain your muscle and mainly lose fat, leading to both a leaner and more muscular appearance?  Every time I have posed this question to new clients, they have chosen the latter scenario. 

Recommended Intake 

Intakes are generally recommended in terms of kilograms of body weight.  To calculate your weight in kilograms, divide your weight in lbs. by 2.2.  As for how much you should be taking, one research review suggests consuming 1.2-1.8 grams per kilogram of body weight per day [6].  Another study found 1.4 grams per kilogram of body weight per day to be sufficient [5].  These recommendations are for individuals who are active, especially those who strength train (I will not discuss recommendations for sedentary individuals since I don't believe sedentary is a natural or healthy state).  Using 1.4 grams per kg. per day as a minimum, here is what it looks like for 100, 150, and 200 lb individuals:

• 100 lb. person = 45.5 kg.  Recommended Intake (RI): At least 64 grams per day.
• 150 lb. person = 68.2 kg. RI: At least 96 grams per day.
• 200 lb. person = 91 kg. RI: At least 128 grams per day.

Honestly, I think even these recommendations are low, but research has shown 1.4 to be as effective as 2.4 grams per kg. per day in aiding the growth of muscle (5).

Protein: Final Notes 

While 1.4 grams can serve as a minimum for the general population, some populations need even more protein to avoid deficiency/muscle wasting.  Some of these populations are people on low calorie diets, those starting a strength training routine, vegetarians, elderly, and people with eating disorders [6]. 

A major reason why increasing protein likely leads to weight loss has to do with its general inability to support the process of storing fat.  Only two amino acids (leucine and lysine) could support a meaningful amount of conversion to fat [5].  Therefore, excess protein is generally broken down for other uses or just excreted out of the body through urine. 

With all of this in mind, I support increasing protein intake to help with weight loss, muscle retention during weight loss, or muscle gain when calories aren't restricted.  Greater amounts of protein can be taken in through eating more red meat, poultry, fish, or eggs at each meal.  All of these provide about seven grams of protein per ounce/egg.