Sunday, September 30, 2012

Is organic food better for you?


Is organic food better for you?

Organic food sure costs more but is it worth the extra cost?

Is organic food more nutritious than conventional food?

Is organic food safer?

Two recent studies addressed these questions. One study published in 2010 asked whether there were nutritional related health outcomes from eating organic foods. They examined over 50 years of studies. They found no evidence of benefit from organic foods as compared to conventional.

A study published this year examined the question of safety and nutritional content of organic foods versus conventional foods. This rigorous analysis looked at 223 studies of nutrient and contaminant levels in organic and conventional foods.

Although a previous study  of produce had suggested better content of micronutrients in organic produce as compared to conventional, this more extensive analysis showed no benefit in terms of nutrients in any organic foods.

Organic certification varies by country. The process is complicated and burdensome. 
The United States Department of Agriculture (USDA) has a long, complex set of requirements.

Synthetic pesticides cannot be used. So it is no surprise that this recent study concluded that there is less pesticide residue on organic produce as compared to conventional produce. 
The differences were quite small however.

The USDA has a National List of Allowed and Prohibited Substances for the National Organic Program. Only certain fertilizers can be used. There are many other restrictions.

Perhaps because of the restriction on fertilizer use,  organic farms have lower crop yields than conventional.
The need for more land would mean more deforestation to grow crops and less biodiversity. 
So you might feel better about the environment if you buy organic, but organic foods are in some ways actually less eco-friendly.

Poor people with small farms in developing countries are likely to do all they can to maximize yield. Organic farming is not for them. Maybe organic farming is more for wealthier countries and those with ample land.

As for produce, almost all of us should try to consume more fresh produce.
Those on a tight budget should not buy the more expensive organic produce.

So there is no good evidence thus far that organic foods are worth the extra price.
I would advise that you have the money and prefer organic foods, for whatever reason, go ahead buy organic.   

But don't feel holier or healthier if you do! 

What do you think? Am I wrong? Let me know.

Dan Weiss MD CDE FACP PNS CPI




Sunday, September 23, 2012

How do I lose a pound?


How do I lose a pound?

For many years we were told that you if you consumed 3500 calories less each week you would lose 1 pound every week. That meant, eating 500 calories less each day and you would lose one pound every week.
Or if we exercised to expend 3500 calories more each week we would lose a pound that way.
Many dietitians and doctors still use those estimates.

Well it turns out those estimates are frequently way off.
One reason for the inaccuracy of those estimates is that our metabolism changes as we lose weight. Lots of things change over time. Our bodies are not static; they are dynamic.

Now sophisticated mathematical models allow for more accurate estimates of body weight changes with changes in calorie intake or physical activity.
These dynamic models factor in changes in our metabolism as weight is lost.
The previous static models failed to do so.

Much of this is the work of physicist Kevin Hall .
Dr. Hall received the Lilly Scientific Achievement Award at the annual scientific meeting of The Obesity Society this year.

Dr. Hall’s dynamic model showed that a 20% tax on sugar-sweetened beverages would lead to a trivial amount of weight loss. A static model vastly overestimates the weight that would be lost.

You can access the online body weight simulator here.

Are you working on weight loss? Are you counseling patients?

Access the body weight simulator for guidance. 
Now you know how to lose a pound. 
Are you surprised by the results?


Dan Weiss MD CDE FACP PNS CPI


Sunday, September 16, 2012

Does Calorie Posting on Menus Reduce Calorie Intake?


Does Calorie Posting on Menus Reduce Calorie Intake?

McDonald’s recently announced that they would post calorie content of their foods on their menu boards. The so called Patient Protection and Affordable Care Act (PPACA), un-fondly known as Obamacare, mandates that chain restaurants with 20 or more locations post calorie content on their menus. That mandate takes effect in 2013.

So how about it?

Does calorie posting on menus reduce calorie intake?

A study in 2006 indicated that calorie labeling would be either misunderstood or unused. 
A recent critical analysis of published studies on fast food restaurants concluded that the data do not show reduced calorie intake from calorie posting on menus.

Two recent randomized trials were too brief and not real world.  One of these was performed by a vocal proponent of government intervention and showed positive results. The other study showed no benefit

In 2008, New York City required posting of calorie content on menus for all restaurant chains with locations in the city. The only study since then to determine the effectiveness of this regulation showed no impact on calorie intake.

In fact, posting calories on menus in fast food restaurants may actually do more harm than good. Some financially strapped customers may choose the most calories for their dollar. Others may be more anxious and conflicted seeing the calorie content of their food.

Assorted online responses to the McDonald’s announcement were really worth reading.

So, like most government mandates, this one does not have the science or data to support it.  

Those persons ready and motivated to lose weight or those trying to control their weight can choose smaller portions and lower calorie items.

All others are likely to say like one online responder: “just leave us alone”.

What do you think?  Are you surprised by these findings?
Share your thoughts and comments.

Dan Weiss MD CDE FAPC PNS CPI









Sunday, September 9, 2012

Does Sensa Work?


Does Sensa work to help people lose weight?

Those Sensa ads sound amazing!

Sensa is a combination of three chemicals: maltodextrin, tricalcium phosphate and silica.

I have no doubt that that those substances are safe; they’re in hundreds of foods.
And all three of these substances are considered safe by the FDA.

The question is how can these simple substances make you eat less?
How can sprinkling this stuff on food make you lose weight?
And you don't even have to exercise or change your diet! 
Those pounds just drop off.
Is this some kind of miracle? How come no one else thought of this?

After all, appetite and weight control are very complex.

Dr. Alan R. Hirsch, is a neurologist and the so-called creator of Sensa.
He states on his website that he also supports a healthy diet and exercise.
That’s a sensible recommendation. I was pleased to see that. 

But even without efforts to change diet or increase exercise, Sensa is claimed to reduce your appetite. Sensa is supposed to make you feel satisfied with less food.

But where are the clinical trials proving the benefit of Sensa on weight?

Well it turns out that no clinical trials have been published.
Dr. Alan R. Hirsch’s 20 or so published articles show up.

But what a surprise!
I could not find any reports of clinical trials on Sensa or on weight loss co-authored by this creator of Sensa.

If this stuff is so great, Dr. Hirsch, let’s see the scientific evidence, .
Publish the trials in a peer-reviewed journal. Post them on your website.
Let other independent investigators try to reproduce your results.

So why can’t we find published results of clinical trials using Sensa?

Now I could be wrong but I think the answer is quite simple. 
Sensa does not work.
Sensa is no miracle.
Sensa is a scam. 
Sensa is a fraud.
The FDA should take note.

What do you think? Have you lost weight?
Have you tried Sensa? Did it work for you?
Did you try to reduce food portions too? How about exercise?

I'd like to know. Leave a comment. Share your thoughts.

Daniel Weiss MD CDE FACP PNS CPI

Sunday, September 2, 2012

How much protein do I need during weight loss?


How much protein is needed for safe weight loss?

Adequate protein intake is important especially during weight loss.
Eating enough high quality protein reduces the chance of serious life threatening problems during weight loss.

But how much protein is enough?

Protein intakes of 1.1 gram per kilogram of “ideal body weight” are a good minimum protein intake
This amount of protein is more than you would need if you were not trying to lose weight..

Okay so how do you calculate that protein intake?

Here’s a simplified approach:

Find out your weight if your body mass index or BMI is 24.

A BMI of 24 is a reasonable estimate of your “ideal body weight.”

Here's a table for BMI.

So let’s say, you weigh 226 pounds with a height of 5 feet 7 inches.
If you had a BMI of 24, your weight would be 153 pounds. You find that in the table.
Now divide your weight in pounds by 2.2. This gives you your weight in kilograms.

153 divided by 2.2= 69.5 kilograms.

69.5 X 1.1= 76 grams of protein daily.

So in this example while you cut down on calories you should try to get about 76 grams of protein each day.

Good protein sources include:
Fish
Shrimp
Lean Beef
Lean Chicken or Turkey
Lean Pork
Tofu and edamame
Skim milk and low fat cheeses
Eggs

And don’t forget regular exercise. Exercise helps reduce muscle loss too as you lose weight.
A visit with a registered dietitian can help get you started on safe healthy weight loss.