Zone Living Articles
Calorie Restriction: Why There's More To It Than Simply Weight Loss
Regardless of what you are told, the only way to lose excess body fat is to eat fewer calories. I have long talked about the benefits of calorie restriction as a way to improve your cardiovascular health thereby improving your healthspan as well. (1-3). A recent analysis of CALERIE (Comprehensive Assessment of Long term Effects of Reducing Intake of Energy), a study looking at two years of prolonged caloric restriction in healthy individuals, found this to be true in “normal weight” subjects (4). I say “normal weight” because although their average BMI was 25, their percent body fat was 33 per cent which is considered to be obese (greater than 25 percent for males and greater than 32 per cent for females). Although they tried to reduce their calorie intake by 25 percent for the two-year study, the best they could achieve was about 12 per cent. This means the calorie-restricted group was eating about 300 fewer calories per day for two years. A couple of surprising things from the study. First, nearly all the change in weight took place in the first six months with very little change in the next 18 months even with continued calorie restriction. This is typical of most controlled calorie-restriction programs like the long-term Pounds Lost studies at Harvard (5). Likewise, it appeared that most of loss of body fat happened in this same time period. At the 12 month mark, individuals had lost on average 13 pounds of fat, but more than 10 pounds of muscle mass. The loss of body fat was due to the restriction of calories, but the loss of muscle mass was due to protein restriction. Total protein intake went from an average of 102 grams of protein per day to 89 grams of protein per day. At 24 months, muscle mass hadn’t been regained, but individuals had gained back about 2 pounds of fat. Although the calorie-restricted group had lower insulin levels, the change in their fasting glucose levels was virtually the same as the control group. This is because muscle is the primary site for taking glucose out of the blood, and if you lose muscle mass, then glucose levels in the blood don’t go down even though you are consuming fewer calories. Nonetheless, those in the calorie-restricted group did see their blood pressure and blood lipids decreased. However, all of these changes occurred in the first year with virtually no changes in the second year of the study. The only parameter that continued to change in the second year compared to the first year was a continued reduction in inflammation as measured by C-reactive protein. What this means is that most of any weight loss, fat loss, reduction in blood pressure, blood lipids, as well as blood glucose levels are all likely to take place in the first six months of any calorie restriction program. That’s not encouraging news. But the continued drop in inflammation with calorie restriction is great news because that is the real cause of both a decreased healthspan as well as lifespan. This is why Zone Pro-Resolution Nutrition offers an even greater potential for health care in the future. The Zone Diet is a calorie-restricted diet, but unlike the CALERIE study the Zone Diet contains adequate protein to not only maintain muscle mass, but also to improve satiety. However, as we have shown clinically, when using the new generation of Zone Protein as a significant source of your total protein, you gain muscle mass instead of losing it (6). But the real benefit of following the Zone Diet for a lifetime is the continued reduction of inflammation that can be greatly accelerated by the addition of high-dose omega-3 fatty acids to speed up the resolution of any existing inflammation. Finally, by adding high-dose polyphenols, you can further active the gene transcription factor AMPK that repairs tissue damaged by inflammation. All of this is detailed in my new book, The Resolution Zone, that will be available shortly (7). Increasing your intake of omega-3 fatty acids and polyphenols (along with calorie restriction) can also help you finally reach the Zone. Once you're in the Zone, then you know you have done everything possible to optimize your body’s internal Resolution Response which is the real key to future of medicine. {{cta('7e36e182-1d26-4052-ae0d-23a08508788b')}} References Sears B. The Zone. Regan Books. New York, NY (1995) Sears B. The Anti-aging Zone. Regan Books. New York, NY (1999) Sears B. The Anti-Inflammation Zone. Regan Books. New York, NY (2005) Kraus WE et al. “2 years of calorie restriction and cardiometabolic risk.” Lancet Diabetes Endocrinol DOI.org: 10.1016S2213-8587(19)30151-2 (2019) Bray GA et al. “Lessons learned from the POUNDS Lost study: genetic, metabolic, and behavioral factors affecting changes in body weight, body composition, and cardiometabolic risk.” Curr Obes Rep. 8: 262-283 (2019) Johnston CS et al. “Use of novel high-protein functional food products as part of a calorie-restricted diet to reduce insulin resistance and increase lean body mass in adults: A Randomized controlled trial. Nutrients 9: E1182 (2017) Sears B. The Resolution Zone: The Science of the Resolution Response. Zone Press. Palm City, FL (2019)
Healthy Road Trip Snacks
More than 53% of Americans are expected to hit the road for their vacations this year 1. Flexibility of being able to go where you want, when you want, coupled with no baggage restraints top the reasons why 2. Part of the fun of road trips is sampling new cuisines and hitting popular restaurants, but it’s important to be prepared and plan for the unexpected. Being equipped with healthy snacks is not only handy in traffic and for “hangry” passengers, but will save you time, money, and counteract some of the inactivity and indulgences along the way. It’s pretty easy to be in the Zone even on the road. The key is to remember to always balance your carbohydrates with protein and a little fat. Here are some snack ideas from each of the macronutrient groups. Some require a cooler but others need no refrigeration. The best part is that if you have to restock and there’s no grocery store in sight, you can find many of these items in convenience stores. This list will help you know which foods to choose. Protein Greek Yogurt: With anywhere from 12-20 grams of protein per serving this is pretty much Zone balanced with the amount of protein, carbs and fat (always good to still check labels). Look for the Greek yogurt tubes which eliminate the need for a spoon and are great way to avoid messes if you’re traveling with young kids. Freeze the sticks ahead of time to help with keeping things cool. Jerky: Great protein option when you don’t have refrigeration that you can take on the go. Jerky has come a long way and you can find varieties with simple ingredients that are grass-fed, no nitrites, hormones, sugar, and low in sodium. Do try and drink water when eating them since they are a higher sodium food. Hard-boiled egg whites: Assuming your passengers don’t mind the smell of eggs, egg whites are packed with protein and low in calories. Before you go, remove the yolk and then fill with hummus, guacamole, or even nut butters. Tuna: No need for a can opener here. This comes in portable pouches for a convenient source of protein that doesn’t require refrigeration. Cheese Sticks: Both kid and adult friendly these are perfectly portioned and when coupled with lower sugar fruits (think berries, apples, pears) they make the perfect Zone snack. Deli meats: Roll-up a bunch of slices of lean deli meats for an easy and convenient protein choice on the go. Edamame: For those looking for a plant-based source of protein, edamame is high in protein, high in fiber and supplies a bunch of vitamins and minerals too. Carbohydrates Veggie Sticks (Carrots, Cucumbers, Peppers, Celery, Snap Peas): Chopping vegetables may not fit in your to-do list before leaving, so go the prepared route and grab them in the refrigerated case at the store to save yourself some time. Fruit: Although berries are one of our favorite fruits in the Zone, apples, oranges, clementines, and pears are probably the easiest fruits to bring since they don’t require refrigeration. Pouches: Fruit and vegetables squeezers are not only are great for kids but are an easy and portable way to sneak in some fruits and veggies in a no-mess way for adults too. They don’t require refrigeration, but do check the labels to ensure they don’t contain any added sugar. Baked Chickpeas: These are an easy and healthy snack you can make ahead and season to your liking if you’re looking for a snack with crunch. Preheat oven to 450 degrees F. Rinse and drain a can of chickpeas. Blot them with a paper towel to dry. In a bowl, toss chickpeas with a drizzle of olive oil (1 tsp), and season to taste with salt and pepper or seasonings of your choosing. Spread on a baking sheet, and bake for 30 to 40 minutes, until brown and crunchy. Wasa Crackers: Although we recommend keeping grains and crackers to condiment sized portions, if you are looking for some crunchy carbs, Wasa crackers are good in a pinch. Each cracker is just about 1 Zone carbohydrate block. Bread Alternatives: If you want a sandwich but are trying to avoid the bread, consider using the smaller versions of low-carb wraps or corn tortillas. Roll-up and cut into 1” pieces to make mini roll-ups you can share or swap the wrap for romaine lettuce for an added crunch. Fat Hummus: Great for dipping veggies and available in the individual containers so you can avoid the waste. Guacamole: You can find mini versions of these in the store which supply about 100 calories and 3 grams of fat (~1 fat block in the Zone) per serving. Nuts/Nut Butters: Nuts and nut butters make for a great snack choice, just be careful with your portions as they add up quick. You can find many brands selling single serve packages of nuts, but just be careful to read labels as what might appear as a single serving to you could easily add up to almost 3. Now you can find nuts in all kinds of flavors like wasabi or blueberry, but try and keep it plain as the flavored varieties generally have ingredients you should keep to a minimum, like sugar and corn syrup. Look for one or two ingredients in the Nutrition Facts max. Beverages Don’t forget to stay hydrated along the way and try to keep soda, coffee and caffeine to a minimum. Water: This is one of the best ways to stay hydrated. With so many reusable bottles that keep beverages cold for hours its easy to have a refreshing beverage and fill up again along the way. Add some lime, lemon, or orange slices for flavor. If using bottled water consider this tip from one of our customers: "I freeze bottles of water and use those instead of ice packs in a small cooler. This way you can drink the nice cold water as it melts, or refreeze them at your destination. The best part is you don’t have to cart around the ice packs once you are through."- Paula B Seltzer: A great way to get the carbonation of soda without the calories and additives. All-in-One Zone Meal/Snack Ideas Zone Shake Mix: Easy to portion out into baggies, just bring your shaker cup and grab a small container of 2% milk and you have an easy meal on the go. ZoneRx Bars: A perfectly balanced Zone snack that hits the sweet spot. References Stats: 100 Million Americans to Go on Family Vacation This Year. Available at: https://www.travelagentcentral.com/running-your-business/stats-100-million-americans-to-go-family-vacation-year. Accessed: July 17, 2019 The Great American Road Trip: Shorter and More Popular Than Ever. Available at: https://www.nytimes.com/2018/02/16/travel/road-trips-in-the-united-states.html. Accessed: July 17, 2019.
Omega-3 Fatty Acids and Blood Pressure
The FDA recently announced limited health claims for the use of omega-3 fatty acids in the treatment of hypertension and heart disease. These are qualified health claims since each of the allowed claims must carry the following language, “FDA has concluded that the evidence is inconsistent and inconclusive”. Nonetheless this indicates the FDA is beginning to acknowledge that omega-3 fatty acids have potential in the treatment of hypertension and cardiovascular disease. These health claims can only be used if a single-serving size contains at least 0.8 g of EPA and DHA. It took more than five years of study by the FDA to even allow these limited health claims as the petition for them was launched in 2014. The primary scientific document that used was a meta-analysis of various clinical trials published in the American Journal of Hypertension (1). More than 70 clinical trials were included in the analysis. Although the average reduction in systolic blood pressure by 1.5 mm Hg and diastolic blood pressure by 1 mm Hg was seemingly small, the effects in untreated hypertensive subjects was far greater (4.5 mm Hg reduction in systolic pressure and 3.1 mm Hg reduction in diastolic pressure). Furthermore, the reduction in the diastolic pressure was only observed if the daily dose of EPA and DHA was greater than 2 grams per day. Ironically, a lower dose of EPA and DHA between 1 and 2 grams per day had no effect on diastolic blood pressure. Therefore, it seems that the FDA qualified health claim would be far stronger if the minimum omega-3 dosage was greater than 2 grams per day as opposed to the stated 0.8 grams per day. Of course, there might be a problem since at those levels of daily EPA and DHA, intake of commercially available omega3s may contain too many toxins such as PCBs. The benefits of a higher dose of EPA and DHA for treating hypertension has been confirmed in more recent studies (2,3). In these studies, there were equivalent drops in systolic blood pressure at 0.7 and 1.8 grams of EPA and DHA per day, but the higher dose (1.8 grams per day) had a drop in diastolic pressure, but not with the lower dose (0.7 grams per day) (4). This differential effect of omega-3 fatty acids on risk of heart disease was illustrated in two recent trials (5,6). At a low dose of 0.8 grams of omega-3 fatty acids per day, there was no clinical benefits. At a higher dose of 3.9 grams of omega-3 fatty acids, there was a strong cardiovascular benefit. Further analysis of the high-dose omega-3 data indicated that among statin-treated individuals, the addition of the high-dose omega-3 fatty acids reduced the occurrence of a first heart attack, secondary heart attack, and total ischemic events by approximately 30 percent compared to statins alone (7). As pointed out in a recent commentary by me, the appropriate dose of omega-3 fatty acids are best measured by the reduction in the arachidonic acid (AA) to eicosapentaenoic acid (EPA) ratio in the blood (8). Unfortunately, the AA/EPA ratio was not reported in any of the hypertension or cardiovascular trials. Hopefully future clinical investigators will use the levels of omega-3 fatty acids required to reach an appropriate AA/EPA ratio (1.5 to 3) to obtain much stronger research findings so that the health claim for omega-3 fatty acids in hypertension and cardiovascular disease is not followed by the qualifier, “FDA has concluded that the evidence is inconsistent and inconclusive” . Miller PE et al. “Long-chain omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid and blood pressure: A meta-analysis of randomized controlled trials.” American Journal of Hypertension 27:885-896 (2014) Yang B et al. “Lowering effect of n-3 fatty acid supplements on blood pressure in Inner Mongolia hypertensive patients.” J Agric Food Chem 67: 184-192 (2019) Casanova MA et al. “Omega-3 fatty acids supplementation improves endothelial function and arterial stiffness in hypertensive patients with hypertriglyceridemia and high cardiovascular risk.” J Am Soc Hypertension 11; 10-19 (2017). Minihane AM et al. “Consumption of fish oil provide eicosapentaenoic acid and docosahexaenoic acid reduces blood pressure in adults with systolic hypertension.” J Nutr 146: 516-523 (2016) Manson JE et al. “Marine n-3 fatty acids and prevention of cardiovascular disease and cancer.” N Engl J Med 380: 23-32 (2019) Bhatt DL et al. “Cardiovascular risk reduction with icosapent ethyl for hypertriglyceridemia.” N Engl J Med 380: 11-22 (2019) Bhatt DL et al. “Effects of icosapent ethyl on total ischemic events.” Am Coll Cardiol 73: 2791-2802 (2019) Sears B. “Appropriate doses of omega-3 fatty acids for therapeutic results.” CellR4 6: e2578 (2018)
Weight Loss Tips Backed With Science
Chances are you know someone whose following keto, doing intermittent fasting, or onto cabbage soup and grapefruit to shed some pounds. While a quick fix might seem like the best option to reach your weight loss goals, the reality is these diets can be hard to follow over the long-term and some can do more harm than good. The secret to weight loss is finding something you can stick with while keeping the weight off for good. Here are 8 science based tips you can start now that will help you reach your goals without landing you back where you started. Eat Protein: Crash diets that don’t contain adequate protein won't work even if they might produce some initial changes on the scale. Not only will they make you hungry and fatigued, but you end up losing muscle mass which makes it harder lose weight in the future. If you want to cut back on calories, don’t do it at the expense of protein. Make sure that every meal and snack has adequate protein about 25 grams for meals and 7 grams for snacks. This will keep hunger in check while ensuring you don’t lose your muscle mass at the same time. One more fun fact is that studies have shown that starting your meal with your protein choice first dramatically reduces hunger levels. Calories Do Count: Our overestimation of how much we are eating can make all the difference when it comes time to weigh in. Calorie restriction has been shown to activate AMPK, an enzyme important in energy metabolism. Higher levels of AMPK have been associated with numerous health outcomes, one of which is reduced abdominal fat. Curb Hunger with Fermentable Fiber: You can still cut back on calories without having to feel deprived. Processed carbohydrates (breads, pastries, cereals, starchy snacks and sweets) are easy to over consume and quickly add up. Instead, replace these foods with those rich in fermentable fiber like vegetables and fruit. Fermentable fiber improves the release of hormones in the gut tied to satiety. This hormones send signals to our brain that we're full. Just remember as your bump up your fiber intake to increase your water consumption too. This will ensure better digestion and keep everything moving as it should. Keep Insulin in Check: We often blame carbs as the reason for our weight gain, but in actuality it is constantly elevated insulin levels that makes us gain weight, and keep the weight on. Inflammation is at the root of high insulin levels, also known as insulin resistance. The best way to keep insulin levels in check is to lower inflammation by ensuring you have the right balance of protein, carbohydrate, and fat at every meal and snack. Stay Hydrated: Having a broth based soup as an appetizer or 16 ounces of water may help to curb how much food you consume during your meal. Try and keep a water bottle on your desk, in your bag, or when dining out finish your glass before your appetizer or entrée arrives. Keep Healthy Foods on Hand and in Sight: Having a supply of healthy snacks on hand allows us to make better decisions throughout the day. Small frequent meals every 3-4 hours that are balanced in protein, carbohydrate and fat help maintain stable blood sugars throughout the day making us less inclined to indulge should the opportunity come our way. Log it: There are so many apps for tracking what you eat and some of the features from scanning barcodes, syncing with your Fitbit, to online communities for support are great for accountability. That said it doesn’t matter whether you use a pen or paper or an app of your choosing. The data is clear that if you log it you’re less likely to overeat and that’s a good thing. Try the Zone Food Journal. Rev Up Your Workouts: High intensity interval training (HIIT) helps to burn more body fat as its been shown to increase AMPK activity. HIIT is based on doing intense bursts of exercise followed by an active recovery to keep your heart rate up and burn fat quicker. Not in your wheelhouse? It doesn’t take cutting edge fitness trends to make it work for you. Find an activity you enjoy doing and stick with it. Consider incorporating both strength training and cardio so you can maintain and build muscle while you torch calories too. Making simple changes based in science is the most successful way to lose weight and keep it off. Just make sure your changes are simple, sustainable and fun. That’s the formula for success. {{cta('f794fdb4-e128-4289-b30c-cba36c1ddb7d')}}