Skip the Sip: Why you should keep the fruit but ditch the juice

Juice seems to be everywhere in the American diet, from apple juice at kids’ snack time to orange juice on every breakfast table.  While I love the taste of juice as much as the next guy, when it comes to health, I know that choosing an actual fruit is the way to go. (and yes, this includes 100% fruit juice).

Here’s the deal: nature packages fruit in the perfect way by combining sugar with tons of fiber.  Yes, you’re consuming some simple sugars, but by slowly consuming it along with slow-digesting fibers, you also slow down glucose absorption and minimize blood sugar spikes. When we instead take a fruit, squeeze out the sweet juice, and discard all of that wonderful fiber, we wind up absorbing way more sugar in a fraction of the time.  This leads to blood sugars that climb too quickly and go far above the desired limit. If you have pre-diabetes, diabetes, or insulin resistance, this is exactly the type of sugar overload you want to avoid.

A large orange, for example, has ~15 grams of sugar mixed in with 4.5 grams of fiber, and it will probably take a while to eat. Your standard 12 ounce single-serving bottle of orange juice, on the other hand, has about 35 grams of sugar and no fiber– and most of us could drink that in a few minutes!  Think about what a difference that makes for your blood sugar spikes.

Here are my tips for avoiding the fruit juice sugar spike:

  • If you just can’t kick the craving for juice, try diluting it to cut the sugar. Mix with water for a milder flavor, or try mixing with seltzer for a bubbly alternative.
  • Don’t be fooled by the healthy sound of “100% fruit juice”– although they may be pure natural juice, they are still incredibly high in sugar.
  • There are lower-sugar juice available on the market if you’re comfortable consuming non-nutrative sweeteners (aka artificial sweeteners without calories). Always check the label, though, to see just how much lower the total carbohydrates (which includes sugar) will be.
  • If you’re used to drinking juice with certain meals/snacks, try substituting it with fruit if cutting it out cold turkey sounds too ambitious.  If you like juice with breakfast, swap it for a small fruit cup, add berries to your pancakes or cereal, or slice up an orange for that same OJ flavor. If you usually choose juice for something sweet on the go, try a more portable fruit like grapes, clementines, or apples.
  • Juice can actually be a better alternative than other sweeteners if you’re using it as an ingredient in place of table sugar or corn syrup, as you will still get some vitamins and minerals from juice but not from straight sugar. Try substituting a 100% fruit juice concentrate like apple or grape for granulated sugar in your baked goods, keeping in mind that the sugar content may be similar but the nutritive value is a bit better.  You’ll likely need ~6oz juice for every 1 cup of sugar, and a bit less liquid as even juice concentrate contributes liquid.

Happy New Year: Crafting a Realistic Resolution

“New Year, New You!”
“This year, I’m going to be healthy!”
“My New Year’s diet starts today!”

New Year’s is the perfect time to hit the reset button — a fresh year represents a new start where you can commit to self improvement.  I love the idea of establishing a New Year’s resolution to help kick start your healthy changes, but it’s hard to overlook the tendency of resolutions to fizzle out by the end of February.

To stretch the lifespan of your resolution and create a long-lasting behavior, try making it a very specific goal.   The solution lies in a classic goal-setting acronym S.M.A.R.T. Specific, Measurable, Attainable, Relevant, Time-Bound.  By tailoring your resolution

  • Specific: Define what actions you need to do to achieve your goal
    • If your overall goal is to be healthier, ask yourself HOW you will do that. Perhaps you want to eat more vegetables, less fast-food, or fewer refined sugars.
  • Measurable: How will you measure your success?
    • Avoid just stating you’ll do something “more” or “less” (work out more, eat more fruit, drink less coffee) and instead add a defined target goal, like eating at least 1 serving of fruit a day or going to the gym 3 times a week.
    • These concrete numbers will help you keep better track of your progress by giving you a reference point.
  • Attainable: Set goals you can realistically achieve
    • This is a huge part of setting successful goals- choose something that is challenging but doable, to make sure you can see it through.
    • If you haven’t touched a vegetable in years, it would be ambitious to say you’ll eat 3 servings of veggies every day. If you try to add one serving per day, though, you may stick with it much longer.
    • Similarly, you’re more likely to stick to “cutting back” than you are to “cutting out” foods or behaviors that aren’t particularly healthful. This will lead to sustainable behavior change so you can turn your resolution into your new norm.
  • Relevant: Is this goal going to help you achieve your big picture goal?
    • Here’s the key question: Will the specific goal you’re setting help you achieve the overall desired outcome?
    • If the answer is yes, then you’ve set a goal that aligns with your overall vision of health (relevant!).
    • If the answer is no, then your focus may have shifted throughout the process, so center your attention back on what it is you really hope to achieve.
  • Time-Bound: Factor in frequency or deadlines for your goals
    • There is no right or wrong timeline for a goal– it is entirely up to your current habits and your desired outcomes.
    • You might resolve to start eating at least one vegetable per day, one vegetable serving per meal, one new vegetable each week… They’re all worthwhile goals with a timing-specific limit (per day, per meal, each week).
    • Defining this aspect of frequency will help you be consistent, keep track of your actions, and know whether or not you’re hitting your target.

If you make your goals S.M.A.R.T, you will be able to gauge your success, stay dedicated, and hopefully see your resolution through for the year to come!

Wishing you a very happy, healthy 2019!

Why Your Diet Doesn’t Work: The Imprecise Science of Caloric Balance

“Want to lose one pound of fat? Just cut 500 calories from your diet each day and you’ll shed one pound per week!” We’ve all heard that sensationalized claim before, and if it sounds a bit too good to be true, that’s because it is. This math is based on the premise that it takes exactly 3500 calories to burn one pound of fact, but that information itself is inherently flawed.

Weight maintenance is essentially a function of our basal metabolic rate, or BMR: the amount of calories your body burns daily just to survive. Just like it takes more energy to power larger machinery, it takes more calories to feed all of the cells in larger or heavier people– so they naturally have higher BMRs. If you were to lie in bed for 24 hours without any activity or intake, after fasting for at least 10 hours, your BMR is the number of calories your body would burn.

We can estimate our BMR with equations like the Harris-Benedict and Mifflin St Jeor equations, which take your height, weight, age, and gender into account. If you’ve ever tried to calculate your calorie needs online or via app, they probably use these equations.

The only way to actually measure your BMR, though, is through ‘calorimetry‘ (which literally means ‘calorie measurement’); direct calorimetry requires you to stand in a specialized chamber that measures how much heat your body is producing (impractical for most people), and indirect calorimetry can use respiratory tests to measure how much oxygen you inhale and carbon dioxide you exhale over a set period of time (somewhat more practical and actually available at some fitness and medical centers).

Of course we don’t just lie in bed all day. When we factor in our daily activities, we can find our Total Energy Expenditure (TEE), which means how many calories you burn on a typical day doing your usual activities. This is about 20% higher than your BMR if you are mostly sedentary to up to 90% higher if you are a professional athlete. Most people who are moderately active (1-3 days of intentional physical activity or exercise) burn about 38% more calories than their BMR.

This is where the error happens: It is very difficult to know how many calories you truly burn in a day. According to predictive equations, as a 5’4″, 27-year-old, mildly active, average weight female, my estimated BMR ranges from 1360 calories (Mifflin Jeor) to 1430 calories (Harris-Benedict), and my TEE should be about 1630 – 1720 calories daily.   I actually had indirect calorimetry done at a local gym last year, however, and my results showed that a better estimate for my BMR is 1123 calories and my TEE is close to 1350 calories.

That’s about 20% fewer calories fewer than traditional estimates- meaning that my body needs way fewer calories than the textbooks tell me.

Moving onto the second major issue: the 3500-calorie rule just doesn’t seem to be true.

This number came from a 1950s study by Max Wishnofky called “Calorie Equivalents of Gained or Lost Weight,” which posits that one pound of fat would require about 3500  calories to burn based on the scientific principles of fat. (If you’re interested in the gritty details: 1 pound (454 grams) of fat cells contains about 87% actual fat, and since it takes about 9 calories to burn one gram of fat, than a whole whole pound (454 grams) should burn up using about 3700 calories).  If you took a literal pound of fat and threw it into an incinerator to measure how much energy was required to literally burn it, that might be accurate. However, it doesn’t take our physiology into effect, and for better or for worse, our bodies are extremely adaptive at trying to preserve our energy stores.

Wishnofsky also examined a 1930s study by Strange, McCluggage, and Evans (“Further studies in the dietary correction of obesity”) which essentially starved for weight loss and found that they lost 0.6 pounds per day with a 2100 calorie deficit. How would one have such a severe deficit, you ask? They were put on a 360 calorie diet.

  • The diet: 360 calories made up of lean steak, fish, egg whites, whole milk, orange juice, yeast, minimal vegetables, and salt contributing ~58 grams of protein, 14 grams of carbohydrates, and 8 grams of fat each day. By today’s medical standards this would be a study of intentionally invoking severe malnutrition.
  • The participants: only 13 patients participated, and they were all in a hospital setting. Their weight ranged from 180 pounds to 427 pounds at the start of the study.
  • The outcomes: everyone obviously lost weight – the average was 35 pounds over 59 days. This was VERY inconsistent, though: actual weight loss ranged from 5 pounds over 8 days to 104 pounds over 176 days. 

This very small data pool based on a severe starvation diet showed that people lost about 0.6 pounds with a 2100 calorie deficit each day – making the weight loss ratio 1 pound to every 3500 calories. The 3500 calorie rule is based on these 13 people, severe starved for anywhere from a week to 25 weeks. 

I think this just exposes a truth we all know deep down inside: it’s just not that simple. Reviews of studies indicate that we lose weight more slowly than the rule would predict because our body burns fewer and fewer calories as we lose pounds. If you’ve ever watched a season of The Biggest Loser, you’ve seen this reality in action. Contestants used to lose over 20 pounds per week in the beginning when they were larger and had more excess weight to lose, but by the final weeks, they were following severe diets and working out 10 hours per day only to lose 2 – 3 pounds per week. Over time, their bodies required fewer calorie per day to run, so that calorie deficit rule shifted for them.

The good news is that researchers are now starting to battle this well-known rule to promote more realistic weight loss attempts. Dr. Diana Thomas and colleagues are leading this crusade with a math-driven approach, modeling actual weight loss journeys to create calorie / weight loss curves showing significantly less weight loss than the 3500 calorie rule predicts. Though many weight loss apps still use standard formulas to calculate how many calories you need per day for weight loss, a much more sustainable method would be to try to improve the overall quality of your diet, monitor what you currently eat and try to implement a slight deficit, increase your physical activity, and adjust things your plan as you go.

There is one slight upside to the 3500 rule, which is that it is memorable enough to communicate that caloric deficit is needed to burns weight. The downside is that it dramatically overestimates the rate of weight loss and can inspire dangerous levels of calorie cutting. I would never recommend eating less than 1200 calories; crash diets slow down your metabolism as your body adapts quickly to its new low-energy state, and nearly everyone rebounds back to a poor higher-calorie diet later on. Emphasizing overall nutrition quality, seeking a registered dietitian for ongoing nutrition counseling and support, and focusing on nutrition as a health goal rather than a means to an end can help you actually achieve your goals and maintain them long-term.

 

The overall takeaway:

  1. It is difficult to calculate your accurate BMR.
  2. It is even harder to then calculate your TEE
  3. Even if you can figure out how many calories you need daily, it is difficult to know how steep of a calorie deficit you would need to burn 1 pound of fat as the 3500 calorie rule is unreliable and based on absolutely extremist, insufficient research.
  4. Focus on improving diet quality, achieving a mild but sustainable caloric deficit, and seek assistance from a nutrition professional if you feel lost!

 

 

Resources:

Wishnofsky M.  Caloric equivalents of gained or lost weight. American Journal of Clinical Nutrition. 1958 Sep-Oct; 6(5):542-6.

Strang JM, McCluggage HB, Evans FA. Further studies in the dietary correction of obesity. American Journal of the Medical Sciences. 1930;179(5):687–693.

Thomas DM, Gonzalez MC, Pereira AZ, Redman LM, Heymsfield SB. Time to Correctly Predict the Amount of Weight Loss with Dieting.  Journal of the Academy of Nutrition and Dietetics. 2014;114(6):857-861.

My Egg Obsession

Scrambled, poached, over easy, hard boiled, tossed into salads, floating in ramen… eggs can be added to any meal!

The myth that eggs cause high cholesterol has been debunked (your body makes more cholesterol from saturated fats, but the 200mg cholesterol in an egg won’t cause a corresponding spike in blood lipids), and the benefits of eggs are clear:

  • Protein! Eggs are one of the few non-meat items that provide all of the amino acids you need in your diet, and though the egg whites are known for this protein-punch, egg yolks also provide the nutrient.
  • Choline- this important nutrient is needed for brain health and neural development.
  • Lutein- a type of carotenoid that protects eye health
My egg splurge: eggs on a BLT with avocado, atop seven grain toast