Low Carb Fairy Tales

Obesity is a complex problem. But, as is human tendency, we want a simple answer to a complex problem. And low carb is a simple answer. Yes, you can lose weight, but this is almost by accident, as when you go low carb, you cut out wheat and sugar, two very problematic things.

Low carb proponents tell the obese exactly what they want to hear:

1) It's not my fault I am fat; my metabolism is broken.
2) I can eat all the fat and protein I want and still lose weight, because low carb gives me a metabolic advantage.
3) Calories don't count, only carbs matter, since all carbs are fattening.
4) Exercise doesn't matter.
5) Carbs increase insulin, which increases fat storage. Cut the carbs and burn fat.
6) Add yummy fat to your diet to be even more healthy and speed up weight loss.

Isn't that nice? Only it's not true: it's merely a fairy tale, with very little empirical science to back it up.

But it is one heck of a persuasive argument to tell an obese person. It shifts the blame from your willpower to something you can't control: an out of whack metabolism. And it worked! At least at first. Then it stalled as it always does after 17-20% weight loss and I got wiser.

It was like learning that Santa Claus is not real: low carb is not the magic weight loss bullet I thought it was.

What I really wanted was a simple solution to what I now know is a complex problem. I didn't want my being fat to be blamed on my sloth and gluttony, I wanted another explanation (broken metabolism, fattening carbs!). I didn't want to exercise and I didn't want to count calories. I wanted to eat until I was full and lose weight. Nice, neat, simple, compelling, and wrong.

I am currently following the Perfect Health Diet, a scientifically developed Paleo diet that is not based on fairy tales and which encourages exercise and calorie counting, is already high fat (you don't have to add any more), and complex. But that is okay, because I no longer believe in Santa Claus.

On Exercise

I've done a lot of thinking about exercise lately. The standard thinking on the subject is that exercise is a powerful tool for weight loss. However, in recent months, the role of exercise in weight loss has been questioned. The basic problem: people work up an appetite when exercising, and consequently consumer more calories. A friend of mine who is an exercise physiologist at the same university at which I work, told me the role of exercise in weight loss has been oversold, and that while exercise is very good for the health, it doesn't help with weight loss, only the prevention of weigh gain. One study showed that even thinking about exercise caused people to eat more.

Gary Taubes makes two, contradictory statements in his book, Why We Get Fat and What to Do About It, the book that introduced me to the low carb lifestyle. He says that, when eating low carb, calories don't count (I am on record as stating that calories do count, at least in my personal experience). Then he claims that exercise fails to help people lose weight, because they get hungry after exercising and eat more calories, preventing them from losing weight. So which is it?  I bought into this idea through the first fifty pounds of my low carb weight loss and haven't been exercising for weight loss. But with my recent stall, I am rethinking this. Tabues can't have it both ways: either calories don't count, or exercising helps. Personally, I think calories count, so does this mean exercising might help with weight loss?

I see a flaw in the argument that exercise causes us to eat more. First of all, that statement should be, "exercise can cause us to eat more," but it doesn't necessarily have to do that. This is a lesson I learned while on Weight Watchers: don't deviate from your program and exercise. That way, you don't overeat, even after exercising. That seemed to work for me and is what helped me to reach my goal weight on Weight Watchers. There is no immutable law that says you must overeat after exercising; one can exercise willpower and not overeat after exercising.

So here is what I think I will do. Continue monitoring my calories on livestrong.com and stay below the calorie threshold for my height and weight in order to lose two pounds per week, continue eating low carb, and exercise. I will do it for at least six weeks before reviewing the results. My prediction: I will bust through this weight loss stall and get back on track in the weight loss department.

Born to Run

Have you read this book: Born to Run: A Hidden Tribe, Superathletes, and the Greatest Race the World Has Never Seen?

I love that book. McDougall manages to populate the narrative with a whole cast of wacky, real-life ultrarunning characters. While doing so, he traces the roots of the human race as persistence hunters. Before we invented guns and spear-throwers and whatnot, we ran our prey down. We have the ability to keep up with and surpass (to the point of exhaustion) a horse, an antelope, any herd animal, over the long haul. The way we look, how we eat, how we breathe, why we think ahead, how we might have begun the rather uniquely human process of mentalism (being able to understand from someone else's point of view) - McDougall uses the paradigm of persistence hunting to tell us who we are.

(Here's a link to a youtube video of a persistence hunt by the Kudu, narrated by Attenborough himself - well worth a look!)

After reading Born to Run, I bought myself some VibramFiveFingers and started running again. I'm not the best runner, but I've noticed since stopping wheat and milk (except butter), I never get stitches in my side anymore. I used to get them with nearly every run, no matter how hard or long I trained. They tended to go away after about 30 minutes, so as long as I could "power through" the pain at the beginning, I could get in a nice long run. One doesn't get through medical school and residency without a bit of tolerance for unpleasantness and pain. It doesn't necessarily make you wise, but it may make you tough. The other day my husband made pizza, and (moderation being my motto - I have wheat maybe twice a month), I had a few slices. The next morning, I couldn't do my usual sprints - stitches in my side! Remarkable, that. Don't know if it is the wheat or the cheese. Butter seems to not have the same effect. But I've digressed.

I don't do too many long runs anymore. I try to work out most days a week, but it is mostly weights, sprints, long walks or hikes, and the occasional 5K in the neighborhood. Turns out that long, hard runs (or any long, hard cardio workout, such as a hard-going 115 minute spin class) may be bad for you.

I know. It is hard to fathom. I even looked at the studies a few times before I believed them. Here's one of them. Here's an article about another. Turns out, a lot of marathon runners have crappy, plaque-filled coronary arteries. I'm no radiologist. But Kurt Harris is, and his blog post (and the follow up is here) explains the studies better than I ever could.

My mother had a copy of Aerobics for Women by Kenneth Cooper. Mrs. Cooper writes a lot of the book (I suppose to make it more accessible to women), and she describes how, in the 60s, no one exercised, and her husband Dr. Cooper was the neighborhood freak who loved to jog. The conventional wisdom at the time was that exercise was probably bad for you. (The book also had an exercise program for the "young, dating girl" that counted Friday night's dancing date as part of your points for the week. I should watch more Mad Men).

So is exercise bad for you? Aren't we born to run?

No, and yes, but not born to run long distances very fast. Mark Sisson explains all of this very well in his terrific book, The Primal Blueprint: Reprogram your genes for effortless weight loss, vibrant health, and boundless energy Chris McDougall in Born to Run reports on a persistence hunt where the runners went 10 minute miles. 10 minute miles aren't too fast for hearty, healthy people who run their whole life long. Mark Sisson breaks it down so that for any "chronic cardio" the best thing is to keep your heart rate below 75% maximum (in general, 220 minus your age X 0.75). For most of us, that means a leisurely bike ride, a brisk walk, or a light jog. Chronic hard cardio raises cortisol, stress, and inflammation. Evolutionary Psychiatry is all about anti-inflammation.

Exercise is good for the psyche! No question (1). Regular, 5 times a week moderate exercise caused the remission of mild or moderate depressive symptoms in 42% of those who did it for 12 weeks. Here's another well-known study from 2000. From an evolutionary medicine perspective, we are meant to move.

Does exercise help you lose weight? Well, "chronic cardio" probably doesn't (also, it's not good for you). We tend to eat more to offset the exercise that we do. High intensity interval training (HIIT) definitely does help fat loss (2), and weight training increases muscle mass (thus increases the metabolism and aids in fat loss). Hikes and walks are excellent for the soul, and the more "basic" fitness (the more time you spend walking and hiking, etc.), the more you can push very hard on those once or twice a week sprints to maximize the fat loss. Just steer clear of the chronic, hard-going cardio. Or keep it to a few times a month. Suffering may be good in moderation.