#128 The Top 10 Causes of Weight Gain

October 25th, 2015 by
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The Top 10 Causes of Weight Gain

The average American gains 1 to 2 pounds a year.  That is as little as 10 extra calories a day–less than one bite of food.  This weight gain is so subtle that most people don’t even know it is happening until one day they tune in and discover that they have gained 20 to 30 pounds since high school.

The famous 5th century B.C. Chinese General, Sun Zi, said in the book The Art of War, “If you know the enemy and yourself, you need not fear…If you know neither the enemy nor yourself, you will lose every battle.”

In this article, I am going to help you better know the enemy and share with you the top 10 causes of weight gain.  It is only by knowing the enemy and yourself that you can enjoy the weight that works best for you.

My High School Weight

While not especially lean, I weighed a respectable 180 pounds in high school.  My first year away at college, rather than “The Freshman 15,” I actually added “The Freshman 25” and hit a peak weight of 205 pounds during my first nine months away from home.

Fortunately, I started exercising again after my freshman year of college, which helped prevent further weight gain. However, it did not allow me to lose all of the weight I had gained.  I carried that extra weight around for two more decades until my 40s when I was forced to change my diet and lifestyle due to other health problems.

The Best Study on Weight Gain

To better know the enemy, most of the scientific data I am going to share with you is from a seminal Harvard study published in the most prestigious medical journal, the New England Journal of Medicine.  This study involved 120,877 U.S. men and women and the lead author was my former classmate, and fellow cardiologist, Dr. Dariush Mozaffarian.

What surprised me most about this Harvard study was that it wasn’t just one thing that cause people to gain weight.  Rather, it was a cluster of bad habits and lifestyle choices that led to 1 or 2 extra pounds each year.  Unfortunately, as the weight goes up so do chronic medical problems as well as the need to take lifelong medications and make appointments with the cardiologist or other doctors.

I should also point out that these top 10 causes of weight gain have also been seen in other studies.  Also, the Harvard study did not show causation but rather correlation.  In other words, weight gain was observed to happen in people who reported doing these 10 things–whether or not this was the actual cause of their weight gain cannot be determined from this Harvard study.

The Top 10 Causes of Weight Gain

1. Can’t Find Time to Exercise: 0.44 pounds/year (0.2 kg/yr)

It should come as no surprise that not exercising was the number one cause of weight gain.  While a weight gain of just 0.44 pounds per year (0.2 kg/yr) may not sound like too much of a price to pay for not exercising, this adds up to a total weight gain of 21 pounds (9.4 kg) from high school to retirement at age 65.

While many people mistakingly feel that you can exercise off a bad diet, the research just doesn’t support this.  Exercise is for maintaining not losing weight.  Even during my marathon running years, when I was running 20 or more miles a day, I never seemed to burn off the extra weight I gained from my freshman year of college.

2. French Fries and Potato Chips: 0.42 pounds/year (0.19 kg/yr)

The number two cause of weight gain caught me by surprise.  While I knew French fries and potato chips caused people to gain weight, I would never have predicted that this effect would be stronger than sugary drinks.

Even more surprising was that the average person in this study only ate French fries or potato chips one time per week at most.  I suspect the reason why fries and chips are so dangerous to your waistline is because these processed potatoes are instantly converted to sugar in the body, they contain high amounts of unhealthy oils, and the same people who eat fries are more likely to eat other junk food as well.

As with a lack of exercise, this gradual weight gain from fries and chips, on average, adds up to a grand total of 20 extra pounds (9.1 kg) by retirement.

3. Trans Fat from Processed and Fried Foods: 0.36 pounds/year (0.16 kg/yr)

Number three in this Harvard study also came as a surprise to me.  While I was well aware of the ultra artery clogging effects of trans fat, I had no idea this toxic fat also causes people to pack on the weight.

When it comes to trans fat in the diet, most of my patients mistakingly believe this is no longer a problem as all of their packaged food labels read “zero” for trans fat.  What they don’t understand is that, based on lax reporting guidelines, processed food companies can create such unrealistically small portion sizes so that the trans fat content in a “microscopic serving” is below the required reporting level of 0.5 grams.

To keep your arteries clean and your weight in check, if you see “partially hydrogenated oil” anywhere on the ingredient list then this is something that you should never eat.  When it comes to trans fat, there is no safe amount you can eat.

In addition to processed foods, the worst trans fat offenders are fried foods, microwave popcorn, and store bought bakery items.  If you give in and eat processed or fried foods you can count on gaining an average of 17 pounds (7.7 kg) and a likely visit to a cardiologist by retirement age.

4. Sugary Drinks: 0.25 pounds/year (0.11 kg/yr)

While falling much lower on this list than I would have expected, sugary drinks are still an important cause of weight gain.  In addition to sugary drinks, other forms of sugar like desserts, refined grains, and fruit juice combined also added up to an additional 0.25 pounds/year (0.11 kg/yr).  By refined grains, I am referring to the typical grocery store breads, pastas, cereals, crackers, etc.

Thus, if you do sugary drinks, desserts, refined grains, and fruit juice you can expect to gain 0.5 pounds/yr (0.22 kg/year) from your sweet tooth–an even greater effect than not exercising.

It is interesting that fruit juice did not cause as much weight gain as sugar sweetened beverages like Gatorade or soda pop.  The lead author of the Harvard study, Dr. Dariush Mozaffarian, was also surprised and explained that the reason was likely because they found that most people seem to drink sugary beverages in much greater quantities than fruit juice.

Once again, it did not take much to increase weight.  The average person in this study only had a little more than 1 sugary drink per week and 1.3 servings of dessert and 1.2 servings of refined grains each day.

Regardless, doing all forms of sugar namely sugary drinks, desserts, refined grains, and fruit juice, even in very small amounts, can add up to a hefty 23.5 pound (10.7 kg) average weight gain by retirement.

5. Red Meat: 0.24 pounds/year (0.11 kg/yr)

For those who follow a dietary regimen that advocates meat, I’m sure the number five cause of weight gain in the Harvard study comes as a surprise.  I should point out that all meats are not raised and processed equally, and that most of the 120 thousand plus people in this study were eating the typical grocery store or prepared forms of meat which come from antibiotic and hormone treated animals.

Equally as strong as red meat for weight gain in this study were processed meats.  By processed meats I mean meats like bacon, hot dogs, sausage, and deli meats.  If you eat processed meats you can expect to gain an additional 0.23 pounds each year.  Thus, eating both red and processed meats will cause you to gain, on average, 0.47 pounds per year or 22 pounds (10 kg) by retirement.

I should point out that the people in this study did not eat much red or processed meats.  Indeed, the average person had less than one serving daily of red and processed meats combined.

If you are a meat eater, and don’t want to gain weight, then the Harvard study would suggest giving up red meats as well as processed meats and instead focus on poultry or fish.

6. Stress: 0.15 pounds/year (0.07 kg/yr)

Most of us also know that we naturally crave junk food when we are feeling stressed.  Stress causes changes to the hormones that regulate hunger.  According to the study I use to calculate the damage from stress, you can also count on gaining an average of 7 extra pounds (3.2 kg) if you are under a lot of stress.

7. Sleep Deprivation, 0.14 pounds/year (0.06 kg/yr)

Most people intuitively know that they also crave junk food when they are tired.  I know this is a weakness of mine after I have been up all night in the hospital taking care of patients.  Sleep deprivation is a well known cause of activating our hunger hormones in a way that causes weight gain.

What most people don’t understand is that when it comes to weight gain, over sleeping seems to be just as dangerous as under sleeping.  In a separate study I use to calculate the weight gain risks associated with sleep duration, it shows that sleeping under 5 hours or over 9 hours a night puts you at risk of weight gain.

Based on these definitions, if you under or over sleep you can count on gaining an average 7 extra pounds (3.5 kg) from high school to retirement.

8. Butter: 0.12 pounds/year (0.05 kg/yr)

In the 1980s and 90s a, few people would have been surprised to see butter on this list.  Yes, it is true that butter is much healthier for you than the trans fat containing products, like margarine, from the 1980s and 1990s.

While butter made the top 10 based on the data from the Harvard study, I should point out that dairy had mixed effects when it came to weight gain or loss over time.  For example, the Harvard study showed that cheese also caused weight gain but milk was neutral and yogurt even caused significant weight loss over time.

Thus, the type of dairy seems to be important in determining whether or not you gain or lose weight with dairy.  For the worst dairy offender, butter, it can cause you to gain an average of 6 pounds (2.7 kg) from high school to retirement.

9. Alcohol: 0.1 pounds/year (0.05 kg/yr)

As with dairy, the data on alcohol and weight gain are mixed.  Heavy beer drinkers seem to show the highest weight gains from alcohol.  In the Harvard study, alcohol drinkers can expect to gain an average 0.1 pounds per year or 5 pounds (2.3 kg) by retirement.

10. Electronic Devices: 0.08 pounds/year (0.04 kg/yr)

Rounding out the top 10 list are electronic devices. When this Harvard study looked at television watchers, they found that just 36 minutes a day contributes to an average four extra pounds (1.7 kg) by retirement.

Final Thoughts

So there you have it, the scientifically proven 10 best ways to gain weight as an adult.  When it comes to changing any bad habit, the first step is awareness.

As the 5th century B.C. famous Chinese general, Sun Zi taught us in The Art of War, the key to wining any battle is to know the enemy and yourself.  Now that we have identified our top 10 enemies in weight gain, it is time to become aware and create an environment that helps us to conquer these enemies.

What is your number one weight gain enemy?  What has helped you to battle this enemy?

#118 Is Saturated Fat Safe for the Heart?

August 15th, 2015 by
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Is Saturated Fat Safe for the Heart?

“I never eat red meat or butter,” Cindy said proudly at a recent dinner event as she put whole wheat bread and pasta on her plate.

Based on the ongoing guidance from our government and the American Heart Association, Cindy thought she was eating a heart healthy dinner as she was limiting saturated fat.  Do the scientific data support restricting saturated fat intake?

In this article, I will share the most recent medical studies answering this question, is saturated fat safe for the heart.  If you would rather skip directly to the video interview I did on this blog at KUTV, our local CBS affiliate in Utah, here is the link.

Saturated Fat Is Not Dangerous

This past week the prestigious British Medical Journal published yet another article, building upon recent research over the last decade, that saturated fat may not be dangerous for our heart health.  This study was based on an analysis of 73 recently published medical studies including a total of 339,090 people.

The main findings of this study are as follows:

1. Saturated fat didn’t increase heart disease or premature deaths

2. Replacing saturated fat with simple carbohydrates increases heart attacks

3. Replacing saturated fat with complex carbohydrates prevents heart disease

4. Replacing saturated fat with healthy fats prevents heart attacks

5. Trans fat causes premature death and heart disease deaths

Big Picture on Saturated Fat

The findings of this study may help to clarify the previous confusion about saturated fat from our government and large organizations like the American Heart Association.  It appears that saturated fat, like that found in animal meat, butter, cheese, etc. are relatively neutral when it comes to heart disease risk and premature death.

If we replace saturated fat with refined carbohydrates like those found in 99% of commercially available breads/pasta/cereal, white rice, processed foods, etc., much like we did in the 1980s and 1990s, our overall risk goes up.  In fact, many researchers feel that replacing saturated fat with refined carbohydrates was the single most important reason for the obesity epidemic we are now experiencing.

If our goal is optimal health then we should focus on replacing excess saturated fat with complex carbohydrates, like legumes, fruits, and vegetables or healthy fats like nuts, avocado, and oily fish.  Indeed, based on the results of this study, the heart disease risk goes down significantly if we eat more complex carbohydrates and healthy fats while minimizing saturated fat.

Trans fat, like what is found in microwave popcorn, commercially prepared bakery items, and processed foods is clearly dangerous to our health.  In fact, studies show that there is no safe level of trans fat that we can eat.

I need to emphasize that even though the food label states “zero trans fat” you can’t believe the label.  To determine if there is trans fat, you must read the ingredients due to legal loopholes in the government reporting guidelines.  If you see “partially hydrogenated” or shortening on the ingredient list, run as these fake foods are likely loaded with trans fat.

Is Plant-Based Saturated Fat Healthier?

Unfortunately, in this study, researchers did not look at whether the source of saturated fat matters when it comes to health.  For example, nuts, avocado, and coconut all have varying degrees of saturated fat.

My personal opinion is that unprocessed, plant-based sources, of saturated fat, like that which is found in nuts, avocado, and coconut, is much heart healthier than animal based saturated fat like animal meat, cheese, and full-fat dairy.  Hopefully, in the next few years we will have conclusive proof on this subject.

Is Natural Trans Fat Dangerous?

Another question that was not answered in this study is whether natural trans fat is as dangerous as the processed food form of trans fat.  For example, animal meat and dairy contain natural trans fat.  Is the natural trans fat in animal meat and dairy dangerous like the trans fat in microwave popcorn, commercially prepared bakery items, or processed foods?

Once again, conclusive proof is still lacking.  Personally, I suspect that the natural trans fat from real food sources, like organic, grass-fed animal meat and dairy, is probably much safer than what is made in an industrial “food” factory.

Take Home Message

Hopefully, this study lays to rest much of the confusion about dietary fat.  Based on this, and other emerging research, here is what I recommend to my patients trying to eat a heart healthy diet.

1. The worst foods for your heart are refined carbohydrates and industrial trans fat.

2. Complex carbohydrates are heart healthy.

3. We need more fat from nuts, avocado, and wild oily fish in our diets.

Do you feel that this study helps to clear up the dietary confusion we have been receiving from our government and large organizations like the American Heart Association?  Please leave your comments below for our community.

#110 The 7 Most Dangerous Foods for Your Heart

June 19th, 2015 by
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The 7 Most Dangerous Foods for Your Heart

“Margarine is healthier,” I was told in the 1980s.  I still remember moving out of my parents house and buying groceries for the first time in 1985. Like everyone else, I cringe to think that I used to buy that tub of trans fat laden margarine because I thought it was safer for my heart than butter.

The sad thing is that most Americans still unknowingly eat this unhealthy fat each day!  Fortunately, the FDA has finally intervened and announced this week that “food manufactures” must eliminate added trans fat from our food supply within 3 years.  As with lead poisoning, there is no safe level of this toxic fat.

Despite this good news from the FDA, there is a catch.  Food manufacturers can petition the FDA to keep putting trans fat into their fake food products.

Even if the food label says zero trans fat, you are still at risk due to legal loopholes in trans fat reporting requirements.  As long as there is less than a half of a gram, food manufacturers do not need to report this.  For people who eat a lot of processed foods or eat out a lot, this can really add up.  A large percentage of fast food establishments, restaurants, and bakeries still use this fat.

In this article I will share with you how to protect yourself from the 7 most dangerous foods for your heart. These 7 foods are those highest in trans fat.

Why Should We Worry About Trans Fat?

Trans fat causes inflammation to our arteries. It also dramatically raises our bad cholesterol (LDL) and lowers our good cholesterol (HDL).  The end result is rapid plaque build up within our heart.  The CDC estimates that trans fat causes up to 20,000 heart attacks and 7,000 unnecessary heart deaths each year in the U.S.

Why Does the Food Industry Like Trans Fat?

Why do food manufacturers still insist on putting this fat into their products?  The answer is because it gives fake food products a shelf life that just may be longer than your own life.

In addition to a long shelf life, some claim that trans fat makes things “taste better.” Lastly, when frying with trans fat, you can re-use the oil over and over.

Trans Fat in Meat and Dairy

It might surprise you to learn that trans fat is also found in meat and dairy.  Grass fed animals may even have more trans fat than grain fed animals.

I should note that the chemical structure of naturally occurring trans fat is different from that of the man-made variety we have discussed thus far in this article.  Fortunately, the natural forms of trans fat don’t seem to present the same cardiovascular risks.  To stay on the safe side, it may be wise to eat leaner cuts of animal meat.

Why Are Cholesterol Levels Falling?

Something strange is happening in the U.S.  Despite the fact that we are gaining more and more weight, our cholesterol numbers keep dropping.  The pharmaceutical industry would like us to believe that this is due to the cholesterol lowering, “statin” drug, prescriptions being written.

Personally, I believe it is because we have been gradually phasing trans fat out of our diet.  As mentioned, trans fat raises our bad cholesterol (LDL) and lowers our good cholesterol (HDL).

Since the FDA loosely required food manufacturers to report trans fat in 2003, we have reduced our consumption of this fat by 78%.  Interestingly, over this same period of time, the number of people with high cholesterol in the U.S. has dropped by 27%.

Heart Stent and Bypass Surgeries Are Falling

Not only have our cholesterol levels dropped but the number of heart stent procedures has declined by 28% and cardiac bypass surgeries have gone down by 46% during this same period of time.  I suspect that much of this decrease has occurred due to the gradual elimination of trans fat from our diets.

The 7 Most Dangerous Foods for Your Heart

1. Pastries

As if the sugar and refined grains were not dangerous for your heart, the trans fat in many commercially prepared pastries delivers the triple hit to your heart.  Never eat cookies, cakes, donuts, or pies without first checking the label to see if there are partially hydrogenated oils.

Commercially prepared frosting and refrigerated dough can also be high in trans fat.  Even breads or crackers may contain trans fat.

If you want to have a pastry, try making a healthier version at home without all of the sugar, refined grains, or trans fat.  For suggestions on healthier options, please review the many recipes my wife has posted on our website.

2. Margarine and Shortening

Margarine was the poster child for trans fat a generation ago.  Shortening is another common source of trans fat.  Fortunately, Crisco has recently eliminated trans fat.

If you want to use a healthier oil, try using olive oil or coconut oil.  There are many healthier options than margarine or shortening.

3. French Fries and Fried Foods

French fries and fried foods are often fried in trans fat.  If you love French fries, try baking your own at home with a little bit of olive oil and sea salt.  Homemade sweet potato fries can be especially healthy.

4. Chips

Potato chips and other chips often contain trans fat. If you like the taste of chips, consider switching to kale chips.  Better yet, make your own kale chips at home with some olive oil and sea salt.

5. Candy

Candy can be another source of trans fat.  If you love your sweets, like me, consider switching to dark chocolate instead.  With regards to health, the darker the chocolate the better.  Dark chocolate has much less added sugar than milk chocolate.

6. Frozen Pizzas

Frozen pizzas are yet another source of hidden trans fat and other heart unfriendly ingredients.  Consider making your own pizza.  It is surprisingly easier than you think.  You can even include almond flour and coconut flour into your homemade pizza dough recipe.

7. Popcorn

Microwave popcorn often contains trans fat.  Movie theater popcorn is no better.  If you love popcorn you can still eat it–just try the air pop variety at home.

Bringing It Home

The key message is that trans fat is still in our food supply and there is no safe amount you can eat.  If you buy processed or prepared foods, you must ensure that partially hydrogenated oil or shortening is not listed anywhere on the ingredient list.

If you like to eat out, ask the manager, or your server, what types of oils are used.

Was it hard for you to eliminate trans fat from your diet?

#047 Do Processed Foods Cause Memory Loss?

November 20th, 2014 by
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Do Processed Foods Cause Memory Loss?

Can what we eat actually affect our memory?  Yes, according to a study just recently presented at the American Heart Association’s annual scientific sessions in Chicago.  This study showed that trans fat, which is common in processed and fast foods, can cause memory loss in even younger adults.

Can You Believe Trans Fat Food Labels?

You may be thinking, “I always read the labels and make sure that I do not buy any food with trans fat.” But sometimes the labels are not clear.

For example, a Fig Newton bar, which is even made with “real fruit” and is freely given to patients at my hospital, lists 0 grams of trans fat.  However, upon closer inspection of the ingredient list you will notice that it contains partially hydrogenated cottonseed oil.

Whenever you see “partially hydrogenated” or “shortening” listed on the ingredient list it is a trans fat.  This is a man made “Franken Fat” that improves the shelf life of the food like substance but decreases our own shelf life.

The problem is with our labeling laws in the U.S.  Many other countries have much stricter labeling laws.  As long as you have less than 0.5 grams of trans fat per serving in the U.S., you can legally advertise “0 trans fat”.  Although technically legal in the U.S., this is deceptive food labeling and many “food” companies participate in this practice.

How Much Trans Fat Do Americans Still Eat?

Another problem is that most serving sizes are not realistic.  Many people eat much more than one measly little serving as defined on the food label.  Also, trans fat is still in so many of our foods such as fast food, pizza, french fries, biscuits, bakery items, and a large percentage of packaged foods.  At the end of the day, the average American has eaten 5.8 grams of trans fat from all of these food like products.

The Dangers of Trans Fat

No amount of trans fat is safe.  Even the FDA realizes this and is working to ban this man-made trans fat from the American diet.  Trans fat dramatically increases both the bad cholesterol numbers and the risk of heart disease.  Trans fat has also been linked to obesity, cancer, diabetes, and depression.  Clearly, our goal is to completely avoid this very dangerous man-made fat.

Memory Loss from Trans Fat Study

This study, recently presented at the American Heart Association annual meeting  in Chicago, was interesting in that even younger adults (ages 20-45) showed significant memory loss after eating trans fat (here is a link to the news report of this study).  Specifically, they looked at 1,018 people and found that for every one gram of trans fat they ate each day resulted in a memory loss of 0.76 words on their memory test.

The biggest offenders of trans fat younger adults remembered 11 less words that those who tried to avoid these man made fat-like chemicals.  As the memory test only involved 104 words, this becomes even more remarkable.  A “healthy” young adult lost 10% of their memory just from eating junk food.

One could not help but ask, how is this memory loss from junk food affecting them in their schooling or with their jobs?  If these young and middle aged adults were showing memory loss from processed foods is it any wonder that Alzheimer’s Disease has also been linked to a diet high in trans fat?

We Are Making Improvements in the War Against Trans Fat

Fortunately, with recent labelling laws and other regulations, we are eating much less trans fat now than we did a generation ago.  Our average cholesterol numbers in the U.S. have been dropping and most feel the major driver has been less trans fat in our diets.  The recent decline we have seen in heart disease nationwide is also felt to be due to lower amounts of trans fat in our diets.  However, if one eats out a lot or purchases processed foods you are still exposed to this dangerous man-made fat.

How to Avoid Trans Fat

To answer the question, do processed foods cause memory loss the answer is clearly yes according to this most recent study.  As the goal is really zero trans fat in our diet, not the deceptive “0 grams of trans fat” that you see on so many food labels, here are my six rules to completely eliminate this toxic trans fat from your diet.

1. Do not eat anything with “partially hydrogenated” or “shortening” listed on the ingredient list.

2. Assume french fries contain trans fat unless proven otherwise.

3. Assume all pastries, cookies, cakes, pies, and other bakery items contain trans fat unless you are shown proof that they do not.

4. Assume anything fried or battered is trans fat until they can prove to you otherwise.

5. Assume anything that tastes like butter has trans fat unless you can see the ingredient list.

6. Assume any popcorn has trans fat unless you air pop your own corn yourself.

Has your memory or brain fog lifted with elimination of processed and fast foods?  What rules do you follow to keep trans fat out of your diet?