Recently, I read “How Not to Diet” by Michael Greger, M.D. He is a founding member and fellow of the American College of Lifestyle Medicine, author of another book, “How Not to Die,” and founder of NutritionFacts.org.
The book was long, 570 pages, and included 4,990 references. Dr. Greger and his staff extensively research scientific studies related to nutrition in health and disease. The book was detailed and one I will often refer back to for its depth of information. This blog gives an overview of some of the important research-based concepts regarding weight loss that Dr. Greger discusses.
The book starts with a discussion of the problem – what it really means to be overweight. Most professionals use the body mass index, which considers a person’s height and weight. There are many websites with directions for calculating your own BMI. In the past, a BMI of less than 25 was considered “normal,” but since the 1980s, sadly, being overweight (with a BMI greater than 25) has become the norm. Being overweight (or obese) brings about many health concerns. For example, the risks of developing cancer, heart disease, type 2 diabetes, dementia, and impaired brain function increase. Some think that a BMI of 20-22 is really the ideal BMI in terms of increasing life expectancy.
Dr. Greger discusses the “toxic food environment” in which we presently live. This started in the 1970s with the development of what I call “manufactured food”; calorie-rich, low-nutrient, processed foods. These foods are high in straight sugar, oil, white flour, and condensed calories. High-calorie, low-nutrient foods and beverages are the major cause of obesity, per Dr. Greger. Our bodies were not made to eat such foods.
Foods fall into one of two categories, those causing inflammation and those that are anti-inflammatory. Foods that cause inflammation increase a person’s risk of chronic diseases (heart disease, cancer, diabetes, arthritis, dementia, depression, anxiety). They contain saturated and trans-fats. Fats are made up of carbon and hydrogen. A saturated fat means that each carbon in a molecule has four single bonds. These fats are solid, like butter, lard, and shortening. Trans-fat means that some of the carbons are connected to each other with double bonds. Your body does not need trans-fats; of all the fats, they are worse for your heart. Trans-fats have been used in snack foods to prolong the shelf-life, think Twinkies, but in recent years governmental pressures on the food industry have decreased their use. Some pro-inflammatory foods are cheese, animal-based foods – beef, pork, lamb, poultry, dairy, eggs, butter – those made from refined carbohydrates – desserts like cake, ice cream, pastries – French fries and other fried foods, mayonnaise, palm and coconut oil, and, of course, sodas.
Anti-inflammatory foods contain fiber and flavones. Fiber is found in all plant foods and is especially concentrated in legumes such as split peas, beans, chickpeas, and lentils. Flavones are in vegetables, fruits, and herbs. Dr. Greger says increasing the “intake of fiber-rich foods may…actually be one of the single most effective pieces of advice for weight loss.” “Fiber is like comfort food for your colon.” He also states, “Limiting consumption of processed foods may be an effective strategy for obesity prevention and treatment.”
When discussing some techniques for weight loss, Dr. Greger emphasizes that permanent weight loss requires dietary changes that a person can live with over time, as opposed to being on a fad diet. He feels that frequent weighing is a safe, effective tool for weight control. One study he discusses found that weighing twice daily, first thing in the morning and just before bed at night, was very effective.
He recommends the old adage:
Breakfast like a king
Lunch like a prince
Dinner like a pauper
Eating in this fashion is in sync with our natural sleep-wakefulness pattern, known as the circadian rhythm. Glucose tolerance declines during the day. It is highest in the mornings, a bigger meal then is metabolized better than later in the day. By evening, our body’s ability to handle sugar deteriorates. And with our hunter-gatherer genes, our bodies are not expecting us to eat when it is dark.
Dr. Greger also discusses the importance of sleep, about 7 hours per night being a “sweet spot” for adults. Shift work and stress can cause weight gain. He includes a good discussion regarding studies done on the impact of stress on weight gain and techniques to help manage stress.
Dr. Greger makes an interesting point. He says that our brains “just don’t seem to recognize liquid calories,” meaning those calories in sodas, sweet tea, sports drinks, Kool-Aid, etc. He goes on to say, “If you could only make one dietary change, getting rid of sugary beverages would be a good choice.”
After covering many studies regarding weight loss techniques, including the use of some spices and herbs, the book concludes with a list of “21 tweaks” that may help with weight loss. The following is my amended list of some of the tweaks Dr. Greger recommends that might help with weight loss:
- Drink two cups of cold water before every meal.
- Before each meal, as an appetizer or first course, have an apple or raw vegetable (s) or a vegetable soup (under 100 calories).
- There should be no distractions during mealtime – no cell phones, TV, etc.
- For the natural satiety signal to kick-in, meals should last for at least 20 minutes.
- Whole grain servings should be intact grains, not ground-up grains. Use sprouted wheat or pumpernickel bread, farro, barley, brown rice, and other whole grains.
- Have more of your calories earlier in the day.
- Time restrict your eating to daylight hours, consistently. Evening food intake should end before 7 p.m.
- Exercise regularly. On an empty stomach might be most effective.
- Weigh regularly.
- Get enough sleep.
- And, of course, a food intake mostly of anti-inflammatory foods (high in fiber, vegetables, fruits & whole grains, low in animal protein and processed foods).
If something in this blog interests you and you would like to know more about the studies Dr. Greger and his team have reviewed, reading this book might be just for you. It was published by Flatiron Books in 2019. Other ways to access information from Dr. Greger are through his YouTube videos and his website, NutritionFacts.org.
Here is to a New Year of healthy eating, healthy weight, decreasing your risk factors for chronic disease, and more fun and enjoyment!
