Weight Loss

All the mechanisms that cause most people to accumulate body fat can be traced to one and only one cause: excessive blood glucose and the ensuing insulin production.

As we saw in the last post, a valuable lesson can be learnt from the Biggest Losers: weight loss is not a matter of willpower, and certainly not a simple matter of eating less than you burn. In order to lose weight, you need to modify your metabolism. This is not easy, but it’s not impossible either.

Body fat is regulated – How fat is stored in our cells is a complex, regulated system. The body is working hard to stabilize the amount of fat around a set value. This set value is a function of our genetics, as well as our long term nutritional behavior, environment and medical history.

It’s true that our body fat is regulated by several factors over which we have little control, such as genetics or past behavior, but there are steps that can be taken towards a healthier metabolism.

Note that being thin is not necessarily healthy, and that body fat is not necessarily a problem. It is the underlying causes of body fat that pose a health threat, as well as bringing the undesired fat.

Actually, all these causes are related to one and only one item: excessive blood sugar. We will explore a few of the mechanisms below, but there are many more.

1. Elevated insulin, a consequence of high blood sugar, puts the body in fat storage mode.

During digestion, carbohydrates are broken into simple sugars and passed into our bloodstream. The elevation in blood sugar causes the pancreas to produce insulin, a hormone that allows the cells to let sugar in.

The glucose (sugar) taken away from the blood and into the cells can be used to provide immediate energy. If energy is not needed, sugar is stored as glycogen. When the glycogen storage is full, the remaining glucose is stored as fat in fat cells.


Insulin activates the enzymes that enable fat storage and impairs the action of hormones that release fat from fat cells: high insulin signals that glucose (i.e. immediate energy) is available; fat is therefore not needed and should be stored for later use.

2. Elevated blood glucose induces the enzymes that favor using sugar for energy (and impairs the enzymes that are necessary for burning fat).

The bulk of our energy is generated through cellular respiration, a complex series of chemical reactions that take place in the mitochondria in our cells.

TCA / Krebs Cycle – All three types of macronutrients (carbohydrates, fats, proteins) behave in a similar fashion.

The body is a marvelously adaptable machine that can work with whatever it has. If there is a lot of glucose in the blood, the body will produce the enzymes to burn glucose for energy. If the body sees less glucose, it will generate the enzymes that burn the fat instead.

3. Elevated blood glucose next to fat cells locks the fat inside the cells.

Fat is travelling in the blood or stored in cells under the form of triglycerides.

The molecules in the fat tissue are in constant motion, crossing the cell walls into the blood stream and back. Since triglycerides cannot cross the cell walls, to go in and out of the cell, they are disassembled into free fatty acids and glycerol and reassembled into triglycerides on the other side of the wall.

This process is also regulated by the levels of insulin and blood sugar: insulin causes fat cells to take in glucose and burn it for fuel; this produces a glycerol-phosphate molecule, which in turn provides the glycerol molecule that binds with free fatty acids to create triglycerides.

Thus, burning glucose in the fat cells reduces the number of free fatty acids that can escape the cell and increases the proportion of fat locked as triglycerides inside the cell.

There are several more mechanisms that cause fat to be stored, all involving sugar. Very surprisingly, these facts have eluded most weight loss researchers for a century. Instead, the notion that eating fat makes you fat still prevails.

(To be continued…)

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Lessons From the Biggest Losers

A study finds that people who lost a bunch of weight after participating in the TV reality show “The Biggest Loser” gained most of it back. That’s of course no surprise. What’s more interesting are the findings about how their metabolism changed after the weight loss.

A KQED broadcast last week (May 2, 2016 – All Things Considered) reported on a study that examined what happened to the participants in the TV reality show The Biggest Loser after the show was over. A (not too surprising) fact was that many of them regained much of the weight they had lost during the show.

One of the report’s conclusions was that body weight is biologically determined and that “it’s not just a matter of willpower to produce weight loss and to keep weight off.” It seems that the body wants to regulate its fat content to a set point, like a spring: you can compress it, but as you let go, it returns to its original position.


No surprise

This finding, of course, doesn’t come as a surprise. Anybody that has been on a weight loss diet could have told you that. With the risk of sounding conceited, this result was highly predictable, not to say inevitable.

So why do most people still believe that after going on a weight-loss diet, they can return to their old ways and still keep the weight off?

This has always seemed odd to me, until I examined the prevailing weight-loss beliefs more in depth.

It turns out that most people, including doctors and health professionals, view the body as a calorie bag: if you eat more calories that you expend, you gain weight; if you spend more than you eat, you lose weight. Before people embark on their lean quest, their weight is more or less constant (maybe several pounds higher than they wished, but stably so). The logical deduction is that what they are eating balances exactly what they expend. Therefore, if they could only lose the extra pounds, they’d be fine and could resume their old lifestyle happily ever after. QED.

Logical? Well the fact that this scheme doesn’t work should be proof enough that the “calorie in – calorie out” view of weight control is incorrect.

Regulation – The Spring effect

Actually, how fat is stored in our cells is a complex, regulated system, the body trying hard to stabilize the amount of fat around a set value.

This set value is a function of our genetics, as well as our long term nutritional behavior, environment and medical history; with age our body is less resilient, and coping with excesses becomes more difficult.

Still, another sensible line of reasoning says that you can’t produce something out of nothing, and that, in order to gain weight, you have to take in more calories than you consume. After all, like gravity, thermodynamics are not just a good idea, they are the law! So how can a weight-loss contestant eat less than ever, keep-up the exercise, and still gain the weight back? Read on…

Somewhat of a surprise (but not that

One contestant interviewed explained that she had worked extremely hard at shedding the original weight: it took a grueling regimen of diet and exercise. Listening to her, one could sense that she is a very strong-willed person; nobody could suspect her of being lazy or self-indulging. Yet after she gained the weight back, she found it nearly impossible to lose it again.

The interesting “discovery” of the study was that after they lost weight, the people’s basal metabolic rate (BMR, amount of energy expended while at rest) was disproportionately low compared to the rest of the population: these people needed to burn less calories to sustain their weight than people with the same weight that have never been on a weight reduction program. Conversely, these weight-reduced people needed to eat less than the other people in order to sustain their weight.

Another interesting observation was that, after they regained their weight, the people’s BMR was still low. That contributed to make losing weight the second time around even harder.

There is a prevalent view that muscles burn more calories than fat, and that if you lose fat and build-up muscle, your metabolic rate will increase. The study’s findings go against that theory.

A conclusion

The “calorie in – calorie out” view of the body has been proven wrong over and over again. To reach your ideal weight, you need to improve your metabolism. This goes way beyond “eating less and exercising more”. It includes changing your metabolism, lifestyle and especially your nutrition.

Calorie restriction makes you metabolically weaker.

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The ERFOE Plate

Although eating a large variety of foods is our safest bet so far, we need guidance that goes beyond “Eat a little bit of everything” if we don’t want to be an easy prey for the food industry.

When considering nutrition, both macronutrients and micronutrients come into play:

Our food needs to provide enough macronutrients to supply energy and building material for our body (hormones, proteins, enzymes, antibodies, membranes, etc.).

But in a society where getting enough calories in not an issue, it makes more sense to think in terms of micronutrients and seek the most micronutrient-rich food. In fact even in countries where there is a risk of undernutrition (that is, not enough macronutrients), there is an emerging problem of malnutrition (that is, lack of adequate micronutrients).

Macronutrients play an important role, but they must be selected wisely:
– Modern diets include too many carbohydrates. Carbs should not be eliminated from our diet, after all, vegetables provide a fair amount of carbs, but the carbs we eat must be useful: they must also contain micronutrients.
Proteins portions are often diminished usually because of fear of fat. That is bad. We need proteins for the largest array of functions in our body: structure, hormones, enzymes, antibodies…
– Fats are feared because of the mistaken belief that fats make you fat and that fats are responsible for cardiovascular diseases. Don’t fear fats. Fats are needed for important functions in our body.

♦ ♦ ♦

ideal plateOur “ideal” plate is the result of years of clinical practice. It was designed empirically to provide enough micronutrients and macronutrients for most people.

Although it is easier to illustrate this concept with volumes (as in the picture), the proportions are intended in weight of cooked ingredients.

The “ideal” plate contains:
• 1/4 Proteins
• 3/4 Micronutrient-rich vegetables
• Fats
• No sugars or starches or cereal

Proteins can be animal or vegetal. They include meat, fish, poultry, eggs, dairy, nuts and seeds.

It is assumed that vegetables are cooked or seasoned with fats. Protein generally comes with built-in fat. Fat is important: in the vegetable portion of your plate, half of the calories might come from fat (this is, however, not much in volume).

The exact quantity of fat for cooking vegetables is not important, as long as you use a reasonable amount. The window for “reasonable” is pretty wide: within the context of our micronutrient-rich diet, the body can deal with excess fat fairly easily, but it cannot cope with deficiency.

♦ ♦ ♦

On the ideal plate, the protein sets the agenda. This doesn’t diminish the importance of vegetables; it simply means that the quantity of vegetables is determined by the quantity of protein on the plate:

Whether you eat a 4-oz steak, a 6-oz fish fillet or a 3-egg omelet, make the vegetable portion of the meal about 3 times larger than the protein portion.

After you have finished your plate, if you want more food, make sure the next serving has the same 3 to 1 proportion of vegetables to proteins.

The quantity of protein required varies from person to person and also depends on the activity for the day. Younger or older people, or athletes, might need more than the general population. However, the “ideal” plate offers a good method for most people.

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Food Labels: The Worst is Still to Come?

“The FDA plans an overhaul of nutrition information on packages to make it more useful for consumers.” The proposals for this much needed update are scary in more ways than one!

Wall Street Journal article (Feb. 16, 2016, A Hunger for Better Food Labels) discloses several food label updates that are under consideration. While we agree that an overhaul is needed, this is also potential for disaster.

The changes proposed by the FDA include: making the calorie information more prominent, changing the serving size to reflect the bigger portions that people eat, showing added sugar.

FDASome think that it is still not clear enough. Here are proposed “better” labels:

NuvalNUVAL score grades food on a scale of 1 to 100 based on many factors, positive or negative, including protein, calcium, sugar, cholesterol… It replaces the complex label by a single number.

TrafficLightTraffic light, developed in the UK, assigns a red yellow or green to the components that are deemed important: fat, saturated fat, sugar and salt.

GuidingStarsGuiding stars (developed in 2006) assigns 1, 2 or 3 stars to grade the food according to an algorithm that takes into account vitamins, minerals, fibers, sugar, fat, cholesterol.




Our Opinion

The new FDA proposal for sugar is misleading. It focuses people’s attention on added sugar (when in fact natural sugar is not better than added sugar). This line of thought makes people eat a ton of fruit, not realizing that they are ingesting sugar at the same time and no more vitamins than in vegetables.

But it is only the least of evils… The other proposals make our hair stand on end:

At first glance, simplified labels are good idea. After all, navigating the maze of nutrition is hard and most people don’t have the time. What’s wrong with helping them save time and effort in buying their groceries?

  • For starters, you’d have to trust the agencies to make the right choice for you. But, as everyone can understand, government recommendations are constrained by many factors other than pure science: practicality, the need to provide a diet affordable to all, politics, business interests, etc.
  • You’d have to blindly trust the science that’s underlying the labeling. At this point, nutritional science is still shaky and has been proven wrong many times. Take dietary cholesterol for example…
  • But most importantly, assessing ingredients using simplistic rules will not encourage people to consume a variety of foods. You could eat the same thing day in, day out, and still believe you are getting a “3 star” nutrition.
  • Simplified labels don’t allow us to think for ourselves; since all we have to work with are those silly stars, we cannot rate our food ourselves. This might help a minority but not regular people.

By reducing nutritional information to simplistic values, these systems hide the actual contents of the food and prevent people from understanding what they are eating.

Nobody will contest that food labels need improving. But the simplistic route is just not the solution.

Looking at nutrients on a broad basis and encouraging people to educate themselves about their food is the way to go.

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A Little Bit of Everything?

Most people agree that we need to eat a balanced diet. However, the interpretations of this principle vary widely.

Popular wisdom says that we should have a balanced diet: a little bit of everything and not too much of anything. This seems to be a safe approach and we do agree with this wise principle, especially in light of our body’s complexity and the lack of a definitive scientific answer concerning the perfect diet.

But from a practical point of view, what does “a little bit of everything” mean? A little bit from each aisle of the supermarket?


If we still led the hunter-gatherers’ life, the question wouldn’t arise: we’d eat what we can find in nature, and we’d be fine. Our bodies have evolved for hundreds of thousands of years to do just that. In comparison, agriculture is a very recent development (10,000 years).

Agriculture has made available an abundance of unnatural new foods:
– Unnatural because selective breeding creates crops that evolve faster than our metabolism.
– Unnatural also in the proportions of the macronutrients offered: the advent of agriculture mostly meant “grains” and we’ve been eating an excessive proportion of our diet as cereals and starches since then. While grains made civilization possible by feeding large populations, it was also the first step in consuming food that our body isn’t built for. Maybe we’ll adapt to it in a few hundred thousand years, but, for the time being, our bodies still think we are hunter-gatherers.

fish sticksThe problem is made more acute by the food industry: understandably, companies want you to buy what’s profitable for them, not what’s good for you. Sfishhopping habits, lack of time, shear volume of the offering, constant advertising disguised as science,  all contribute to make it hard for people to distinguish real food from junk. How many kids think of “fish” (as food, not as in The Little Mermaid) as a rectangle?

♦ ♦ ♦

In the modern supermarket, without more precise guidance than “Eat a Little Bit of Everything” we are doomed.

Of course, most things found in the supermarket are man-made: apart from some rare wild-caught fish or game, and wild fruit (mostly berries), vegetal and animal products are grown or bred. The fruits available today are much bigger and sweeter than the original ones.

We don’t suggest that we go back to prehistorical lifestyles. But if we want to be healthy, it is important to look for fresh ingredients that received as little processing as possible, and try to eat food that is closest to what exists in nature, closest to:

Pulled from the ground,
Cut from the flesh,
Plucked from the plant.

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Macronutrients vs. Micronutrients

We are used to think of our food in terms of its macronutrient composition: carbohydrates, proteins and fats. Nowadays, it would make a lot more sense to think in terms of micronutrients, including, but not limited to, vitamins, minerals, electrolytes.

There are many ways to classify food. The good old macronutrient approach is primarily linked with energy production: just anybody will tell you that you need to eat carbs to have energy (never mind that it conflicts with the widespread knowledge that fat is very calorie-dense, with almost twice the calories of protein or carbs for the same weight).

This energy-oriented approach makes sense if you consider that for a long time the main concern of humankind was survival and getting enough calories was a matter or life and death.

_DSC0927 corrThe micronutrient approach started with the discovery of vitamins. While this scientific breakthrough opened new horizons in nutrition, it also created the enduring myth that sugar equals vitamins, because fruits were the first foods to be associated with vitamins.

Since then we have discovered that, in fact, many vegetables are richer in vitamins than fruit.

Continue reading “Macronutrients vs. Micronutrients”

“CAULI-FLOUR” – Trader Joe’s stole my idea (and I’m not even angry).

Grated cauliflower is now available in several stores. This is great news overall, with some reservations.

A recent article in the Wall Street Journal reports on the price hike and possible shortage of cauliflower due to the crucifer’s increased popularity. Not a good thing in the immediate future, but an encouraging trend health wise: its new-found popularity can only help cauliflower become more readily available and affordable in the future.

♦ ♦ ♦

And the future is already here!

Cauliflower crust aficionados will be happy to learn that they can buy ready-grated cauliflower at Trader Joe’s: at first it lived in the frozen section, but now “riced” cauliflower is also available in the fresh produce aisle. Green Giant is selling its own version too, and by the time this post is published, I am confident that there will be more offerings.

Cauliflower - white
Good old cauliflower – at Safeway about $4 / lb

Green Giant Cauliflower Crumbles - $3.49 / 16 oz
Green Giant Cauliflower Crumbles – $3.49 / 16 oz

Organic Trader Joe's riced cauliflower - $1.99 / 12 oz
Organic Trader Joe’s riced cauliflower – $1.99 / 12 oz

So how does packaged cauliflower compare to the real thing? Let’s take a look, taking into account:

1 – Practicality – YES, YES, YES!
Even though it’s not difficult to shred cauliflower, the operation can be messy or painful (have you ever grated your knuckles?). Grating adds one step to a process that is already a little complicated. So if you don’t have infinite amounts of time, riced cauliflower is definitely worth it.

2 – Nutritional value – looks OK, but read the fine print.

Stems vs. florets
Don’t discard the stems: they possess as much nutritional value as the florets. The stems contain more chloroplasts and the associated chlorophyll and carotenoids, they also have more fiber. The maturation of nutrients in the stem and in the floret are different and complement each other.

It doesn’t look like much nutrition can be lost in the process of grating. In fact, one advantage is that the stems are probably blended together with the florets, which has more nutritional value than eating the florets alone.

However, Green Giant proudly boasts that its product “can be steamed in its pack” (always scary) and uses a “patent pending process to extend shelf life” (I don’t know about you, but this makes my hair stand on end): Additives are a problem in all packaged foods; under certain conditions, they don’t have to be listed with the ingredients. My daughter is not allergic to fresh carrots, yet she has had serious allergic reactions to packaged carrots, although the only ingredient listed was “carrots.”

We need to know a little more about the industrial processes involved in bringing the product to market. Real food with the least possible processing is always preferable; packaged cauliflower may be an acceptable alternative, if produced in a reasonable manner.

3 – Price
A quick survey doesn’t reveals huge price differences. But note that the price of fresh cauliflower fluctuates a lot these days.

In any case, compared with a box of cereals (roughly $4/lb), cauliflower is well worth it, no matter under what form you buy it.

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What’s Wrong With the Food Pyramid

The food pyramid never reflected the scientific knowledge of the time. It may have started life with good intentions, but bad influence led it astray.

The once ubiquitous food pyramid has now been replaced by my MyPlate, but it doesn’t hurt to examine it one more time to understand where we came from in terms of food recommendations.

For a better understanding of how the food pyramid came to be, a great read is Denise Minger’s Death by Food Pyramid. In spite of its funny, not-so-subtle title, it is a very serious investigation of the forces that conspired to create the monster.

On the topic, see also Marion Nestle’s Food Politics. Marion Nestle was the editor of the 1988 Surgeon General’s Report on Nutrition and Health.

In this post, we’ll just comment on the result:

Food pyramid

The pyramid implies that starches (grain, cereals, bread) should constitute the basis of our food. This might have been true at the dawn of mankind, when calories were scarce. Agriculture and grains allowed large populations to be fed, and with the division of labor came the arts, politics, war, in short, civilization. But when consumed on top of everything else we eat now, grains become a liability: our body is not equipped to deal with the large amounts of starch and sugar that are effortlessly available nowadays.

The popular belief is that starches are needed for energy. This is plainly not true (but this will require a separate blog post to itself).

Fats appear at the very top of the pyramid: the proportion is not so bad (after all, fats are very dense nutritionally, and a little bit goes a long way), but it instills an unnecessary fear of fats: fat plays an important role in our body, we need fat for our brain, membranes and more.

The popular belief is that eating fat makes you fat. This is also false. (Look for a future post on the subject.)

ERFOE Food pyramid
A non-USDA-sponsored food pyramid (still not ideal, but better).

The rest of the pyramid is more or less OK. We could argue that fruits are not really necessary since you get more vitamins and micronutrients from non-starchy colorful vegetables than from fruit, but this is in the noise level compared to the rest. So in fact, the food pyramid would not be so bad if we just cut off its bottom.


The “MyPlate” recommendation is a slight improvement over the food pyramid. But:


  • Even though it has reduced the recommended proportion of grains, it still implies that grains are a basic food group.
  • We don’t agree that grains are a food group, or that fruits are necessary at all.
  • The proportion of proteins in “Myplate” seems reasonable, but the fats are completely missing from the picture.
  • In our mind, dairy is not necessarily a glass of milk (as implied by the drawing), and not an add on: it is part of the protein and fats.

Grains are not a basic food group!
The indispensable, basic macronutrients are:
– Proteins
– Fats and
– Carbohydrates.

Cereals, starches and grains are not a separate food group: they are mostly carbohydrates. Eating a balanced diet doesn’t imply that you must include a proportion of starches and grains. Eating colorful, nutrient-dense vegetables will bring a fairly large amount of carbohydrates and fiber.

The ERFOE Ideal Plate

ideal plate

The plate that we advocate consists of:

 1/4 Proteins
 3/4 Colorful vegetables
No sugars or starches or cereal

This “ideal plate” is designed to provide enough micronutrients and macronutrients. Proteins can be animal or vegetal. They include meat, fish, poultry, eggs, dairy, nuts and seeds.

It is assumed that vegetables are cooked or seasoned with fats. Protein generally comes with built-in fat. Fat is important and greatly contributes to satiety: in the vegetable portion of your plate, half of the calories might come from fat (this is, however, not much in volume).

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Don’t Eat Cauliflower to Lose Weight!

A recent piece in the Wall Street Journal (Feb.2, 2016) is calling attention to the astonishing possibility of a cauliflower shortage. According to the article, cauliflower has become very popular in the U.S. lately: this is mainly because many people who cut carbohydrates in an effort to lose weight are turning to cauliflower as a low-carb substitute to starchy foods.

To which I say:
Don’t eat cauliflower to lose weight!
Eat cauliflower because:

Cauliflower - orange

  • It is replete with nutrients. As a member of the cruciferous family, it is rich in sulphoraphanes, which have many beneficial properties: in particular they protect against UV radiation, contribute to joint health and help the immune system fight cancer.

But don’t focus on any single micronutrient in your food: just eat real food such as (but not limited to) cauliflower and know that it brings you many of the micronutrients that your body needs to thrive!

Cauliflower - green

  • Yes, cauliflower has a low starch/sugar contents. Consuming less starch will probably result in weight loss for those who need it: starch and sugar are converted into body fat, and the insulin resulting from high blood sugar tells your metabolism to go into “storage” mode.

Sugar and starches are very nefarious to your body in many other ways. So the benefits of replacing starchy foods by non-starchy vegetables go way beyond weight loss.

  • Cauliflower tastes great and is, in fact, very versatile. (See recipe in upcoming post.) In comes in several colors that bring different nutrients to your body. So try them all!

And if indeed, one head of cauliflower seems expensive, think of how much more nutrition it brings compared to those boxes of cereals that people routinely buy.