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New Year - New You ? - January 2010
Amid the confusion of dubious advice that traditionally fills the middle pages of the newspapers at this time of year, there are a few nuggets of value. One of these is the encouraging emphasis being placed on activity, not only as a means of honing your body but also as one of the most important ways of improving your health.
It has been known for some time that regular exercisers have substantially lower risk of heart disease and other cardiovascular disease (Chong Do Lee et al.1999). It has also been noted with curiosity that physical fitness is so powerful a protector against these common diseases of ageing that fit people actually seem to have a lower risk than much younger couch potatoes. The reasons for this are now becoming clear. Regular exercise actually prevents the stiffening of the large arteries around the heart normally seen in older people (Seals et al.2009). It is this stiffening that causes the age-related increase in blood pressure and the consequent increase in risk of cardiovascular disease. Even if exercise is started later in life, this stiffening can still be reduced.
There also seems to be a link with eating habits. It has tended to be assumed that the only important influence on our long term health is to select what we eat to limit calorie intake in order to prevent a rise in body fatness. This is surprisingly difficult for many people to achieve. As a result, a huge industry has developed around dieting, offering increasingly bizarre solutions to the perennial question “how can I lose weight?” Unfortunately, success is too often judged by the rate of initial weight loss rather than looking at the situation one or two years down the line. Too many desperate slimmers lose some weight in the first few weeks only to put it back on again, with interest, over the following months.
Among the most popular ways of losing weight rapidly is to cut down on carbohydrates, despite the fact that it is known that the weight lost will be partly body water, rather than fat. Some people even translate a low carbohydrate calorie- reduced diet into a long term eating pattern, when weight stable and not cutting calories. This tends to lead to permanently bad breath and fragile mood, caused by the body’s efforts to replace the glucose normally derived from carbohydrate foods. A low carbohydrate diet will also inevitably be high in fat, which is likely to raise heart disease risk by increasing blood cholesterol levels.
Two additional reasons to reject the low carbohydrate diet fad have now emerged. One is that an adequate intake of carbohydrate is necessary to support regular exercise. All physical exercise needs some carbohydrate as fuel. The more vigorous the exercise the more beneficial to heart health and the more carbohydrate is needed. If the body is short of carbohydrate it has to make it from protein and fat. In this process mildly toxic by-products (ketones) are produced. These adversely alter mood (Brinkworth et al. 2009) and can be smelt on the breath.
But a much more serious suggestion has been raised by recent research. This is that low carbohydrate diets may adversely affect arterial stiffness (Bradley et al. 2009), an important risk factor for heart disease, especially among older people, who of course, experience the most heart attacks (Franklin et al. 2001). If confirmed, this latest research would indicate that a low carbohydrate diet coupled with a lack of exercise would be a highly undesirable combination!
Unlike fat, which can be stored in virtually unlimited amounts, the body’s ability to store carbohydrate is very limited. A regular supply is therefore needed. Exercise uses up these stores more quickly than normal life. The body’s replacement of this strategic store of carbohydrate is most efficient immediately after exercise. This is why it is recommended that a sugar-containing soft drink and a carbohydrate snack bar are good just after a bout of vigorous exercise. These will replace the water and carbohydrate expended during the exercise. If the bout is prolonged and sweaty, a sports drink containing salt as well as sugar may be advisable.
The key thing to remember is that your body’s shape and weight is a reflection of your lifestyle. If you want a slender figure you will need to change your lifestyle in a permanent way. Short-term fixes simply will not last. If you go back to the habits that led to your present shape you will return to the same dimensions. But the change in lifestyle may not need to be a drastic one. Most people are not too far off in judging their eating habits to match their needs. This is why only a few people put on weight rapidly. Most of us put it on very gradually over a period of many years. So a small change in calorie consumption, or better, a small change in exercise habits will, if maintained, lead to a gradual return to the figure you should have.
This is why the choice of eating habits needs to be practical and enjoyable. If you do not like the diet plan you have chosen you will not stick to it for long. Research has shown that losing weight by reducing calorie intake works equally well whatever the calories that are cut. It is a myth that cutting one source of calories is intrinsically better than another for weight loss. Where there is a difference is in the likelihood of you sticking to the New Year resolution. Cutting out favourite foods is a recipe for disaster! You will simply want them more and, sooner or later, give in and eat far more of these foods than you would have in the first place. A far better approach is to limit all foods to some extent but continue to enjoy your food. A slight reduction in overall calorie intake of as little as 50-100 calories per day is enough for most people to see a gradual reduction in weight. Combine this with 30 minutes walking and you will see a steady improvement. Most importantly, you will find you can maintain these sorts of changes over the long term.
It is in this change of lifestyle that sugar-containing snacks and drinks have been shown to help. By taking a small sugar-containing snack or drink (even tea or coffee with some sugar in it) when you might otherwise reach for a more substantial snack, you will find you can limit your calorie intake more easily than by cutting out meals or trying to delay meals (West and de Looy 2001). Recent research has observed that people who take sugar in their tea and coffee are less likely to be overweight than those who avoid sugar (Glyntberg et al. 2009).
So, if you intend to join the flood of enthusiastic volunteers who sign up to gym membership in January, here is some sound advice. Choose an exercise level and frequency that you can maintain. It is no good behaving like Renee Zellweger in Bridget Jones’s Diary and exercising till you drop and then giving up. It will not benefit your waistline or your general health unless you exercise regularly. And when it comes to eating habits, variety is the key to a healthy and interesting diet. Do not cut out any food group, as this can lead to nutrient deficiencies. Rather than avoiding carbohydrate, all meals are best based around starchy foods like potatoes, rice, pasta or bread. Fruit and vegetables are important, and most people do not eat enough. Include some sugar-containing foods as well, as these add variety (FAO/WHO, 1998) and contribute to the necessary carbohydrate intake. Contrary to popular belief, incorporating some sugar-containing snacks can be useful to weight control and slimming (West and de Looy, 2001) and may be the most acceptable way to get some carbohydrate into your system immediately after an exercise bout.
References
Bradley U, Spence M, Courtney CH, et al. (2009) Low-Fat versus Low-Carbohydrate Weight Reduction Diets: Effects on Weight Loss, Insulin Resistance and Cardiovascular Risk A Randomised Control Trial. Diabetes 58: 2741-2748.
Brinkworth GD, Buckley JD, Noakes M, Clifton PM,Wilson CJ (2009) Long-term Effects of a Very Low-Carbohydrate Diet and a Low-Fat Diet on Mood and Cognitive Function. Archives of Internal Medicine 169: 1873-1880.
Chong Do Lee, Blair SN, Jackson AS (1999). Cardiorespiratory fitness, body composition, and all-cause and cardiovascular mortality in men. American Journal of Clinical Nutrition 69: 373-380.
Food and agriculture Organization/ World Health Organization Expert Consultation Carbohydrates in Human Nutrition. FAO food and Nutrition paper No. 66. FAO, Rome. 1998.
Franklin SS, Larsen MG, Khan SA et al.(2001) Does the relation of blood pressure to coronary heart disease risk change with ageing ? The Framingham Heart Study. Circulation 103:1245- 1249.
Gyntelberg F, Hein HO, Suadicani P (2009) Sugar in coffee or tea and the risk of obesity: a neglected issue. International Journal of Food Science and Nutrition 60 (Supplement 3) 56-64.
Seals DR, Walker AE, Pierce GL, Lesniewski LA (2009) Habitual exercise and vascular ageing. Journal of Physiology 587: 5541-5549.
West JA & de Looy AE (2001) Weight loss in overweight subjects following low sucrose or sucrose containing diets. International Journal of Obesity; 25: 1122-1128.
