Friday, March 31, 2023

Is an overweight but not obese BMI protective, especially as you age?

There is a JAMA study from 2013 (see below) that seems to think it might be.  The study is a meta analysis that compares the hazard ratio of overweight BMI (25-30), and obese BMI (>30) to normal BMI.  Obese BMI was more hazardous than normal weight, which is what you would expect, but overweight was less hazardous, which is somewhat surprising.  

The effect is even greater for people over 65.

I checked that "normal weight" didn't include underweight people, and I don't think it does.  

 Flegal, K. M., Kit, B. K., Orpana, H., & Graubard, B. I. (2013). Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA, 309(1), 71-82

I keep hearing successful people talk about not cheating on low-starch, low-sugar diets.

 I wrote before how there is this common meme in all dieting which says "you can't deprive yourself for very long."  I wrote that what I thought this meant in terms of low carb diets was that ocassionally you had to come off the diet and have a cheat day.  I think this is actually counterproductive.

What I think it really means is that you have to endulge in ways that are concomitant with the diet -- meaning endulge in luxurious steaks and fish with good (often salty) seasoning pretty regularly.  For me it also means ocassionally adding raspberries or keto cups.

My mental health professional shys away from talking about food or sex issues as addiction.   Unlike substances, you can't totally quit food, and it plays a positive role in your life.  Same with sex.   However, I think there is a real argument for completely abstaining from high-sugar, high-refined-carb foods.

My argument is that there is a physiological adjustment to low carb or "keto" (see "keto flu" or the "Atkins flu").  There is also an adjustment to your pallette that happens, where you fundamentally stop craving sugary foods in favor of just real nutrition.

An additional note on the palette changes that make this diet sustainable:  I'd stay away from artificially sweetened soda.  I don't really buy the argument that says it subtly raises insulin, but I do buy the argument that it exerts a pressure on your palette towards the old way of eating.  It's better to just become accomodated in a way that makes seltzer water and lemon more appealing.

Finally, there is an aesthetic shift that happens:  once you realise you can have success eating this way and have lost some mass, it becomes very hard not to walk through the world looking at the huge people who haven't figured it out. (Nutrition isn't about willpower, it's about knowledge, so these fat bastards shoveling pancakes into their faces at 9am on a Thursday are more stupid than slothful.  [sorry, I couldn't resist -- that statement will probably come back to haunt me karmically])

Thursday, March 30, 2023

Beware cheese

 One mistake I have made over and over again doing low carb is eating too much cheese.  This last go round on a road trip, I ate so much, that I think I gave myself a hernia trying to pass it. (I'm not joking or using hyperbole, I literally have had a sore stomach for days) That's my main objection, I just can't eat it without getting really bound up.  YMMV.

The food environment was always pretty f*** up.

 I went on a road trip this past week, surving on truck stop food.  I was eating mostly the innards of sandwiches, which primarily consisted of meat and cheese.  There were also some more modern "keto" packages with a few nuts, again cheese, and meat cubes.

Looking around a typical truck stop, the thought I had was -- this must be what it was like for our foraging ancestors to go into the forest among poisenous plants, berries, mushrooms, and try to scratch out an existance.  The shelves were lined with inedible, sugary, garbage, and you really had to hunt for something that wasn't going to lead to an early death.

So I guess my hypothesis is that the food environment was always a little f*** up.  There was never a utopia where you walked into a store and the shelves, including the ones at kids heights at the register, were just lined with fresh berries, protein, and dark chocolate.

I support political efforts to clean up our food chain, but I also think that you shouldn't wait for that to happen, or use that as an excuse to not eat well right now.

Wednesday, March 29, 2023

Sunday, March 26, 2023

The last time I did this drive I almost crashed!

 I'm on my yearly road trip, this time to Fort Wayne Indiana.  I did a similar trip 2 years ago before I was eating a low-carb diet.

This trip I left NJ kind of late, and only rolled into Fort Wayne around 3am.  What was strikingly different between this trip and the previous one was that I never reached a point of tiredness that pulled me off of the road.

On this trip I ate mostly the innards of 7-11 turkey and roast beef sandwiches with shelf-stable mayonaise and mustard packets.  I drank a lot of coffee, but I didn't feel the need to result to sugary snacks to keep me awake.

Even at 2am during the last hour of the trip, I wasn't falling asleep like I was the first time I did this trip, and I attribute that to better blood sugar stability.

Wednesday, March 22, 2023

Memetic Explanation for the Obesity Epidemic

 Around 1968 we went from understanding that frequent snacking, and consuming starchy and sweet foods makes you fat to whatever the new lay undertanding of calories was.  The prevalent memes were, "a calorie is a calorie", "calories in = calories out", and "eat less move more", and probably also "eat smaller meals more frequently".

And in the early 1980s, we villified fat, further adding carbohydrates to the recipe.

Note on Mindful Eating: Out of Sight, Out of Mind

Keep your counters clear!

"The researcher Brian Wansink tells the story this way: A man comes into the office on Friday, hungry because he’s had to rush to work with no breakfast. On the way to his cubicle he sees a plate of doughnuts left over from a meeting the previous day. He pokes a doughnut and finds that it is hard and stale. He goes to his cubicle, where the vision of the doughnuts keeps reappearing in his mind. He says “no!” to the impulse to get up and go get a doughnut. He says “no!” ten times. Finally he gets up and heads for the staff room and the stale doughnuts. There he meets a coworker who did not see the doughnuts on his way into the office and has been working all morning without the distracting visions and impulses. Who will eat the most doughnuts? As Wansink notes, the man who has been struggling with the vision and the impulses all morning will always eat more. Because the existence of the doughnuts entered his awareness, because he took in the possibility of eating them and said no ten times, eventually he is likely to say yes."

Heart Rate Monitors And Other Electronic Aids are Great, But They Can Be A Faff. Try The "Conversation" Metric Instead.

 A coach / English teacher friend of mine from way back in my rowing days once told me:

"With aerobic exercise, you should be able to carry on a conversation, perhaps more in the manner of Hemingway than Joyce."

I love gathering data with a heart rate monitor, logging software, Polar Flow, spreadsheets...etc.  However, I am finding that there is a reality to the idea that reducing the number of pain points in getting set up to work out is absolutely critical.  Perhaps once you know what 65% max heart rate feels like, you don't need to wire up each time.

I'm even willing to sacrifice having consistant workout logs, just to not have to keep the gear charged and with me all the time.  I suggest creating a blog as I have done to keep track.

Boring Low-Starch, Low-Sugar Meals Aren't The Problem, It's The Resistance To Them That Gets You

 The context for this post is having learned how to do mindfulness meditation during the pandemic with a reputable mediation app.  In that process I learned to manage anxiety by reducing the aversion to being anxious.   I learned to live with anxiety as just a phenomenon,  something that can be experienced as a physical sensation rather than a scary emotional state, and one that I could live with.

At the outset of the nutrition modification of the last few months, I found myself strategizing about how I was going to get really tantalizing, interesting meals when on low-carb.  I found myself thinking in terms of equivalents to really tasty (addictive) carb-full meals like chocolate chip pancakes for breakfast.

The reality is that it is much more helpful to not consistantly battle the fact that you are going to be eating whole foods like meat, protein, and fat. It's helpful to just acknowledge that the dynamic range (difference between the highest and lowest values) of excitingness of the meals  has got to come down.  Just kind of embrace that new range, and stop fighting it.

What I learned is that the pallete adjusts.  A really luxurious meal of prime rib, brocoli, and caesar salad with anchovies feels, in terms of pleasure response, just as beautfiul as gorging yourself on those pancakes, with much more satiety longevity, and much fewer downsides in terms of mood and energy.

One learns to move about that range with more adeptness using spices, salt, umami...etc.  As with the anxiety, the boringness of low-carb is much more tolerable when you kind of just acknowledge it and stop fighting against it.

Tuesday, March 14, 2023


 Since going on a low carb diet, my trigs have entirely normalized from nearly double the recommended range.  My total cholesterol and LDL are still marginally high, albeit lower than they were before the diet.    

I'm hesitant to post the actual labs, but I will at some point.

Calorie Density

 My PCP in Philly from a few years ago was kind of an idiot, and I don't guess that he succusfully reduced very many patients.  He was one of those guys that tried to steer me away from what I was at the time referring to as an "Atkins" diet, towards a diet that consisted of "low calorie density foods", such as salads.

Now, I think the first half of that, steering away from low-carb nutrition is patently stupid.  However the second half of that, "low calorie density food" has some merit.  

My dinner tonight was two cajun-spiced, reasonably small but tasty chicken breasts.  The only reason that this meal was satisfying is I pretty much also ate a whole head of steamed broccoli with it. 

I love broccoli so this wasn't a chore.  If there is something you like that is similarly green, fiberous, grown-above-ground, and tasty, then I would recommend mixing it in with your source of protein, fat, and calories.

Note to Self: Adding in Exercise After an Initial Success with Weight Loss (round #2)

Be very careful that adding workouts doesn't derail the diet.  I need to eat more food, or potentially more frequently, but I dont want to start eating crap.

Before workouts I was OK with 2 meals a day.  If I try to just "tack on" workouts, and don't modify my diet / calorie intake / meal frequency, it will exert undue pressure on being able to maintain low carb.

Newly Discoverd Spice / Recipe

 There is a restaurant near me called "The Chicken Or The Egg" (Marlton, NJ).  They make a mean order of chicken wings, non-breaded, with a cajun spice dry rub.

OMFG.  There is some slight danger of overeating because it tastes so good, but it is a low carb / high fat / high protein recipe, so if you do, you will feel very, very full for a long time.

Budget Secret Weapon #1

 Go for the cheaper / leaner cuts of sirloin, with a side of melted butter!

Progress Report (Reasonable Expectation For The Next 4 Months)

 I'm 4 months in and down about 35 pounds, which is about 10% of my starting body weight.  I and my PCP are ecstatic about this.

One temptation is to assume that the next 4 months will have the same negative slope as the previous 4 months.  It feels a lot healthier just to frame it this way:

"If my weight loss completely plateaus for the next 12 months, I will have still made significant inroads towards health."

I'm not arguing for starting to eat crap again, I'm just putting a lot of value in maintenance.  I'm not significantly liberalizing my nutrition plan, but I have started regular incline-power-walking for exercise.  (That new workout alone has the power to really derail a program due to apetite increase if not handled carefully).

Seasons are changing, given my seasonal job my agency over my own location, free time, and nutrition is about to get more challenging.  Even at total body weight just under 300, which _is_ heavy for my frame, I'm willing to be totally happy with maintenance for a little while, but I secretly hope weight will continue downward.

March 14th: current weight is about 297.  The first hump was a fasting-regimen that resulted in weight regain. The second hump is the current low-carb nutrition plan + exercise.