I had dinner with Dr. Robert Atkins years before his untimely death. He ordered a juicy marbleized steak with a baked potato drowning in butter and sour cream. At the time I thought this wasn’t a healthy choice- I was wrong! A front page article in the NY Times earlier this week reports on a large year-long NIH funded study published in the Annals of Internal Medicine supporting the ideas of Dr. Atkins, viz. high fat/ low carbohydrate diets are better for your health than equal calories of high carbohydrate/ low fat diets. You not only lose more weight but your total cholesterol goes down and the good cholesterol (HDLs) goes up. This is a great example of showing us that what we firmly believe to be the truth (i.e. a low fat is best for your and health) may not be so. An important issue in this study is that both groups lost weight. Calorie restriction does work to lose weight- but it may be easier for some patients who have difficulty dieting, to limit their carbohydrates, still feel satisfied, and lose weight.

vegetables-and-fruits-farmers-marketAs I report in my book End Back Pain Forever, a previous NIH funded study also showed that calorie reduction consistently resulted in weight loss; this new study reaffirms that low carbohydrate/high fat diets are healthier for your heart. In my book I reported that eating plant rather than animal protein/fat was preferable if you were concerned about lowering levels of the bad cholesterol (low density lipoproteins-LDLs). If you’re thinking of becoming a vegetarian- eating a vegetarian diet has been shown to produce the lowest levels of cholesterol and in general to be associated with the lowest BMIs (Body Mass Index, which is a measure of body fat based on weight and height.). The carbohydrates that are most damaging are refined carbohydrates such as found in white flour and sugar. No matter what diet you choose you need to get the minimal amounts of essential minerals and vitamins, therefore always include healthy amounts of fresh fruits and vegetables.

To paraphrase Mark Twain, it’s very easy to diet and lose weight- I’ve done it twenty times; The trick is to keep it off once you’ve lost it. Here are some tips from my book:

1. Increase your physical activity. If you never walk anywhere, start to do that. If you walk two blocks a day, increase it to four. If you go to the gym once a week, increase it to twice a week. The idea is to begin where you are now and increase slowly and steadily. Don’t take on more than you can handle, but work your way up. Make yourself a winner by taking on an achievable goal.

2. Don’t attempt total deprivation. Avoid starvation diets. Your body senses that you are starving, and it adjusts by slowing your metabolism, the rate at which calories are burned. This makes it harder to lose weight. Being able to lose weight and maintain the loss requires changing the way you eat and increasing physical activity. Just as you changed your activity level gradually, do the same with diet. In other words, start slowly. Make one simple change. I recommend to my patients that they stop eating bread and pastries. Some love bread and can’t imagine living without it. They soon learn, though, that after a short while, the craving for bread diminishes and their weight starts to drop. Then stop eating pasta or only allow it (and bread) as a treat; let’s say on Sundays.

3. Learn how many calories are in the food that you eat. When patients tell me that all they eat is salad, but they’re gaining weight, I have to remind them that any sauce or dressing may contain high-calorie ingredients. When you are out at a restaurant, it is best to avoid foods that may hide unwanted calories.

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