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Category Archives: Medicalizing Obesity and Eating Disorders


To check the details of my nutritional plan please see the following link:

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What follows are some of the prerequisites for following my nutritional recommendations:

  1. Go grocery shopping at least once per week
    • Buy foods that are portable and contain  3 to 6 grams of fiber per serving. The food should be packaged in such a way that freshness is maintained, you can take or store it anywhere including in your car.
    • Make sure you buy enough to last you the entire week.
  2. Never be more than an arm’s length away from your food.
    • Keep it in your desk drawer, purse, backpack, briefcase, coat pocket and glove compartment.
  3. Find your new hunger equivalent
    • If we eat only when we are hungry we will always be in one of two states, famished or full; and, neither one is compatible with optimal functioning.
    • Eat for optimal function. The next time you have to read an e-mail twice or notice you are having a little difficulty keeping focused, eat something. Our function deteriorates before we feel hunger and we should respond to these functional signals by eating, well before we feel hunger. Start paying attention to your performance level and when you sense a slight drop, time to re-fuel. Find your new hunger equivalent, respond to it and you will start eating small amounts frequently, especially if you add fiber each time that you eat.

In summary, eat upon awakening; eat four to six times per day and consume four to six grams of fiber every time that you eat. You will function optimally and the scale will do the right thing.

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Mitchell R. Weisberg, MD, MP

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Childhood Obesity

By

Dr. Mitchell Weisberg

I originally published this post two years ago but I decided to re-post it in response to a new “weight-loss” product gaining popularity called, Sensa.

It just can’t be true!  How can a mere 12% increase in our daily caloric intake can result in a three-fold (300%) increase in the childhood obesity rate in just a single generation? According to statistics from The United States Department of Agriculture (USDA) this is precisely what occurred in the United States between the years of 1980 thru 2004. While I am not one to rely on damn statistics, in this particular instance, the stats quite literally add up, and they point squarely at the root cause of the  world-wide Obesity Epidemic;

IT’S THE FIBER, STUPID!

This 12% translates into each American eating an additional 300 calories per day, 138 of which are coming from refined grains. Understanding how such a seemingly minute amount of refined grains can have such an exponential impact on our national Body Mass demands a  review of some of the basics of cellular metabolism. Based upon its proportions of Carbon, Hydrogen and Oxygen atoms, dietary fiber is classified as a carbohydrate. Unlike other carbohydrates, such as sucrose (table sugar), fructose (fruit sugar) and lactose (milk sugar) which contain 4 calories per gram, there is no enzyme in the inner lining of the human digestive tract that allows fiber into the bloodstream where cellular metabolism takes place. Therefore, in reality, fiber has no calories.

By remaining within the digestive tract, fiber enhances satiety (the sense of being full or satisfied) and effectively reduces the total amount of food an individual consumes. Moreover, fiber reduces the rate at which other nutrients (carbohydrates, fats and proteins) ingested together with it are absorbed into the blood stream. This in turn facilitates a more complete extraction of the energy in the food that we eat by our 40 trillion cells, the actual site of cellular metabolism and reduces the amount of energy left over that would be stored in our bodies as fat. In other words, the physical and chemical properties that cause fiber itself not be metabolized are the same properties that  allow dietary fiber to optimize the process of cellular  metabolism.  It is these same properties  that underlies the abundant evidence that a generous intake of dietary fiber reduces risk for developing the following diseases: coronary heart disease,1 stroke,2 hypertension,3 diabetes,4 obesity,5 and certain gastrointestinal disorders.6 Furthermore, increased consumption of dietary fiber improves serum lipid (cholesterol) concentrations,7 lowers blood pressure,8 improves blood sugar control in diabetes,9promotes regularity,10 aids in weight loss,11 and appears to improve immune function. However, average fiber intakes for US children and adults are less than half of the recommended levels.

Always the optimist, I see the silver lining in the USDA’s statistics. Rather than our collective obsession over what not to eat, we can turn our attention to a much more positive and practical message about what it is that we should eat. To illustrate the rationale for this paradigm shift, I will naturally offer you some food for thought. Imagine that we eat a slice of chocolate cake and then test ourselves for the glycemic index of this piece of cake. The technical explanation of the glycemic index of food is the area under the two-hour blood glucose response curve (AUC) following its ingestion. Simply stated, the glycemic index measures how much of the energy from the piece of cake will be turned into actual energy available for our bodies to use versus how much of the energy from the piece of cake will go un-utilized and stored in our bodies in the form of fat. Now imagine we eat a second piece of chocolate cake identical to the first one but, the only difference being that to this piece of chocolate cake, 3 grams of fiber is added to the recipe. The glycemic index after  eating this piece of cake will be be significantly lower than the first piece. In other words, the addition of a relatively small amount of dietary fiber allows us to get more useable energy and store less of the energy as fat from, an otherwise identical piece of chocolate cake.

Processing food breaks down whole grains and causes a classic double whammy. First, the refinement of whole grains removes the two major benefits of fiber I just stated; enhanced satiety and metabolic optimization. Secondly, once whole  grains are refined they become the metabolic equivalent of pure sugar. Now when we ingest processed grains they are completely and almost immediately absorbed from our digestive tract into our blood stream and flooding our 40 trillion cells all at once. This does not allow our cells to be efficient in extracting usable energy which explains why diets high in processed sugar leads to Obesity. Ironically,  Obesity is a sign of cellular starvation!

When viewed from the perspective of cellular metabolism, we can see that it is no coincidence that in the same 25 year period that we added an extra 138 calories per day of refined grains to our diets that our nations childhood obesity rate tripled. The lesson we need to be passing on to our children now becomes equally clear; let them eat cake and their fiber too!

End


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My Nutritional Formula for Optimal Performance

Eat upon awakening in the morning: this does not mean that we have to cook or go out for breakfast; it’s as simple as opening an energy bar or pouring cereal and skim milk into a cup and drinking it.

Eat frequently: Eat at least at least 4 and as many as 6 times per day. Do not let 3 hours go by where you do not eat. The evidence shows that when we eat in response to being famished that we will consume more calories than if we eat before getting hungry. In addition, based on the principles that govern the process of cellular metabolism by the time that we feel hungry our cells’ efficiency at converting our nutrients into energy that we can actually use goes down and you know what that means? The cells will store more of the food that we eat as fat.

Consume 4 to 6 grams of Fiber each time that you eat: Fiber while classified as a carbohydrate, in the pure sense, is not a nutrient at all in that the human intestine does not have the necessary enzyme for absorbing fiber into the blood stream. Therefore, it is not metabolized, or used as a source of energy for life processes. However, due to its unique properties, fiber slows down the absorption rate of food from the intestines into the blood stream . This is why it is essential to consume fiber every time that we eat; as a result of this slower rate of absorption, the 40 trillion cells that make up our bodies can more efficiently capture the energy (calories) from the food that we eat for activities such as thinking, moving, growing our bones, our hair and our skin and leaving less total calories to store in our bodies in the form of fat. In addition, by not being absorbed and remaining in our digestive tracts, fiber enhances satiety, making us feel fuller from less food.

When people on fiber deficient diets gradually increase their fiber intake to the recommended level of 25 grams per day, they drop weight, they can sustain this weight loss, improve their blood levels of sugar and cholesterol, cut their risk of heart disease, improve their bowel regularity and cut their risk of developing Diverticulitis of the colon. 1 Pretty impressive effects for something that never even gets inside the human body. Isn’t it nice, for once that someone is telling you what you should eat instead of what you should not eat?

Eat before you are hungry! This sounds counterintuitive, and will make many dietitians cringe but, compare the task of learning to eat before you are hungry to the task of trying to not eat when you are hungry. It is a behavioral change that is readily achievable, and is more in synch with how our cells use energy most efficiently. In fact, hunger puts us in a sub-optimal functional state in which we are more prone to make mistakes and to fly off the handle. Eating often enough to preempt hunger, however, will keep your performance and your mood on a more even keel. Numerous studies have demonstrated that when people eat before they are hungry they eat fewer calories as compared to when they eat in response to being hungry.2 In addition, more frequent eating leads to a higher rate of efficiency of our cellular metabolism, making it more likely that the food that we eat becomes energy used by our bodies and not stored as fat around our bodies.3

Sources of Fiber: Look at the nutrients labels and check out what you are getting. Here are my general guidance with a few personal recommendations:

  • Whole Grain Cereals: 3 to 6 grams of fiber per serving: the entire line of Kashi cereals ; there are many other Cereals on the market that have 3 to 6 grams of fiber per serving
  • Whole Grain Breads: 2 to 4 grams of fiber per slice.
  • Whole Grain Crackers: > 3 grams of fiber per serving (Kashi brand, once again)
  • Fruits and Vegetables in general are good sources of fiber.
  • Soy, which is a vegetable, is high in protein as well as fiber. Here are some soy recommendations:
  1. Edamame; try Melissa’s brand. It is in the frozen section. Microwave it for 2 minutes and add course kosher salt; it’s awesome.
  2. Boca Brand of burgers and sausages (it’s all soy and actually tastes great)
  3. Morning Star is another brand of the faux meat products (and I am not a vegetarian)
  • Trail Mixes: with 5 grams of fiber per serving these are extremely practical because of how portable they are. Trail mixes can vary in their content quite a bit; some are more candy than anything else. Just check the nutrient content for the  and go for it. This is something you can keep in the car at your desk in backpacks, purses, brief cases, etc.
  • Energy Bars: 3 to 6 grams of fiber per serving.
  1. Cliff Bars
  2. Kashi GoLean

Here is a plug for Starbucks because they seem to get it. They have prepackaged trays such as their protein breakfast with apple, peanut butter, whole wheat bagel, hardboiled egg, cheeses and grapes.They make their sandwiches  on high fiber bread. They sell individual small packages of trail mixes. While on the pricey side, they deserve credit for offering truly healthy food.

To Summarize: Eat 4 to 6 times per day and eat 4 to 6 grams of fiber each time that you eat. If you make Fyour focus, you will see that your dietary fats, carbohydrates and proteins will fall into place, your function (performance) and mood will improve and, the bathroom scale will most definitely do the right thing.


Cereals with > 5 grams or more of fiber: the entire line of Kashi cereals (with a few exceptions); there are hundreds of cereals on the market now that meet these criteria. However, Cheerios, Rice Krispies, Kellogg’s Corn Flakes are all 2 grams of fiber or less. Kellogg’s Special K only has 2 grams but now they have come out with a Special K that has 5 grams of fiber. (they heard I was complaining)

Breads in general should contain 2 grams or more of fiber per slice.

Crackers: > 3 grams per serving (Kashi brand)

Fruits and Vegetables in general are good sources of fiber

Soy,  is a vegetable that is high in fiber as well as protein: Edamame; try Melissa’s brand; Boca Brand of burgers and sausages (it’s all soy and actually tastes great); Morning Star is another brand of the faux meat products (and I am not a vegetarian)

Trail Mixes: these are extremely practical because of how portable they are. Trail mixes can vary in their content quite a bit; some are more candy than anything else. Just check the nutrient content for the 5 grams of fiber and go for it. This is something you can keep in the car at your desk in backpacks, purses, brief cases, etc.

Energy Bars: Look for > 5 grams of fiber per serving:  Cliff Bars and Kashi GoLean are both excellent choices in this category. 

Here is a plug for Starbucks; they seem to get it. They have prepackaged trays such as their protein breakfast with apple; peanut butter; whole wheat bagel; hardboiled egg; some cubes of cheese and grapes. They have a fruit and cheese tray. Most of their sandwiches are on high fiber breads. They sell individual small packages of trail mixes. Granted they are pricey, but I do have to give them credit for offering this type of food.

OK; you got it? Good, then go and have something to eat before you get hungry.

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Mitchell R. Weisberg, MD. MP


Eat before you are hungry

When you eat in response to feeling hungry  you will consume more calories than when you eat before feeling hungry. Hunger is a late phase in the metabolic process occurring some time after our function is sub-optimal. Eating the exact same diet but spreading the calorie intake into smaller, more frequent meals will result in weight loss and an improvement in your overall functioning.  Due to the physical laws which govern the process of  cellular metabolism, 2,000 calories consumed in 5 meals of 400 calories will have a much different effect on body weight and available energy than the same 2,000 calories consumed as a single meal. In the smaller, more  frequent scenario as little as 200 calories (10%) is stored as fat, while in the single meal scenario as much as 1.000 calories (1/2 of the total calories consumed) is stored as fat. If you were to do nothing other than redistribute the same calories you are now consuming into smaller and more frequent meals, you would have more energy and you would lose weight!

Eat 4 to 6 grams of fiber 4 to 6 times per day

Fiber, while classified as a carbohydrate,  is not actually a nutrient in the usual sense in that the human digestive tract does not have the enzyme required for absorbing fiber into the blood stream; it is  not used as a source of energy for life processes.   By remaining in your digestive tract, fiber enhances allows you to feel satisfied for longer. More importantly, due to its unique chemical and physical properties, fiber slows the rate of absorption from your digestive tract of the other nutrients that you consume with the fiber. As a result of this slower rate of absorption, the nutrients you consume will be delivered to your 40 trillion cells at a rate which allows them to handle these nutrients most efficiently; thus, capturing the greatest possible amount of energy for living and the least possible amount for storing these calories as fat.  If you were to do nothing other than add fiber to your diet, you would immediately have more energy and lose weight.

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Mitchell R. Weisberg, MD, MP