Thinking about heart healthy foods and lifestyle

I'm 45 years old and I'm thinking about the recommendations about eating over my lifetime.

In the 70s it was the big push against not eating butter, eat margarine instead.  I don't remember much more, but I'm sure there was. Salt substitutes was a big thing then too, I think.

Then there was the 80 and 90s that demonized butter (still) and eggs (for fat and cholesterol) and we were told to eat a lot of healthy grains and and to limit red meat.

90s continued with that, but eliminating more fat became more important and as did eliminating more red meat. Yogurts became fat free, cottage cheese, etc. And what did they put in (in some cases) to make it taste more platable? artificial stuff and carbs!

The 2000s, butter started to be seen less worse than margarine. Transfats became the new target of bad foods - hmmm.... maybe that Crisco is WORSE than lard your grandmother used to use? People were substituting apple sauce for oil in muffins. Eggs started to make a comeback, but it was still recommended to eat like two whites to one yolk as yolks are fatty.

In the 2010s, things started to shift. Perhaps we "didn't" know as much about fats and carbs? Perhaps making fats the demon led to more obesity and more heart problems? Perhaps it's the abundance of carbs in our diet that is causing obesity and heat disease?

People couldn't explain how Atkins diet (and now several other similar diets) are so successful at weight loss efforts, reducing cholesterol, reducing, other heart strainers. How can you explain less heart disease on a diet full of fats and proteins?

I know for myself that eating a carb heavy diet led to high cholesterol. Eating a fat and protein heavier diet has led to MUCH lower cholesterol - and in the right breakdown - High 'good' cholesterol and low 'bad' cholesterol.

And foods are probably the SMALLEST portion of heart health - it's movement that's key. You could pretty much eat whatever you want in types of food if you exercise regularly. Of course, balanced meals nutritionally to get your vitamins and minerals, but eating butter and meats aren't bad. And some fats give you more than others - like yolks in eggs, avocados, nuts - they are fats that contain essential minerals and vitamins hard to find elsewhere, versus butter, which tastes great and is satiating, but doesn't add much for nutrition.

So, I look at how to take care of my heart and I'm going to take almost any food advise with a grain of salt (funny little cliche there, considering the topic!), but movement is key. I need to keep active - always - in some way. And while weight training is super important, aerobic is too.

And are you not up to date with the "maybe fat isn't so bad"? Read the article below from the New York times, Study Questions Fat and Heart Disease Link, by Anahad O'Connor, March 17, 2014.

Many of us have long been told that saturated fat, the type found in meat, butter and cheese, causes heart disease. But a large and exhaustive new analysis by a team of international scientists found no evidence that eating saturated fat increased heart attacks and other cardiac events.

 The new findings are part of a growing body of research that has challenged the accepted wisdom that saturated fat is inherently bad for you and will continue the debate about what foods are best to eat.

For decades, health officials have urged the public to avoid saturated fat as much as possible, saying it should be replaced with the unsaturated fats in foods like nuts, fish, seeds and vegetable oils.

But the new research, published on Monday in the journal Annals of Internal Medicine, did not find that people who ate higher levels of saturated fat had more heart disease than those who ate less. Nor did it find less disease in those eating higher amounts of unsaturated fat, including monounsaturated fat like olive oil or polyunsaturated fat like corn oil.

“My take on this would be that it’s not saturated fat that we should worry about” in our diets, said Dr. Rajiv Chowdhury, the lead author of the new study and a cardiovascular epidemiologist in the department of public health and primary care at Cambridge University.

But Dr. Frank Hu, a professor of nutrition and epidemiology at the Harvard School of Public Health, said the findings should not be taken as “a green light” to eat more steak, butter and other foods rich in saturated fat. He said that looking at individual fats and other nutrient groups in isolation could be misleading, because when people cut down on fats they tend to eat more bread, cold cereal and other refined carbohydrates that can also be bad for cardiovascular health.

“The single macronutrient approach is outdated,” said Dr. Hu, who was not involved in the study. “I think future dietary guidelines will put more and more emphasis on real food rather than giving an absolute upper limit or cutoff point for certain macronutrients.” 

He said people should try to eat foods that are typical of the Mediterranean diet, like nuts, fish, avocado, high-fiber grains and olive oil. A large clinical trial last year, which was not included in the current analysis, found that a Mediterranean diet with more nuts and extra virgin olive oil reduced heart attacks and strokes when compared with a lower fat diet with more starches.
Alice H. Lichtenstein, a nutritional biochemist at Tufts University, agreed that “it would be unfortunate if these results were interpreted to suggest that people can go back to eating butter and cheese with abandon,” citing evidence that replacing saturated fat with foods that are high in polyunsaturated fats – instead of simply eating more carbohydrates – reduces cardiovascular risk.

Dr. Lichtenstein, who was not involved in the latest study, was the lead author of the American Heart Association’s dietary guidelines, which recommend that people restrict saturated fat to as little as 5 percent of their daily calories, or roughly two tablespoons of butter or two ounces of Cheddar cheese for the typical person eating about 2,000 calories a day. The heart association states that restricting saturated fat and eating more unsaturated fat, beans and vegetablescan protect against heart disease by lowering low-density lipoprotein or so-called bad cholesterol. 

In the new research, Dr. Chowdhury and his colleagues sought to evaluate the best evidence to date, drawing on nearly 80 studies involving more than a half million people. They looked not only at what people reportedly ate, but at more objective measures such as the composition of fatty acids in their bloodstreams and in their fat tissue. The scientists also reviewed evidence from 27 randomized controlled trials – the gold standard in scientific research – that assessed whether taking polyunsaturated fat supplements like fish oil promoted heart health. 

The researchers did find a link between trans fats, the now widely maligned partially hydrogenated oils that had long been added to processed foods, and heart disease. But they found no evidence of dangers from saturated fat, or benefits from other kinds of fats. 

The primary reason saturated fat has historically had a bad reputation is that it increases low-density lipoprotein cholesterol, or LDL, the kind that raises the risk for heart attacks. But the relationship between saturated fat and LDL is complex, said Dr. Chowdhury. In addition to raising LDL cholesterol, saturated fat also increases high-density lipoprotein, or HDL, the so-called good cholesterol. And the LDL that it raises is a subtype of big, fluffy particles that are generally benign. Doctors refer to a preponderance of these particles as LDL pattern A. 

The smallest and densest form of LDL is more dangerous. These particles are easily oxidized and are more likely to set off inflammation and contribute to the buildup of artery-narrowing plaque. An LDL profile that consists mostly of these particles, known as pattern B, usually coincides with high triglycerides and low levels of HDL, both risk factors for heart attacks and stroke. 

The smaller, more artery-clogging particles are increased not by saturated fat, but by sugary foods and an excess of carbohydrates, Dr. Chowdhury said. “It’s the high carbohydrate or sugary diet that should be the focus of dietary guidelines,” he said. “If anything is driving your low-density lipoproteins in a more adverse way, it’s carbohydrates.” 

While the new research showed no relationship overall between saturated or polyunsaturated fat intake and cardiac events, there are numerous unique fatty acids within these two groups, and there was some indication that they are not all equal. 

When the researchers looked at fatty acids in the bloodstream, for example, they found that margaric acid, a saturated fat in milk and dairy products, was associated with lower cardiovascular risk. Two types of omega-3 fatty acids, the polyunsaturated fats found in fish, were also protective. But a number of the omega-6 polyunsaturated fatty acids, commonly found in vegetable oils and processed foods, may pose risks, the findings suggested.
The researchers then looked at data from the randomized trials to see if taking supplements like fish oil produced any cardiovascular benefits. It did not. 

But Dr. Chowdhury said there might be a good explanation for this discrepancy. The supplement trials mostly involved people who had pre-existing heart disease or were at high risk of developing it, while the other studies involved generally healthy populations. 

So it is possible that the benefits of omega-3 fatty acids lie in preventing heart disease, rather than treating or reversing it. At least two large clinical trials designed to see if this is the case are currently underway.

Why I'm trying the same approach despite "failing" 3 times

I often read on forums and hear people in real life saying things like, "Well I tried Atkins and it worked for awhile, but I couldn't stick with it." Or, "I tried giving up foods with refined sugars, but I gave up." They then conclude that there was something wrong with the diet. This may or may not be true.

There are a lot of ways to lose weight. Cabbage Soup diet, calorie restricting, exercising more, low carb, liquid diets, etc. Tons and tons of ways to do it. Some are fast track, some are slow. Some are dangerous and can lead to nutritional imbalances and fatigue and health issues, but most diet plans are fine - if it works for you to get the weight off and you can manage to stay on the diet long enough to get to your desired weight. Then there is maintenance - keeping the weight off. THIS is the hard part.

I "used" to think that you needed to take off the weight the "right" way. I thought there was really only one right way, but over the years and watching other people and noticing how I've changed my tactics too, I realize there are many ways and that's OK. The only thing that really needs to be learned is that you need to find a diet that can work for you for the long haul and then you need to learn how to keep the weight off in a healthy way once the weight loss is over. I used to think you needed to eat above a certain calorie limit. Or that some diet plans weren't great. I even poo-pooed weight loss surgery, but now I know better. That journey down isn't very important as long as you have the know how and have the ability to keep the mental struggle of sticking with the diet and then transition to maintenance eating.

That liquid diet of Oprah's where she melted all that weight? That diet would have been fine, if she ate for maintenance once coming off the liquid diet. That time she worked with Bob Greene and ate healthy and ran and exercised. That way of weight loss would have been fine if she continued eating for maintenance, but she, like most human beings struggled with that. The mental stamina a maintainer has to have is constant and it's probably nearly never, "easy". I don't expect it to be for me and I never have. THAT is the battle. It's easy to stay motivated to lose weight. It's very hard to stay motivated to keep that slow (or not so slow) creep back up in weight.

So, when people say, "That diet doesn't work."  and leap into another one I wonder, "Did it really not work? Or were you unprepared for the long, maintenance haul?"

Sometimes it's the first - I couldn't stick to a high carb, low calorie diet without being totally miserable and it would be very, very hard to not give into the carb cravings for long because I'm carb sensitive.  I probably couldn't faithfully follow the Atkins or Keto diet because I do use some carbs and don't have problems with some. Going too low carb would make me cranky and not like my food. So, I wouldn't want to lose that way. I probably couldn't stick to an all liquid diet either as I enjoy my food and would miss it! An all fish diet? I don't like fish enough for that, etc.

And I think sometimes people feel they can't tweak diets - like "sort of " Atkins, but with your own adaptations. Or, "sort of a liquid diet" but only for 2 meals a day and then a modest dinner or something.

But then sometimes it's the second problem. The diet worked. You managed to stay on the diet for the journey, but then gave up living in maintenance mode. Was that the diet not working for you? Or you not working with the diet?

For some of these diets, you would just quit them and transition back to normal foods. This is probably harder than finding a diet that works all the way down for the weight loss journey because you have so much more learning to do. Going from a liquid diet to a regular food diet would take a lot of trial and error in figuring out how much you can eat and maintain without being too hungry. People who find a system that works for them for the journey down that only needs to be slightly modified for maintenance should have an easier time - perhaps it's just moderately increase calories, or slightly less exercise (one hour a day versus two) or perhaps it's just changing the composition of foods to include more carbs.

Looking for a new diet to work this time is only half the story. It is for me. I have found a way to lose weight and I should be able to eat this way for the rest of my life - with diligence. I cannot blame my diet plan for my past failures. "I" stumbled with the diet, not that the diet failed me.

So, with that... I'll post this article that is resurfacing on some forums. Take it with a grain of salt. These "dieters" weren't given the tools to learn to stay on maintenance - the tricky part! The MENTAL part!!! The New York Times article from December 28, 2011: The Fat Trap by Tara Parker-Pope.

Following a prescribed diet versus tailoring a diet specific to you

Sometimes I read things and it gets me to thinking about it in new ways. As mentioned, I belong to a weight loss forum. On that forum, people are on a variety of diets - South Beach, Atkins, Intermittent Fasting, Weight Watchers, Paleo, Keto, Ideal Protein, Metabolic Research, Low Carb, Calorie Counters, etc. You get the picture. There are also people who have gotten a variety of weight loss surgeries and then a lot of people like me who make up their own diets.

I read a thread yesterday about someone who said that they had tried several diets and never could stick with it for more than three days before cheating/quitting. I responded with, "Well, maybe tailor your own diet that you can live with."  And that got me to thinking about those who follow diet plans out there in the world and those of us who don't And it got me thinking about how diets come and go in waves of fads. Huh... it's interesting. I don't think there is a right or wrong way to lose weight as long as it's done in a non-detrimental way to the health, but why is it that some of us need someone to tell us what to do EXACTLY and others can't or don't want to follow rules of a diet? And then that got me to thinking about myself specifically. Why have I never followed a diet, specifically?

So, my weight loss history. I have tried to lose weight 4 times in 44 years. The first time was when I was 21 years old. I just came up with my own hair brained idea of how to lose weight. I started exercising daily and then went on a heavily restricted diet. I lost weight SUPER fast, but was starving. It lasted about a month.

I went on a diet again when I was 27. I decided to join Weight Watchers to help me stay accountable. They had just started their points plan. I 'sort of" followed it, but not really. It gave me a set of points, but I often didn't follow it. for half the month I felt famished, so I ate more points. For the other half of the month I felt less hungry, so I ate less points. I also included exercise. After a couple months I stopped counting points and I didn't really care about anything they had to say. I just knew to eat less and move more. That lasted for about 6 months before I stopped.

I didn't diet again until I was 41 years old. I went with low carb because my blood sugars were way out of line (most likely caused by my thyroid). I had done low carb before during my second pregnancy because of gestational diabetes, so I knew what to do. But, I didn't follow any low carb diet like Keto or Atkins or South Beach. I don't know why... It never even entered my mind to follow a diet already out there. I just cut out the grains and sugars because those are not really needed for nutrition and they are also a great way to cut calories. And, again, I added in exercise, first just cardio, and then strength training. I had started low carbing specifically to lower my blood sugar levels, but what I found is that eating low carb made it easier to eat less and move more. I had more energy. I had less cravings. Huh, this low carb stuff might be the way to go for me!

I did that diet with a lot of exercise, with little tweaks, for over 2 years. Then I had this disaster half year when I just totally didn't care as I was tired of struggling with injuries. I snapped out of it, and then started right back up with the same diet, with more changes to accommodate for my injuries. At this point, I cannot do the strength training I was doing as I have several issues with neck and back issues (I get spasms quite frequently) and some issues with my left knee. I can, however, walk and walk fast, so I do that. BUT... if I'm too busy... I'm too busy. I don't beat myself up any more for days I can't fit in exercise, OR just don't feel like it. I just adapt my eating to be lower on those days - something I didn't seem able to do the last go around. Exercise is important, for sure, but I also need to be able to adjust my eating around more or less exercise as injuries and time away from exercise WILL HAPPEN.

So, now, with this current weight loss I do a combo of these diets: Keto, Atkins, South Beach, Calorie Counting, Low Carbing, Intermittment Fasting, and Intuitive Eating and probably more.  I don't follow ANY OF THEM specifically.

I fast most of the day and eat one large meal a day with two very light 'snacks' in the morning and afternoon. I keep them low carb to keep hunger at a minimum. However, if I'm hungrier, I listen and eat more (intuitive eating). I will not white knuckle it out. When I eat my big meal of the day, I keep it low carb - high fat and high protein. BUT.. I don't avoid food groups completely. I will eat fruit (minus bananas) and I will eat any vegetable or bean. When I'm craving it, I'll have something with sugar - in small bits. Like a slice of zucchini bread. Or a single small ice cream treat. I don't say, "I can't have that.". I just try to limit them because when I eat more of them, cravings start increasing and it becomes harder to stick with this way of eating. I also still need to calorie count because I do not have an "I'm full" button. I can and could eat my entire calorie allotment in one sitting - in one salad, so I need to count the calories.

This is what has worked for me, and for the most part, has been totally sustainable for 3.5 years. It was only depression that derailed me and now, I have a plan for that too.

Even the mere idea of following a prescribed diet has me balking at the idea. Like, "Who are YOU to tell ME how to eat?" But more, I don't trust any authority with food recommendations because what I've learned is that we still don't know SO MUCH about dietary needs. But also, I don't think I could follow someone else's diet and be able to stick to it. I would find it too restrictive for me. I would feel like I was cheating or failing if I couldn't follow it to a T. I just don't need it and would find it a hindrance.

Yet, I know a lot of people who need to be told what to do. It's why those diets that come with meals are so popular - Jenny Craig, Ideal Protein, etc. It takes all thinking out of it. Just do this and X will happen. Somehow, you need to figure out how to eat once you go off the program, but maintenance on ANY diet has that aspect of it.

I don't even think it's that people don't know what's healthy eating or not, but that they feel they need someone to hold their hand through it - to lead the way for them.

It gets me to wondering if people who follow their own diet are any more successful long term than those who follow a set of rules given to them by someone else. Or the reverse? Of course, people often start out with a particular diet and then tailor it to fit their needs - more points, less points. More carbs, less carbs, etc. I don't even know if there's been studies on that! I LEARN from prescribed diets, for sure. I didn't know about low carb when I was 27, but it was easy to find information on it later. But it's interesting to think about why we flock to diets - and then ditch them too.

Like Atkins was a HUGE rage... then it disappeared. Low fat was (and still is lingering on) a huge way of living, but now is waning for high protein and high fat. Paleo is now huge and will fade. it's always a cycle of diets coming in and out of fashion and people jump on the band wagon and jump off.  Why is that? is the problem of being too strict to follow? Or that it's trying to make all people fit into the same peg hole?  And why do people try a diet, have success at it, quit and then never try it again? Because you quit there was a problem with the diet? Or, was there a problem ELSEWHERE - like in your head?

It's interesting and the more I think about it all, the more questions I have.