Do We Overeat Because We Are Fat or Are We Fat Because We Overeat?

Overweight (2)In the Journal of the American Medical Association (JAMA) Drs. David S. Ludwig and Mark I. Friedman present their point of view that the more fat cells you have and the fatter they are the hungrier you get. They believe we all have a genetic set point for an ideal body weight and intake and use of calories or fuel to maintain that genetically set weight. They believe that in recent years the set point in many of us has been raised leading to the current obesity crisis. Their ideas are discussed in the NY Times Sunday Review Sunday May 18, 2014.

Drs. Ludwig and Friedman believe that when energy is stored as fat , there is less energy available to the other functioning body parts obtaining fuel through nutrients in the blood stream and this leads to increased hunger. They attribute the re-setting of the set point to the introduction of refined sugars or carbohydrates into processed and produced foods to replace fats that had previously done the filler job. This was done in the mistaken attempt to reduce heart disease and vascular disease.

They also believe caloric restriction diets do not work. If they are successful in very disciplined individuals the success is very short lived. They go on to say that in fat individuals who eat more to get more fuel to the cells they actually start to gain weight. If they cut back on calories their metabolism actually slows down aggravating the situation.

Drs. Ludwig and Friedman are great believers in low glycemic and low carbohydrate foods and diets. They cite a recent study published in JAMA in which 21 overweight and obese young adults were fed either a low carbohydrate or low fat diet. Their intake and activity level were similar. They found that those on the low carbohydrate program burned up about 325 more calories per day than those on a low fat diet. Dr. Ludwig published an animal study using rats in which those fat a rapidly digestible carbohydrate diet (high glycemic index) and far fewer calories gained far more weight than rats fed a low glycemic index diet with carbohydrates that took a long time to digest.

The low glycemic index foods are the heart and soul of the meal replacement Take Shape for Life program developed by Medifast. As we move towards the summer months and bathing suit weather the interest in healthy weight loss and sustained weight loss increases.

We are currently offering the Take Shape for Life program in the office and I am a certified TSFL coach. Call us and set up an appointment if you are interested.

Aspirin for Breast Cancer?

Aspirin (2)In an observational study published in the Journal of Clinical Oncology in 2010, Drs. Michelle Holmes and Wendy Chen of the Harvard Medical School showed that women with breast cancer who took one aspirin per week had a 50% lower chance of dying from breast cancer. They have been trying to set up a randomized blinded study of 3000 women with breast cancer to test this finding using the gold standard of research but they have been unable to raise the $10,000,000 required for a five year study. Pharmaceutical companies see no profit in aspirin and prefer to use their research money on medications that are potentially more profitable. Government agencies seem to feel the same way opting to test new cancer drugs pushed by pharmaceutical companies rather than finance an inexpensive available product.

The authors believe aspirin, if proven to be effective in randomized trials, is a less expensive alternative for women who cannot afford or cannot tolerate hormonal therapy post-surgery for five years. Great Britain, through its national health service has decided to study the effects of aspirin on four cancers, with breast cancer one of them, in a study that will not be completed until 2025. Drs. Holmes and Chen believe that with proper funding their study of women with stage 2 and 3 breast cancer, would answer the question of aspirin’s efficacy within five years.