Tagged Diet and Nutrition

The Always Hungry Teenage Boy

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Credit Anna Parini

Ah, the adolescent male appetite. Those always hungry growing boys who eat standing up, drain the quart containers of milk or juice, and are fully capable of finishing off as an after-school snack the whole lasagna or pot of stew or cold roast beef that was supposed to serve as dinner for the family. I have come home to this myself: the teenager who greets his parents in the evening with an empty refrigerator, a sink full of dirty dishes, and the hopeful question, “What’s for dinner?”

In January, when the recently revised Dietary Guidelines for Americans came out, adolescent boys were specifically mentioned in a slightly unexpected context: “Some individuals, especially teen boys and adult men, also need to reduce overall intake of protein foods by decreasing intakes of meats, poultry and eggs, and increasing amounts of vegetables or other underconsumed food groups.”

Are teenage boys eating too much protein? What do we actually know about the dietary habits of adolescent males, beyond the sitcom jokes?

Dr. Elsie Taveras, the chief of general pediatrics at Massachusetts General Hospital for Children, is an expert on childhood obesity. “The forces that are working against good diet quality in adolescent boys,” she told me, begin with that famous appetite. “They’re always hungry, and that hunger, and a lack of satiety with small portions, leads to impulsive eating and eating large portions. And the foods they are choosing aren’t really keeping them full, since foods with high fiber levels are the kinds of foods which do keep people full.”

The dietary guidelines include graphs of what people in different age groups eat, drawing on data from the large National Health and Nutrition Examination Survey and showing, for each food group and at each age, how those amounts compare with the recommended daily intake. No one will be surprised to hear that when it comes to vegetables, both males and females of all ages eat significantly less than what is recommended.

For protein, the graphs look very different. For males, intake rises steadily from the 9- to 13-year-old category up through 31- to 50-year-olds, so that by the time they reach late adolescence and young adulthood, males report eating significantly more protein than recommended. Females, on the other hand, report eating quantities at the bottom of the daily standards, and 14- to 18-year-old girls say they’re eating less protein than recommended.

“There’s so little research focused just on boys,” said Alison Field, an obesity and eating disorders expert who is the chairwoman of epidemiology at the Brown University School of Public Health. “We know that at puberty, boys will acquire more muscle mass, and females will end up with more fat mass,” she said. “When males go through their growth spurt, which is longer than females’, their appetite is tremendous.”

These hungry fellows have big appetites, and as a group, they don’t tend to fill up on salad. So the primary dietary advice for them is probably “eat more vegetables,” and the hope is that would mean less meat. “What this recommendation really says is that teen boys should be eating more of their calories from vegetables but less from meat to better balance their nutrient intake,” Marion Nestle, a professor of nutrition, food studies and public health at New York University wrote in an email.

We know as much as we do about the dietary habits of teenage girls because there has been so much concern about obesity and also eating disorders. Many, if not most, adolescent girls are trying to lose weight whether they need to or not. Eating disorders are less common in males, but adolescent boys, on the other hand, are often preoccupied with building muscle, particularly if they are athletes in a sport like football, where size matters. “Males may want to bulk up, may want to be big,” Dr. Field said.

“We really underestimate how important weight and shape are to males,” she told me, suggesting that airbrushed images of models and sports figures in the media promise quick results. “Young men are just as influenced as young women by these images.”

The extra protein in the supplements that many boys buy in hope of bulking up may be useless. “The body can only absorb so much protein,” said Jerel Calzo, a developmental psychologist who studies eating disorders in adolescent males and is an assistant professor of pediatrics at Harvard Medical School. Boys who are eager to build muscle may exceed the recommended amounts, he said. “If you’re doubling up, you’re only getting the extra calories — sugars and fats.” Further, he said, the supplements are under-regulated, and the marketing is often deceptive.

In the worst-case scenario, these protein supplements can damage your kidneys, especially if you get dehydrated, so boys who dabble in protein supplements have even more reason to keep drinking fluids. But again, that can lead to problems, since sports drinks, also heavily marketed to young men with athletic ambitions, include additional refined sugars and empty calories. “We do a lot to push the fact that children don’t need sports drinks,” Dr. Taveras said. “Water is just fine.”

Although some teenage boys are clearly preoccupied with their bodies, others manage to eat their way right through adolescence without ever making very clear connections between any aspects of diet and health.

The unbounded adolescent male appetite, the athletic ambitions and the concomitant desire to add muscle, taken together with the very deliberate drumbeat of marketing, can add up to a poor diet. “To me, protein is a nonissue,” Professor Nestle said. “You can’t talk about protein in isolation from everything else people eat.”

The most essential message for adolescent boys and young men is a variant of the basic unsurprising message in the overall report: Eat more vegetables, and substitute healthier, less processed foods for the junk. Oh, and while you’re at it, guys, be careful of the protein powders. By and large, extra protein is not what you need.

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Making a Case for Eating Fat

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Credit Mark Hyman

For years Dr. Mark Hyman was a vegetarian who kept his intake of dietary fat to a minimum. Whole-wheat bread, grains, beans, pasta and fruits and vegetables made up the bulk of his diet, just as the federal government’s dietary guidelines had long recommended. But as he got older, Dr. Hyman noticed something that bothered him: Despite plenty of exercise and a seemingly healthy diet, he was gaining weight and getting flabby.

At first he wrote it off as a normal part of aging. But then he made a shift in his diet, deciding to eat more fat, not less – and the changes he saw surprised him.

He lost weight, his love handles disappeared, and he had more energy. He encouraged his patients to consume more fat as well, and many of them lost weight and improved their cholesterol. Some even reversed their Type 2 diabetes.

Today, as the director of the Cleveland Clinic’s Center for Functional Medicine, Dr. Hyman has become an outspoken advocate about the health benefits of eating fat. He promotes it on talk shows, educates other doctors, and has even managed to wean his close friend Bill Clinton off of his previously prescribed low-fat vegan diet.

Now in a new book called “Eat Fat, Get Thin,” Dr. Hyman takes a deep dive into the science behind dietary fat, making sense of decades of confusing health recommendations and building a case for why even saturated fats, which have long been vilified, belong in a healthy diet. Dr. Hyman argues that Americans have been misled about the benefits of fat because of a disconnect between nutrition science and food policy. In the book he challenges the nutrition orthodoxy while also exploring the food industry’s outsize influence on official health recommendations.

Recently, we sat down with Dr. Hyman to discuss his thoughts on the gap between nutrition science and health recommendations, the reason you should always plan your meals, and why he never leaves home without a stash of “emergency foods” in his backpack. Here are edited excerpts from our conversation:

Q.

Why did you write “Eat Fat, Get Thin”?

A.

I wrote it because we’ve been suffering from 40 years of bad advice about fat that’s led to the biggest obesity and diabetes epidemic in history. The myth that fat makes you fat and causes heart disease has led to a total breakdown in our nutritional framework. I felt it was important to tell the story of how fat makes you thin and how it prevents heart disease and can reverse diabetes. I think people are still very confused about fat.

Q.

In the book you argue that nutrition recommendations are often contradictory. How so?

A.

This year, for example, the U.S. Dietary Guidelines for the first time removed their longstanding restrictions on dietary fat. But they still have recommendations to eat low-fat foods. They say total fat is not an issue, but you should drink low-fat milk and eat low-fat dairy and other low-fat foods. It’s a schizophrenic recommendation from the government, and it’s the same with other professional organizations such as the American College of Cardiology and the American Heart Association. There’s a mismatch between the science and the government and professional recommendations.

Q.

What’s driving this disconnect?

A.

I think the government based its recommendations on some very flawed science, which took hold. It became policy that was turned into the dietary guidelines and the food pyramid that told us to eat six to 11 servings of bread, rice, cereal and pasta a day and to eat fats and oils sparingly. It’s very hard to overturn dogma like that. It’s embedded in our culture now. It’s embedded in food products. The food industry jumped on the low-fat bandwagon, and the professional associations kept driving the message. Unfortunately the science takes decades to catch up into policy and into practice. And I’m trying to close that gap by bringing awareness to the latest science on how fats and carbs work in your body.

Q.

You reviewed hundreds of studies while writing this book. What is your conclusion on saturated fat?

A.

It’s a huge area of controversy. But large reviews of randomized trials, observational research and blood-level data have all found no link between saturated fat or total fat and heart disease. Yet there are still recommendations to limit saturated fat because it raises total cholesterol and LDL cholesterol. But it also raises HDL, and it increases cholesterol particle size, so you actually get a net benefit.

Q.

What do you say to scientists who argue that saturated fat does in fact cause heart disease?

A.

I think the challenge with the research is that a lot of the data combines saturated fat in the context of a high-carbohydrate diet. The real danger is sweet fat. If you eat fat with sweets – so sugar and fat, or refined carbohydrates and fat – then insulin will rise and it’ll make you fat. But if you eliminate the refined carbs and sugar, that doesn’t happen. I think saturated fats can be bad in the context of a high-carbohydrate diet. But in the absence of that, they’re not.

Q.

What foods do you eat and recommend to your patients?

A.

What I eat is a cross between paleo and vegan diets. It combines elements of the two, so I call it a “pegan” diet. It’s low in sugars and refined carbs, and it’s very high in plant foods. About 70 to 80 percent of your diet should be plant foods. It should also include good-quality fats like nuts and seeds, olive oil, avocado, coconut oil and fatty fish. It should basically include whole, fresh food that’s unprocessed and high in fiber and phytonutrients. I always say that vegetables should make up 50 to 75 percent of your plate.

Q.

In a world where fast food is everywhere, wouldn’t that be fairly difficult for most people?

A.

It’s actually very easy to eat well if you just know what to do. The reason most people don’t succeed is they don’t plan their food. They plan their vacations, they plan their kitchen redesign, but they don’t plan out what they’re eating, and that’s a recipe for failure. I always think through how and where I’m going to get my food every day of every week. I also carry with me a set of emergency food so that I’m never in a food emergency.

Q.

What are the “emergency foods” that you carry?

A.

I have to protect myself from myself because I’ll eat whatever if I’m hungry in an airport. So I always carry packets of almond butter, cashew butter, an Evolution bar, a Bulletproof bar, a Tanka bar and a KIND bar. I basically have fat and protein as my snacks, and I have enough food in my bag to last an entire day so I don’t make bad choices.

Q.

We talked a lot about fat. But what is one overarching message you would most like people to understand?

A.

I think we have to get rid of the prevailing dogma that all calories are the same, and that we just need to exercise more and eat less, which is what the food industry and the government promote. The truth is that you can’t exercise your way out of a bad diet. Metabolism is not a math problem. It’s a hormonal problem. Food is not just energy. It’s information. It’s instructions that turn on or off different switches in your body that regulate hunger and metabolism. Obesity is not about how much you eat. It’s about what you eat. If you just focus on quality, not calories, then the quantity takes care of itself.

Organic Meat and Milk Higher in Healthful Fatty Acids

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Credit Matthew Staver for The New York Times

Organic meat and milk differ markedly from their conventionally produced counterparts in measures of certain nutrients, a review of scientific studies reported on Tuesday.

In particular, levels of omega-3 fatty acids, beneficial for lowering the risk of heart disease, were 50 percent higher in the organic versions.

“The fatty acid composition is definitely better,” said Carlo Leifert, a professor of ecological agriculture at Newcastle University in England and the leader of an international team of scientists who performed the review.

The European Commission, the executive body of the European Union, and the Sheepdrove Trust, a British charity that supports organic farming research, paid for the analysis, which cost about $600,000.

However, the question of whether these differences are likely to translate to better health in people who eat organic meat and drink organic milk is sharply disputed.

“We don’t have that answer right now,” said Richard P. Bazinet, a professor of nutritional sciences at the University of Toronto who was not involved with the research. “Based on the composition, it looks like they should be better for us.”

The two new scientific papers, published in The British Journal of Nutrition, are not the result of any new experiments, but instead employ a statistical technique called meta-analysis that attempts to pull robust conclusions out of many disparate studies.

They are certain to further stir a combative debate over whether organic foods are healthier. Some scientists assert that organic and conventional foods are nutritionally indistinguishable, and others find significant benefits to organic. Many people who buy organic food say they do so not for a nutritional advantage, but because of environmental concerns and to avoid pesticides.

The higher levels of omega-3, a type of polyunsaturated fat, arise not from the attributes usually associated with organic food — that the animals are not given antibiotics, hormones or genetically modified feed — but rather from a requirement that animals raised organically spend time outside. Organic milk and beef come from cattle that graze on grass, while most conventional milk and beef come from cows subsisting on grain.

“It’s not something magical about organic,” said Charles M. Benbrook, an organic industry consultant who is an author of the studies. “It’s about what the animals are being fed.”

Most of the same changes would be observed in conventionally raised animals that also grazed for the majority of their diet, the scientists said.“For once, this is a pretty simple story,” Dr. Benbrook said.

The review of comparisons of organic and conventional milk analyzed all 196 papers the scientists found. Because studies of meat are sparser, they could not look at just one type of meat like beef or pork. Instead, they did one analysis of the 67 papers they found for all types of meat. “Only if you throw them all in one pot can you do a meta-analysis,” Dr. Leifert said.

Two years ago, Dr. Leifert led a similar review for fruits and vegetables that found organic produce had higher levels of some antioxidants and less pesticide residue than conventionally grown crops.

Nutrition experts broadly agree that omega-3 fatty acids in food offer numerous health benefits. When the United States Department of Agriculture revised its dietary guidelines in 2010, it urged people to eat more seafood, which is rich in omega-3.

Omega-3 is much more prevalent in grass than in grain, which is why organic livestock and milk also contain higher levels. “Lo and behold, we altered in some fundamental ways the nutrient intake of these animals and hence the nutrient composition of the products that we derive from those animals,” Dr. Benbrook said.

The new analysis found that levels of another polyunsaturated fat, omega-6, were slightly lower in organic meat and dairy. Omega-3 and omega-6 are essential for the functioning of the human body, which can make neither. But some have argued that a skewing toward omega-6 has become unhealthy.

Centuries ago, people ate roughly equal amounts of the two fatty acids. Today, most Americans eat more than 10 times as much omega-6, which is prevalent in certain vegetable oils and thus also fried foods, as omega-3.

In an email, Dr. Walter C. Willett, the chairman of the nutrition department at the Harvard T.H. Chan School of Public Health, said the differences between organic and conventional beef were trivial, and the amount of saturated fat in both were high.

“Far greater, and beneficial, differences in fatty acids are seen if poultry and fish replace red meat,” Dr. Willett said.

A shortcoming of the recommendation to eat more fish is that if everyone followed it, the rivers, oceans and lakes would be emptied of fish. Dr. Bazinet of the University of Toronto said perhaps encouraging people to switch to organic meats and milk would be “a way to kind of get at them with the foods they’re already eating.”

Dr. Bazinet said observational studies suggested that adding 200 milligrams a day of omega-3s to an average diet should yield health benefits. Switching to organic beef would add about 50 milligrams. “Eating one grass-fed beef serving per day is not going to do it,” he said.

But if combined with a couple of glasses of organic milk, “it should make a difference,” Dr. Bazinet said. “That would be the hypothesis.”

Scientists are now trying to examine the health question more directly.

Dr. Leifert cited several studies that indicated that infants of mothers who ate organic fruits and vegetables were less likely to contract some diseases. He is also conducting experiments to see if rats fed organic foods are healthier. So far, he said, it appears that crop pesticide residue does have measurable effects on the rats’ hormones.

“We still don’t know whether it kills you, but we do know it has an effect on hormonal balances,” he said. “It’s something that makes you think a little bit.”

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Ask Well: The Sugar in Fruit

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Credit Andrew Scrivani for The New York Times

Do you have a health question? Submit your question to Ask Well.

Sophie Egan is the director of programs and culinary nutrition for strategic initiatives at the Culinary Institute of America. She is the author of the forthcoming book “Devoured: From Chicken Wings to Kale Smoothies — How What We Eat Defines Who We Are” (William Morrow, May 2016).

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A Diet and Exercise Plan to Lose Weight and Gain Muscle

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Credit Getty Images

If there is a holy grail of weight loss, it would be a program that allows someone to shed fat rapidly while hanging on to or even augmenting muscle. Ideally, it would also be easy.

A new study describes a workout and diet regimen that accomplishes two of those goals remarkably well. But it may not be so easy.

For most of us, losing weight and keeping it off is difficult. If you consume fewer calories than your body requires for daily operations, it turns to internal sources of fuel. Those sources consist of body fat and lean tissue, meaning muscle. When someone on a diet drops a pound of body mass (a measure that does not include water), much of that pound consists of fat. But about a third or more can be made up of muscle.

The problem with losing muscle is that, unlike fat tissue, muscle burns calories. Having less muscle means a lower resting metabolic rate, so you burn fewer calories throughout the day. Losing muscle may also discourage physical activity, which is important for maintaining weight loss.

So researchers have long been looking for weight loss programs that produce hefty amounts of fat loss but diminish any decline in muscle.

For scientists at McMaster University in Ontario, Canada, that goal seemed to demand a high dose of protein and also plenty of exercise.

As the scientists knew, amino acids in protein help muscle tissue to maintain itself and to grow. Many past studies have suggested that low-calorie but high-protein diets can result in less muscle loss than the same number of calories but less protein.

However, the best dosage of protein in these circumstances has remained unclear, as has the role, if any, for exercise.

So for the new study, which was published in The American Journal of Clinical Nutrition, the McMaster researchers rounded up 40 overweight young men who were willing to commit to an intensive weight-loss program and divided them in half.

All of the young men began a diet in which their daily calories were cut by about 40 percent (compared to what they needed to maintain weight). But for half of them, this consisted of about 15 percent protein, 35 percent fat and 50 percent carbohydrates.

The other 20 volunteers began a diet that mimicked that of the first group, except that theirs swapped the protein and fat ratios, so that 35 percent of their calories came from protein and 15 percent from fat. Over all, their protein intake was about three times the recommended dietary allowance for most people.

The researchers handled that switch by changing the make-up of a supplied drink. In the low-protein group, the beverage contained high-fat milk and no added protein. For the others, it consisted of low-fat milk and a large dollop of whey protein.

All of the men also began a grueling workout routine. Six days a week they reported to the exercise lab and completed a strenuous full-body weight training circuit, high-intensity intervals, or a series of explosive jumps and other exercises known as plyometric training.

The diet and exercise routine continued for four weeks, by the end of which time, “those guys were done,” said Stuart Phillips, who holds a research chair in skeletal muscle health at McMaster University and oversaw the study. “All they could talk about was food.”

The routine had succeeded in incinerating pounds from all of the participants. The men in both groups weighed about 11 or 12 pounds less, on average.

But it was the composition of that weight loss that differed. Unlike most people on low-calorie diets, the men on the high-protein regimen had actually gained muscle during the month, as much as three pounds of it. So in these men, almost all of the 11 or 12 pounds they had lost over all had been fat.

These results strongly suggest that extra protein is advisable during weight loss, Dr. Phillips said, to avoid stripping yourself of muscle.

But exercise is also key, Dr. Phillips continued, particularly weight training, since it is known to build muscle. Even the men on the lower-protein diet lost little muscle mass, he pointed out, which was unexpected and almost certainly due, he and his colleagues concluded, to exercise.

Of course, by the end of the month, none of the men wished to continue. This type of extreme calorie cutting combined with intense exercise “is not a sustainable program in the long term,” Dr. Phillips said. “It’s more a kind of boot camp,” he said, manageable in the short term by people who are very committed and generally very healthy.

He and his colleagues plan to conduct follow-up experiments to find a more realistic and sustainable program. They plan, too, to study female volunteers and play around with the diets’ composition, to establish definitively that it is extra protein and not reduced fat that promotes muscle gains.

In the meantime, for those hoping to become thin but not puny, various apps allow you to determine the percentage of your diet that is composed of protein. If it is below 10 or 15 percent, you might want to shift calories from fat to protein. Renew your gym membership, too.

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