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An Ideal BMI

The AHA! Team — Fri, 18 Jul 2025 05:15:35 +0000

Michael Greger M.D. FACLM via Nutrition Facts – Is there a unisex chart for optimal weight based on height? We seem to have become inured to the mortal threat of obesity. If you go back in the medical literature almost a quarter of a century ago when obesity wasn’t run-of-the-mill, the descriptions are much grimmer: “Obesity is always tragic, and its hazards are terrifying.” Not just obesity, though. Of the four million deaths attributed to excess body fat each year, nearly 40 percent of the victims are overweight, not obese. According to two famous Harvard studies, weight gain of as little as 11 pounds (5 kg) from early adulthood through middle age increases the risk of major chronic diseases, such as diabetes, cardiovascular disease, and cancer. The flip side, though, is that even modest weight loss can have major health benefits. What is the optimal body mass index, commonly known as BMI? The largest studies in the United States and around the world found that having a BMI of 20 to 25 is associated with the longest lifespan. Put all the best available studies with the longest follow-up together, and that can be narrowed down even further to a BMI of 20 to 22. That would be about 124 to 136 pounds (56 to 62 kg) for someone who’s five-foot-six (168 cm), as you can see below and at 1:22 in my video What’s the Ideal BMI?. Even within a “normal” BMI range, the risk of developing chronic diseases, such as type 2 diabetes, heart disease, and several types of cancer, starts to rise towards the upper end—starting as low as a BMI of 21. BMIs of 18.5 and 24.5 are both considered to be within the “normal” range, but a BMI of 24.5 may be associated with twice the risk of heart disease compared to a BMI of 18.5. Below and at 2:05 in my video is a graph of diabetes risk and BMI among women. There is a fivefold difference in diabetes rates within the so-called ideal range with a BMI under 25. Just as there are gradations of risk within a normal BMI range, there is a spectrum within obesity. Class III obesity (BMI over 40) can be associated with the loss of a decade or more of life. At a BMI above 45, for example, a person standing at 5’6″ (168 cm) and weighing 280 pounds (127 kg), life expectancy may shrink to that of a cigarette smoker. Skeptics have argued However, “skeptics have argued that the consequences of rising obesity levels have either been greatly exaggerated or are unclear.” A “motley crew,” “obesity skeptics are made up of a kaleidoscope of interest groups…includ[ing] feminists, queer theorists, libertarians, far right-wing conspiracy types and new ageists.” It “has also been popular on far right-wing, pro-gun, pro-America websites where the idea that obesity alarmists are nanny-state communists who simply want to stop us from having fun plays well….” Less treatment of the problem Unlike activists who organized to raise consciousness and stamp out the AIDS epidemic, for example, some in the size acceptance movement appear to have the opposite goal and “have called for less public awareness and intervention regarding obesity,” less treatment of the problem. I’m all for fighting size stigma and discrimination—I have a whole section on weight stigma in my book How Not to Diet—but the adverse health consequences of obesity are an established scientific fact. Can’t you be fat but fit? In a study of more than 600 centenarians, only about 1 percent of the women and not a single one of the men were obese. There does appear to be a rare subgroup of individuals who are obese and do not suffer the typical metabolic costs, such as high blood pressure and cholesterol. This raises the possibility that there may be such a thing as “benign obesity” or “metabolically healthy obesity.” It may just be a matter of time, though, before the risk factors develop. Even if they don’t, though, when followed long enough, even “metabolically healthy obese adults” are at increased risk of diabetes, as well as increased risk of fatty liver disease. They are also at greater risk of cardiovascular events, such as heart attacks, and/or premature death, as shown below and at 4:20. Bottom line? There is “strong evidence that ‘healthy obesity’ is a myth.” Many “fat activists” try to downplay the risks of obesity, even as they may be among “the greatest victims” of the epidemic. “Leading fat acceptance activist Lynn McAfee, who is director of medical advocacy for the Council on Size and Weight Discrimination and takes part in obesity conferences and government panels on obesity,” is quoted as saying, “‘I’m not actually particularly that interested in [health] and God I hate science….” If you missed the previous blog posts in this series on obesity, see related posts below. The final video in this series is What’s the Ideal Waist Size?. Key Takeaways Nearly 40 percent of the four million deaths linked to excess body fat annually are among people who are overweight, not just obese, showing the widespread health risks. Even small reductions in body weight can significantly improve health outcomes, reducing the risk of chronic diseases like diabetes, heart disease, and cancer. The optimal BMI for longevity is between 20 and 22, with risks for diseases increasing even within the “normal” BMI range, especially towards the upper end. Some groups, including far-right and size acceptance activists, downplay or deny the health risks of obesity, despite overwhelming scientific evidence linking it to serious health issues. Although some individuals may appear metabolically healthy while obese, long-term studies show that they still face heightened risks of conditions like diabetes, fatty liver disease, and heart attacks, debunking the idea of “healthy obesity.” To read the original article click here.

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Exploring the Obesity Paradox

The AHA! Team — Fri, 11 Jul 2025 05:24:39 +0000

Michael Greger M.D. FACLM via Nutrition Facts – How do we explain studies that suggest overweight individuals live longer? Martin Luther King Jr. warned that human progress is neither automatic nor inevitable, and the same may be true of the human lifespan. In the 1800s, life expectancy was less than 40 years, but it has been “advancing steadily” over the last two centuries, “increasing at approximately 2 years per decade”—until recently. Longevity gains appear “to be faltering or even being reversed.” Thanks to the obesity epidemic, we may now be raising the first generation to live shorter lives than their parents. A downward trend in longevity “This downward trend in longevity will almost certainly accelerate as the current generation of children—with higher body weights from earlier in life than ever before—reaches adulthood.” Current trends “potentially signal a looming social and economic catastrophe” if the obesity epidemic continues unchecked. In the coming decades, some predict we may lose two to five years or more of life expectancy in the United States. To put that into perspective, a miracle cure for all forms of cancer would only add three and a half years to the average U.S. life expectancy. In other words, reversing the obesity epidemic might save more lives than curing cancer. The evidence that being overweight increases our risk for debilitating diseases like diabetes is considered “indisputable.” However, surprisingly, there is controversy surrounding body weight and overall mortality. In 2013, scientists with the Centers for Disease Control and Prevention (CDC) published a meta-analysis in the Journal of the American Medical Association suggesting that being overweight was advantageous. Grades 2 and 3 obesity, such as being an average height of 5’6″ and weighing about 216 pounds (98 kg) or more, were associated with living a shorter life, but grade 1 obesity, weighing about 185 to 215 pounds (84 to 97 kg) at that height, was not. Being overweight (about 155 to 185 pounds/70 to 83 kg at 5’6″) appeared to be protective compared to those who were a “normal weight” of 115 to 155 pounds (52 to 69 kg). The overweight individuals, those with a body mass index (BMI) of 25 to 30, appeared to live the longest. Headline writers were giddy. “Being overweight can extend your life rather than shorten it,” read one. “Dreading your diet? Don’t worry—plump people live LONGER than their skinnier counterparts…” read another. “Extra pounds mean a lower chance of death.” Not surprisingly, the study ignited a firestorm of controversy in the public health community. The study was called “ludicrous,” “flawed,” and “misleading.” The chair of nutrition at Harvard lost his cool, calling the study “really a pile of rubbish” and fearing the food industry might exploit the study in the same way the petroleum industry misuses “controversy” over climate change. Public health advocates can’t just dismiss data they find inconvenient, though. Science is science. But how could being overweight increase the risk of life-threatening diseases, yet, at the same time, make you live longer? This became known as “The Obesity Paradox,” the subject of my video Is the Obesity Paradox Real or a Myth?. The solution to the puzzle appears to lie with two major sources of bias, the first being “confounding by smoking.” The nicotine in tobacco can lead to weight loss. So, if you’re skinnier because you smoke, then no wonder you’d live a shorter life, albeit with a slimmer waist. The failure to control for the effect of smoking in studies purporting to show an “obesity paradox” leads to the dangers of obesity being “grossly underestimated.” The second major source of bias is reverse causality. Instead of lower weight leading to life-threatening diseases, isn’t it more likely that life-threatening diseases lead to lower weight? Conditions such as hidden tumors, chronic heart or lung disease, alcoholism, and depression can all cause unintentional weight loss for months or even years before they are even diagnosed. It’s normal to be overweight in the United States, for example. So, people who are “abnormally” thin—in other words, at an ideal weight—may be taking care of themselves, but they may instead be “heavy smokers, frail and elderly, and seriously ill with weight loss due to their disease…” To put the obesity paradox to the test once and for all, The Global BMI Mortality Collaboration was formed, reviewing data from more than 10 million people from hundreds of studies in dozens of countries—the largest evaluation of BMI and mortality in history. To help eliminate bias, the researchers omitted smokers and those with known chronic disease, then excluded the first five years of follow-up to try to remove from the analysis those with undiagnosed conditions who lost weight due to an impending death. And? The results were clear: “This analysis has shown that both overweight and obesity (all grades) were associated with increased all-cause mortality”—a greater risk of dying prematurely. So, “adjusting for these biases leads to eliminating the obesity paradox.” In other words, the so-called obesity paradox appears to be “just a myth.” Indeed, when intentional weight loss is put to the test, people live longer. There are bariatric surgery studies like the SOS trial that show that weight loss reduces long-term mortality, and randomizing study participants to weight loss through lifestyle changes shows the same thing. Losing a dozen pounds through diet and exercise was found to be associated with a 15 percent drop in overall mortality. Now, exercise alone may extend lifespan even without weight loss, but there appears to be a similar longevity benefit of weight loss through dietary means alone. If you missed the previous blog posts in my series on the ABCs of obesity, see: The Best Knee Replacement Alternative for Osteoarthritis Treatment The Effects of Obesity on Back Pain, Blood Pressure, Cancer, and Diabetes The Effects of Obesity on Dementia, Brain Function, and Fertility The Effects of Obesity on Gallstones, Acid Reflux, and Cardiovascular Disease The Effects of Obesity on the Immune System and Kidney and Liver Diseases Check out the final two videos in this series: What’s the Ideal BMI? and What’s the Ideal Waist Size?. I cover all of this and more at length in my book How Not to Diet, and its companion, The How Not to Diet Cookbook, has more than 100 delicious Green-Light recipes that incorporate some of my 21 Tweaks for the acceleration of body fat loss. Why are people obese in the first place? I have a whole series of videos on that topic. Check the videos in the related posts. Key Takeaways Rising obesity rates may lead to shorter life expectancy for future generations, reversing centuries of progress in longevity. Studies suggesting that being overweight might extend life were biased due to confounding factors like smoking and reverse causality (diseases causing weight loss), and later analysis disproved the so-called obesity paradox. A large-scale review showed that both overweight and obesity are linked to a higher risk of premature death, contradicting earlier claims of protective benefits from being overweight. Intentional weight loss, whether through lifestyle changes or bariatric surgery, is associated with lower mortality rates and improved long-term health outcomes. Tackling obesity may have a greater impact on life expectancy than even a hypothetical cure for all cancers, highlighting obesity’s significant health risks. To read the original article click here.

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Obesity’s Impact on Back Pain, Blood Pressure, Cancer, & Diabetes

The AHA! Team — Mon, 07 Apr 2025 05:07:54 +0000

Michael Greger M.D. FACLM via Nutrition Facts – Losing weight can reduce sciatica, hypertension, and cancer risk, as well as reverse type 2 diabetes. In the ABCs of the health consequences of obesity, A is for Arthritis, as I discussed in my previous blog post, and B is for Back Pain. Being overweight is not just a risk factor for low back pain, but it is also a risk factor for sciatica (a radiating nerve pain), as well as degenerating lumbar discs and disc herniation. Similar to what we learned in the arthritis story, this may also be due to a combination of the excess weight, high cholesterol, and inflammation associated with being overweight. Why cholesterol? Studies of autopsies and angiographies show that the lumbar arteries that feed our spine can get clogged with atherosclerosis and starve the disks in our lower back, as you can see below and at 0:47 in my video The Effects of Obesity on Back Pain, Blood Pressure, Cancer, and Diabetes. B is also for Blood Pressure. Excess visceral fat—for example, internal abdominal fat—can physically compress our kidneys. The increased pressure can effectively squeeze sodium back into our bloodstream, increasing our blood pressure. Together, the combination of obesity and hypertension can have “disastrous health implications,” but the good news is that just a few pounds of weight loss can help take off the pressure. Losing excess weight has been described as “a vital strategy for controlling hypertension.” In fact, researchers found that losing around nine pounds (4 kg) may lower blood pressure about as much as cutting salt intake approximately in half can. C is for Cancer. As many as three-quarters of people surveyed “were unaware that being overweight or obese increased a person’s risk of cancer,” when, in fact, based on a comprehensive review of more than a thousand studies, excess body fat raises the risk of most cancers, including esophageal, stomach, colorectal, liver, gallbladder, pancreatic, breast, uterine, ovarian, kidney, brain, thyroid, and bone marrow (multiple myeloma) cancers, as you can see below and at 2:00 in my video. It could be the chronic inflammation of obesity or perhaps it is the high insulin levels due to insulin resistance. (Besides controlling blood sugars, insulin is also “a potent growth factor” that can promote tumor growth.) In women, it could also be the excess estrogen. After the ovaries shut down at menopause, fat takes over as the principal site of estrogen production. That’s why women who are obese have up to nearly twice the estrogen levels circulating in their bloodstream, which is associated with an increased risk of developing breast cancer and dying from it. The data on prostate cancer aren’t as strong, though obesity is associated with increased risk of invasive penis cancer. “We’re confident the link between obesity and cancer is cause-and-effect” One of the reasons we’re confident the link between obesity and cancer is cause-and-effect—and not just an indirect consequence of eating poorly—is that the overall risk of cancer goes down when people lose weight, even through bariatric surgery. Researchers found that those experiencing a sustained weight loss of about 40 pounds (19.9 kg) after surgery went on to develop around one-third fewer cancers over the subsequent decade, compared with matched individuals in the nonsurgical control group who continued to slowly gain weight over time. The exception, though, is colorectal cancer. “Colorectal cancer is the only known malignancy where the risk of being diagnosed with disease seems to increase after obesity surgery.” Indeed, after bariatric surgery, the rate of rectal cancer death may triple. The rearrangement of anatomy involved in one of the most common surgeries—Roux-en-Y gastric bypass—is thought to increase bile acid exposure along the intestinal lining. This causes sustained pro-inflammatory changes even years after the procedure, which is thought responsible for the increased cancer risk. In contrast, losing weight by dietary means has the potential to decrease obesity-related cancer risk across the board. D is for Diabetes. As presented in a consensus statement from the International Diabetes Federation, obesity is considered the single most important risk factor for the development of type 2 diabetes, which is the leading cause of kidney failure, lower-limb amputations, and adult-onset blindness. Ironically, many of the leading drugs used to treat diabetes (including insulin itself) cause further weight gain, creating a vicious cycle. So, again, using lifestyle medicine to treat the underlying cause is not only safer, simpler, and cheaper, but can also be most effective. If you missed my previous video, check out The Best Knee Replacement Alternative for Osteoarthritis Treatment. Coming up next? See related posts below. I continue the topic of weight control with these videos that may be of interest to you: Is the Obesity Paradox Real or a Myth? and Friday Favorites: What’s the Ideal BMI and Waist Size?. For more on back pain, blood pressure, cancer, and diabetes, check out their topic pages. Key Takeaways Obesity increases the risk of low back pain, sciatica, and lumbar disc degeneration due to excess weight, high cholesterol, and inflammation, which may restrict blood flow to the spine, and the loss of even a few pounds, can help reduce blood pressure and prevent related health complications. Obesity raises the risk of many cancers, including breast, liver, and colorectal cancer, due to chronic inflammation, high insulin, and, in women, increased estrogen levels post-menopause. Weight loss, including through bariatric surgery, significantly lowers cancer risk, except for colorectal cancer, where the surgery may increase the risk due to bile acid exposure. Obesity is the primary risk factor for type 2 diabetes, which can lead to severe complications. Lifestyle changes targeting obesity can be more effective than medications, which may cause further weight gain. To read the original article click here.

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Epigenetics and Obesity

The AHA! Team — Tue, 03 Dec 2024 06:06:42 +0000

Michael Greger M.D. FACLM via Nutrition Facts – Identical twins don’t just share DNA; they also share a uterus. Identical twins don’t just share DNA; they also share a uterus. Might that help account for some of their metabolic similarities? “Fetal overnutrition, evidenced by large infant birth weight for gestational age, is a strong predictor of obesity in childhood and later life.” Could it be that you are what your mom ate? A dramatic illustration from the animal world is the crossbreeding of Shetland ponies with massive draft horses. Either way, the offspring are half pony/half horse, but when carried in the pony uterus, they come out much smaller, as you can see below and at 0:47 in my video The Role of Epigenetics in the Obesity Epidemic. (Thank heavens for the pony mother!) This is presumably the same reason why the mule (horse mom and donkey dad) is larger than the hinny (donkey mom and horse dad). The way you test this in people is to study the size of babies from surrogates after in vitro fertilization. Who do you think most determines the birth weight of a test-tube baby? Is it the donor mom who provided all the DNA or the surrogate who provided the intrauterine environment? When it was put to the test, the womb won. Incredibly, a baby who had a thin biological mother but was born to a surrogate with obesity may harbor a greater risk of becoming obese than a baby with a heavier biological mother but born to a slim surrogate. The researchers “concluded that the environment provided by the human mother is more important than her genetic contribution to birth weight.” The most compelling data come from comparing obesity rates in siblings born to the same mother, before and after her bariatric surgery. Compared to their brothers and sisters born before the surgery, those born when mom weighed about 100 pounds less had lower rates of inflammation, metabolic derangements, and, most critically, three times less risk of developing severe obesity—35 percent of those born before the weight loss were affected, compared to 11 percent born after. The researchers concluded that “these data emphasize how critical it is to prevent obesity and treat it effectively to prevent further transmission to future generations.” Hold on. Mom had the same DNA before and after surgery. She passed down the same genes. How could her weight during pregnancy affect the weight destiny of her children any differently? Darwin himself admitted, “In my opinion, the greatest error which I have committed, has been not allowing sufﬁcient weight to the direct action of the environment, i.e. food…independently of natural selection.” We finally figured out the mechanism by which this can happen—epigenetics. Epigenetics, which means “above genetics,” layers an extra level of information on top of the DNA sequence that can be affected by our surroundings, as well as potentially passed on to our children. This is thought to explain the “developmental programming” that can occur in the womb, depending on the weight of the mother—or even the grandmother. Since all the eggs in your infant daughter’s ovaries are already preformed before birth, a mother’s weight status during pregnancy could potentially affect the obesity risk of her grandchildren, too. Either way, you can imagine how this could result in an intergenerational vicious cycle where obesity begets obesity. Is there anything we can do about it? Well, breastfed infants may be at lower risk for later obesity, though the benefits may be confined to those who are exclusively breastfed, as the effect may be due to growth factors triggered by exposure to the excess protein in baby formula, as you can see below and at 3:51 in my video. The breastfeeding data are controversial, though, with charges leveled of a “white hat bias.” That’s the concern that public health researchers might disproportionally shelve research results that don’t fit some goal for the greater good. (In this case, preferably publishing breastfeeding studies showing more positive results.) But, of course, that criticism came from someone who works for an infant formula company. Breast is best, regardless. However, its role in the childhood obesity epidemic remains arguably uncertain. Prevention may be the key. Given the epigenetic influence of maternal weight during pregnancy, a symposium of experts on pediatric nutrition concluded that “planning of pregnancy, including prior optimization of maternal weight and metabolic condition, offers a safe means to initiate the prevention rather than treatment of pediatric obesity.” Easier said than done, but overweight moms-to-be may take comfort in the fact that after the weight loss in the surgery study, even the moms who gave birth to kids with three times lower risk were still, on average, obese themselves, suggesting weight loss before pregnancy is not an all-or-nothing proposition. What triggered the whole obesity epidemic to begin with? There are a multitude of factors, and I covered many of them in my 11-video series on the epidemic in the related posts below. We are what our moms ate in other ways, too. Check out: Heart Disease May Start in the Womb Maternal Diet May Affect Stress Responses in Children Flashback Friday: The Effect of Animal Protein on Stress Hormones, Testosterone, and Pregnancy Key Takeaways Babies who are born larger are at higher risk of obesity later in life, suggesting early metabolic programming by maternal diet. The intrauterine environment significantly influences birth weight and later obesity risk, potentially outweighing genetic contributions from the biological mother. A baby with a thin biological mother but born to a surrogate with obesity may harbor a greater risk of future obesity than a baby with a heavier biological mother but born to a slim surrogate. Siblings born to the same mother before and after her bariatric surgery show reduced obesity risk in later-born children, highlighting the critical role of maternal weight during pregnancy. Epigenetics explain how environmental factors, like maternal weight, can influence gene expression and obesity risk across generations. Breastfeeding, especially exclusive breastfeeding, may lower obesity risk in children, contrasting with potential risks associated with formula feeding and excess protein exposure. To read the original article click here.

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Does Marijuana Affect Weight Gain or Bone Density?

The AHA! Team — Wed, 23 Oct 2024 08:19:02 +0000

Michael Greger M.D. FACLM via Nutrition Facts – Are the apparent adverse effects of heavy cannabis use on the bone just due to users being thinner? It’s been recognized for decades that cigarette smoking can have “a major effect” on bone health, “increasing the lifetime risk of hip fracture by about half.” It also appears to impair bone healing, so much so that surgeons ask if they should discriminate against smokers because their bone and wound-healing complication rates are so high. What about smoking marijuana? As I discuss in my video Effects of Marijuana on Weight Gain and Bone Density, “There is accumulating evidence to suggest that cannabinoids [cannabis compounds] and their receptors play important roles in bone metabolism by regulating bone mass, bone loss, and bone cell function.” Okay, but are they “friend or foe?” “Results from research on cannabinoids and bone mineral density in rodent models have been inconsistent. Some studies show increased bone formation, others have demonstrated accelerated bone loss, and yet others have shown no association. This variation in results may be due [in part] to differences in the mouse strain, sex, age…” If you can’t even extrapolate from one mouse to another, how can you extrapolate from mice to human beings? What if you just measure cannabis use and bone mineral density in people? Researchers tested thousands of adults and asked them about their cannabis use. There did not appear to be any link between the two, which is a relief. However, in this study, “heavy” cannabis use was defined as just five or more days of use in the previous 30 days. The researchers didn’t ask beyond that, so, theoretically, someone who smoked just five joints in their entire life could be categorized as a “heavy user” if they happened to use it five times in the last four weeks. How about cannabis use on 5,000 separate occasions over a lifetime? Now that’s a heavy user—decades of regular use. In that case, heavy use was “associated with low bone mineral density and an increased risk of fractures”—about double the fracture rate presumably due to lower bone density in the hip and spine, although heavy cannabis users were also thinner on average, and thinner people have lighter bones. Hip fracture risk goes down as our weight goes up. Nearly half of underweight women have osteoporosis, but less than 1 percent of obese women do, which makes total sense. Being obese forces our body to make our bones stronger to carry around all of that extra weight. That’s why weight-bearing exercise is so important to constantly put stress on our skeleton. When it comes to our bones, it’s use it or lose it. That’s why astronauts can lose a percent of their bone mass every month in “long-duration spaceflight.” Their bodies aren’t stupid. Why waste all that energy making a strong skeleton if you aren’t going to put any weight on it? So, maybe the reason heavy cannabis users have frailer bones is because they tend to be about 15 pounds lighter. Wait a second. Marijuana users are slimmer? What about the munchies? “The lower BMI that was observed in heavy cannabis users at first sight seems counterintuitive,” given marijuana’s appetite stimulation, but this isn’t the first time this has been noted. “Popular culture commonly depicts marijuana users as a sluggish, lethargic, and unproductive subculture of compulsive snackers,” and marijuana has indeed been found to increase food intake. A single hit can increase appetite, so you’d expect obesity rates to rise in states that legalized it. But, if anything, the rise in obesity appeared to slow after medical marijuana laws were passed, whereas it appeared to just keep rising in other states, as you can see in the graph below and at 3:45 in my video. The reason pot smokers may be slimmer is because of the effect of smoked marijuana on metabolism. We’ve known for more than nearly 40 years that within 15 minutes of lighting up, our metabolic rate goes up by about 25 percent and stays there for at least an hour, as you can see below and at 4:04 in my video. So, that may be playing a role. Is that why heavy cannabis use is associated with lower bone mineral density and increased risk of fractures? Because users just aren’t as overweight? No. Even when taking BMI into account, heavy cannabis use appears to be “an independent predictor” of weaker bones. I originally released a series of marijuana videos in a webinar and downloadable digital DVD. There are still a few videos coming out over the next year, but if you missed any of the already published ones, see the related posts below. For more on bone health, check out the related posts below. Key Takeaways Cigarette smoking is known to have a major negative effect on bone health, increasing the risk of hip fracture and impairing bone healing. Surgeons questioned whether they should discriminate against smokers due to higher complication rates. Cannabinoids and their receptors are implicated in bone metabolism, influencing bone mass, bone loss, and bone cell function. However, research on cannabinoids’ effects on bone mineral density in rodents has shown inconsistent results. Heavy cannabis use, defined as more than 5,000 separate occasions over a lifetime, is “associated with low bone mineral density and an increased risk of fractures.” This risk is about double compared to non-heavy users, potentially due to users’ lower bone density in the hip and spine. Heavy cannabis users, despite experiencing increased appetite (the munchies), tend to have lower BMI and are slimmer. The increased metabolic rate observed after smoking marijuana may contribute to this, but heavy cannabis use remains an independent predictor of weaker bones, even when considering BMI. To read the original article click here.

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Seasonal Weight Gain in the Fall

The AHA! Team — Wed, 18 Sep 2024 08:13:49 +0000

Michael Greger M.D. FACLM via Nutrition Facts – SAD doesn’t just stand for the standard American diet. There’s a condition known as seasonal affective disorder that is characterized by increased appetite and cravings, as well as greater sleepiness and lethargy, that begins in autumn when light exposure starts to dwindle. This now appears to represent the far end of a normal spectrum of human behavior. We appear to eat more as the days get shorter. There is a “marked seasonal rhythm” to calorie intake with greater meal size, eating rate, hunger, and overall calorie intake in the fall. In preparation for winter, some animals hibernate, doubling their fat stores with autumnal abundance to deal with the subsequent scarcity of winter. Genes have been identified in humans that are similar to hibernation genes, which may help explain why we exhibit some of the same behaviors, and the autumn effect isn’t subtle. As you can see in the graph below and at 1:06 in my video Friday Favorites: Why People Gain Weight in the Fall, researchers calculated a 222-calorie difference between how many calories we consume in the fall versus the spring. This isn’t just because it’s colder, either, since we eat more in the fall than in the winter. It appears we’re just genetically programmed to prep for the deprivation of winter that no longer comes. It’s remarkable that, in this day and age of modern lighting and heating, our bodies would still pick up enough environmental cues of the changing seasons to have such a major influence on our eating patterns. Unsurprisingly, bright light therapy is used to treat seasonal affective disorder, nearly tripling the likelihood of remission, compared to placebo. Though it’s never been tested directly, it can’t hurt to take the dog out for some extra morning and daytime walks in the fall to try to fend off some of the coming holiday season weight gain. Bright light therapy is used to treat seasonal affective disorder People blame the holidays for overeating, but it may be that “rather than the holidays causing heightened intake, the seasonal heightening of intake in the fall may have caused the scheduling of holidays at that time.” Regardless, as you can see below and at 2:15 in my video, other “specific recommendations for the prevention of obesity and metabolic syndrome by improving the circadian system health,” based on varying degrees of evidence, include: sleeping during the night and being active during the day; sleeping enough—at least seven or eight hours a night; early to bed, early to rise; and short naps are fine. (Contrary to popular belief, daytime napping does not appear to adversely impact sleep at night.) Also recommended: avoiding bright light exposure at night; sleeping in total darkness when possible; making breakfast or lunch your biggest meal of the day; not eating or exercising right before bed; and completely avoiding eating at night. This was the last video in my chronobiology series. If you missed any of the others, check out the related posts below. Key Takeaways Seasonal affective disorder (SAD) is characterized by increased appetite, cravings, sleepiness, and lethargy, starting in autumn with reduced light exposure. This aligns with a seasonal rhythm in human behavior, showing greater calorie intake, meal size, eating rate, and hunger in the fall. Human genes similar to those in animals preparing for hibernation have been identified, suggesting a genetic predisposition to seasonal eating behaviors. The body may be genetically programmed to store more fat in preparation for potential winter scarcity. Research indicates a 222-calorie difference in caloric intake between fall and spring, with increased consumption in the fall. This phenomenon cannot be solely attributed to colder temperatures, as eating in the fall exceeds eating in the winter. Despite modern lighting and heating, environmental cues still influence seasonal eating patterns. Bright light therapy, which addresses SAD, may help mitigate some of the increased calorie intake during fall. Recommendations for preventing obesity and metabolic syndrome include maintaining a healthy circadian system by sleeping during the night, being active during the day, ensuring sufficient sleep (seven to eight hours), adopting an early bedtime and waking time, taking short naps if needed, avoiding bright light exposure at night, sleeping in darkness, making breakfast or lunch the main meal, refraining from eating or exercising right before bedtime, and avoiding nighttime eating. To read the original article click here.

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Which Diet Works Even Better the Longer You Do It?

AHA Publisher — Wed, 24 Aug 2022 07:00:32 +0000

Michael Greger M.D. FACLM via Nutrition Facts – The most well-published community-based lifestyle intervention in the medical literature is also one of the most effective. CHIP, the Complete Health Improvement Program—now known as Pivio, may be “the most well-published community-based lifestyle interventions in the [medical] literature.” It is also one of the most effective, with clinical changes “approaching those outcomes achieved in [live-in] residential lifestyle programs.” As I discuss in my video The Weight Loss Program That Got Better with Time, CHIP encourages people to transition toward a more whole food, plant-based diet, and the “average reductions in blood pressure were greater than those reported with the DASH [Dietary Approaches to Stop Hypertension] study and comparable with the results” of blood pressure-lowering drug trials. If we’re going to reverse the worldwide chronic disease epidemic, though, we’ve got to scale this up. To make CHIP more accessible to a wider audience, each of Hans Diehl’s live presentations was videotaped. Then, a “trained and certified” volunteer facilitator got people in a room to watch the videos and helped foster discussion. When it comes to safe, simple, side effect–free solutions, such as a healthier diet and lifestyle, you don’t need to wait for a doctor to show up and give a lecture. Sounds great, but does it work? Those individuals who were the worst of the worst and participated in the program, finishing all the videos, had a 20-point drop in blood pressure, a 40-point drop in bad LDL cholesterol, and more than a 500-point drop in triglycerides, as you can see below and at 1:08 in my video. Of those who came in with diabetic-level fasting blood sugars, about one in three left with nondiabetic-level fasting blood sugars. Remember, all of this was achieved simply by empowering people with knowledge. Just encouraging people “to move toward a whole-food, plant-based diet” led to these remarkable benefits. What was the effectiveness of this volunteer-delivered lifestyle modification program on 5,000 participants? The same kind of significant reductions in weight, blood pressure, cholesterol, triglycerides, and blood sugars were found. Most studies giving “dietary advice to free-living subjects can be expected to reduce blood total cholesterol by only 3-6%…[but a] sustained reduction in blood total cholesterol concentration of 1% is associated with a 2-3% reduction in the incidence of heart disease.” So, on a population scale, even small differences matter. Put thousands of people through just one month of CHIP, however, and you get an 11 percent drop on average and up to a nearly 20 percent drop among those who need it most, as you can see below and at 2:12 in my video. Do the participants maintain their healthy habits, though? Doctors can’t even get most people to take a single pill once a day. How effective can a volunteer-led video series be at getting people to maintain a change of eating habits? Researchers looked at the CHIP data to find out. How were participants doing 18 months after completing the program? Most were able to maintain their reductions of meat, dairy, and eggs, though some of the junk food had started to slip back in. Their fruit and veggie consumption dipped, though not back to baseline. Ready for the huge shocker? Even though the participants had been told explicitly to eat as much as they wanted without any calorie- or carb-counting and without any portion control, just by being informed about the benefits of centering their diets more on whole plant foods, by the end of the six-week program, they were eating, on average, about 339 fewer calories a day without even trying. Instead of eating less food, they were just eating healthier food. But that was right at the end of the six-week program when they were all jazzed up. Where were they 18 months later? Anyone familiar with weight-loss studies knows how it works: You can excite anyone in the short term to lose weight using practically any kind of diet, but then after six months or a year, they tend to gain it all back—or even more. The CHIP participants were eating about 300 fewer calories a day during the program, but 18 months later, they were eating about 400 fewer calories. What kind of diet can work even better the longer you do it? A whole food, plant-based diet. “Many weight loss programs restrict energy [calorie] intake by limiting portion sizes, which often results in hunger and dissatisfaction with the eating regime, thus contributing to low compliance and weight regain,” but the satiety-promoting all-you-care-to-eat plant-based, whole-food dietary approach may be the secret weapon of sustainable weight loss. Key Takeaways The Complete Health Improvement Program (CHIP) encourages transitioning to a more whole food, plant-based diet and may not only be the most well-published community-based lifestyle intervention in the medical literature, but also one of the most effective. Its clinical changes may be on par with outcomes achieved in live-in lifestyle programs, and the average drop in blood pressure achieved with CHIP exceeded reports by the Dietary Approaches to Stop Hypertension (DASH) study and was comparable to results from trials with blood pressure–lowering drugs. To make CHIP more widely accessible, each live presentation delivered by Hans Diehl, the developer of the program, was videotaped so volunteer facilitators, each trained and certified, could screen the lectures and foster discussion among participants. Participants who completed the facilitated video program had a 20-point drop in blood pressure, a 40-point drop in bad LDL cholesterol, and more than a 500-point drop in triglycerides. Most of those who started CHIP with diabetic-level fasting blood sugars left with nondiabetic levels. Typically, studies giving dietary advice to participants not in a live-in setting may get cholesterol reductions of 3 to 6 percent, and sustained reduction of 1 percent is associated with a 2 to 3 percent drop in heart disease incidence. Just one month of CHIP achieved an 11 percent drop on average and up to a nearly 20 percent drop among those participants most in need of intervention. Eighteen months after completing the volunteer-led video series, most CHIP participants maintained their reductions of animal products, though some began eating more junk food and less fruits and vegetables (though not back to baseline quantities). Importantly, they were eating about 400 fewer calories a day than before they started CHIP. (At the end of the six-week video program, they were down only 300 daily calories.) Unlike many weight-loss programs that count calories and limit portion sizes, an all-you-care-to-eat plant-based, whole food dietary approach appears to be more sustainable. To read the original article click here.

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Your Healthiest Season Ever With Beyond Keto

AHA Publisher — Wed, 30 Mar 2022 07:00:13 +0000

Dr. Don Colbert – This could be your healthiest season yet. If you’re ready to ditch the processed, chemical-laden, unhealthy foods and move into a lifestyle that promotes energy, a healthy weight, healthy digestion, and a youthful brain, here it is. It’s time to take the best attributes of Keto Zone® and combine them with the best of the Mediterranean Diet. It’s time to experience Dr. Colbert’s Beyond Keto and live your healthiest season ever. Build Upon the Success of the Keto Zone® Many people have had incredible success with the Keto Zone. As reflected in studies on ketogenic diet results, Keto Zone users have experienced efficient and long-lasting weight loss, healthy cholesterol and triglyceride levels, optimal blood sugars, and more (1, 2, 3, 4, 5, 6, 7, 8, 9). The Keto Zone has always gone beyond typical ketogenic diets to promote the healthiest low-carbohydrate and high-fat foods. While other ketogenic diets may allow processed foods or a diet too high in saturated fatty meats, Keto Zone encourages the healthiest fats such as extra virgin olive oil and avocado oil, healthy protein from fish, eggs, poultry, and more, and a plethora of fresh, vibrant vegetables, green powders, and fruit powders. Now, Dr. Colbert has put these optimized Keto Zone recommendations into a book. To engage in your healthiest summer, look no further than Beyond Keto Zone. As promised, you will find an eating lifestyle that marries healthy Keto Zone eating with the Mediterranean Diet. The result? A lifestyle that promotes a healthy weight, high energy, youthful brain function, healthy digestion, and more! An Optimal Approach: Beyond Keto Beyond Keto is the next logical step after Keto Zone. If you’ve had great success with Keto Zone, this book and lifestyle will help you move further in your health journey. If you’re new to Keto Zone and Beyond Keto, it will bring you up to speed for both aspects. It’s simply the best of the Keto Diet combined with the best of the Mediterranean Diet. Beyond Keto: Combining Two Diets for the Best Outcome How can Keto Zone and the Mediterranean diet work together? First, Keto Zone offers initial, efficient benefits with weight loss and improved blood sugars. This phase will produce great results for weight loss, optimal blood sugars, less hunger, and a “reset” for eating (10). For anyone who’s struggled with eating the same unhealthy foods for years, a dramatic change is often the “shake-up” they need to see results. This is part one. While in the keto phase, dieters will experience all the amazing benefits of ketosis. They will produce ketones that will reduce hunger, provide amazing natural energy, support mental focus, and encourage healthy weight loss and maintenance (11). Then, the Mediterranean diet allows for continual healthy-eating success, whole body health, better digestion, and a lifestyle of great health outcomes and enables one to live a long, healthy life. How? It’s highly anti-inflammatory. Inflammation is at the heart of many negative health issues, and any healthy diet should aim to reduce it while achieving long term health goals (12). What’s more, the Mediterranean Diet has been proven over centuries to support full body health. It’s especially beneficial for heart health, optimal blood sugars, gut microbiota, and metabolism (13) because it is based on healthy fats such as extra virgin olive oil and seafood. In addition, it’s full of colorful plant foods like vegetables, beans, peas, lentils, salads and healthy, low- sugared fruits. Typically the Mediterranean Diet also allows for some whole grains. However, Beyond Keto emphasizes the amazing foods in the Mediterranean Diet while limiting any refined carbohydrates and sugars. It’s All About Results Scientific study, experience, and decades of research all point to key approaches for a healthy lifestyle: achieve a healthy weight, maintain a healthy weight, and fight inflammation. This is right in line with Beyond Keto. It promotes: A Healthy Weight: Almost all current negative health conditions are linked to, or exacerbated by, obesity (14). By utilizing healthy ketogenic diet principles, Beyond Keto promotes healthy changes and outcomes as soon as the first two weeks (15)! In addition, the Mediterranean diet component continues to support healthy weight and healthy body composition. Its focus on lean proteins, seafoods, healthy oils, beans, legumes, nuts, seeds, and vegetables provide a wonderful well-balanced, satisfying dietary lifestyle to maintain a healthy weight (16). Energy, Vitality, and Mental Focus: One of the greatest benefits of the ketogenic diet is the production of ketones. Ketones are natural energizing compounds that support healthy mental focus and vitality. The Mediterranean diet also encourages great energy and vitality with the abundant variety of healthy foods. Rather than experiencing the ups and downs of a high-sugar diet, you will enjoy steady, youthful energy from delicious, colorful whole foods. Optimal Blood Sugars and Metabolism: An amazing aspect of both the ketogenic diet and the Mediterranean diet normalized blood sugars. By using both eating styles in Beyond Keto, you’ll remove harmful refined starches while focusing on healthy fats, high fiber beans, peas, lentils, vegetables, lean protein and low glycemic fruits such as berries. Part of the improvement comes from weight loss. The other part comes from a diet that supports healthy metabolism and hormones (17). Healthy Cholesterol, Triglyceride, and Blood Pressure Levels. Both the Keto Zone and Mediterranean diet aspects of Beyond Keto support heart health. First, Beyond Keto promotes a healthy weight, which can help optimize heart health. Next, by choosing the incredibly heart-healthy foods in the Mediterranean diet, you can continue to encourage great heart health In fact, the foods in the Mediterranean diet and Beyond Keto work to support heart health, healthy cholesterol, and achieve whole-body health (18). Natural Unprocessed Foods Full of Antioxidants and Anti-Inflammatory Compounds. One of the worst dietary habits plaguing humans worldwide is the consumption of ultra-processed foods. In fact, researchers have found that ultra-processed foods are linked to most modern health conditions and even overall risk of death (19)! Thankfully, you’ll eat a healthy, high antioxidant and anti-inflammatory foods rather than ultra-processed ones (20). Healthy Gut Microbiota. Amazingly, Beyond Keto combines Keto Zone and Mediterranean foods to support gut health! This is great news for the millions of people who suffer from less-than-optimal gut function. In fact, studies have found the Mediterranean diet specifically improves gut microbiota and its associated metabolism functions. The diet’s prebiotics from healthy fibers along with healthy fats and polyphenols support gut health, hormone balance, and metabolism (21). Bottom Line: Experience Your Healthiest Summer It’s not just a diet. You can learn to live a healthy lifestyle that promotes healthy weight, energy, mental focus, reduced inflammation, and vitality! Don’t wait. Get started today with Dr. Colbert’s Beyond Keto and make this next season your best one yet! To read the original article click here.

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Weight Loss Journey: Personal Accountability and Responsibility

AHA Publisher — Wed, 09 Mar 2022 09:37:18 +0000

LifeBridge Health via Newswise – Weight loss may feel intimidating at times, but it can also be an empowering assertion of self-worth and control – your future is in your own hands and no one else’s. It’s a deeply personal journey towards a healthier self. No two people are the same, and the most important contributor is you. This is why a strong sense of personal accountability and responsibility is crucial to achieving your goals. Of course, it’s vital to assemble a team: seek the support of friends and family, and work with your doctor to determine the best path for your health, but only you can make it happen. Your healthy future will be built on a foundation of accountability. While this may feel overwhelming, there are several simple steps you can take to prepare for long-term success. Set Goals When you set achievable goals, your weight loss journey is divided into a series of milestones and opportunities for success. By achieving a string of smaller goals, you can build up the momentum and confidence to propel yourself into your healthy future. And if you happen to stray from the path, your goals can serve as a road map to get you back on track. Talk with your doctor to determine what the best goals are for you based on your unique circumstances. Keep an Online Journal Keeping a journal of your eating habits is a way to deepen your understanding of and connection to yourself. Healthy weight loss requires a sense of honesty about your own habits, tendencies and tastes. Your journal will help you keep track of what works, what doesn’t and how these dietary choices make you feel, all of which are crucial factors in the formation of not only healthier inclinations, but a healthier lifestyle overall. Don’t forget to include protein checklists to make sure you’re getting the most out of your food choices. By comparing your journal to the guidelines and resources provided by your doctor or nutritionist, you’ll be empowered to keep yourself on track and to take control of your own habits. After all, this is your weight loss journey and no one else’s. Get Support Your weight loss journey is your own, but that doesn’t mean you don’t need support. On the contrary, ensuring that you have ample support is a way of setting yourself up for success, and is therefore a critical aspect of your personal accountability. Our community of physicians, dietitians, psychologists, exercise specialists, and fellow bariatric patients is available to uplift, inform, and inspire you as you navigate the challenges of weight loss. And, by participating in the community, you can pay it forward by offering your insights and experiences to those faced with similar challenges. Learn more about LifeBridge Health’s bariatric support groups. Weigh Your Choices Weighing your food for portion control is best, but if you don’t have a scale, try comparing your portions to your own hands or everyday objects to make sure your serving sizes are correct. For example, a 3-ounce serving of meat should have the approximate dimensions of a deck of playing cards. Find additional examples below for a quick and easy way to help keep your portions correct. • 3 ounces of fish should be about the size of a checkbook • 1 serving of cooked grains should be about the size of a lightbulb or closed fist •1 ounce of cheese should be about the size of three dice, a domino or your thumb Check Your Progress Weighing yourself on a consistent basis is an important personal responsibility in achieving your goals. Remember, weighing yourself isn’t about anyone else, so don’t feel pressure to compare the number on your scale to that of others. Weighing yourself can help you: • Track your progress • Establish recorded history of your weight loss •Learn more about how you can most effectively achieve your weight loss goals. Try weighing yourself once a week, always at the same time of day, and preferably before breakfast. Record these weigh-ins in a spreadsheet or journal so that you and your doctor can review to learn more about your weight loss patterns. Stay on Target Whether you’ve had weight loss surgery, are a weight loss surgery candidate, or are simply seeking treatment to improve your dietary health, follow-up appointments are essential to achieving your goals. These appointments are an opportunity to assess your progress and adjust your plan if necessary, helping to keep you on track and well-equipped for a successful weight loss journey. To read the original article click here.

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