Can you be fit and fat?

 The  answer to this  seemingly obvious question is  often confused by trying to define what  fat  and fit means.

Over the years the measurement of fat and indeed its distribution has raised some interesting  questions. I’m very aware of the muscular athletic awesome looking athlete who comes back from their annual medical having been told they are obese according to their BMI. These are people, who when their body fat is checked (using callipers or some sort of science fiction machine) are down into the enviable category! 

The next interesting “quickie” fat measure came when the discussion of abdominal obesity became fashionable the waist to hip ratio measurement was quick and easy and it certainly measured the tummy fat that showed.

Today, we should all be about visceral fat. But, It’s a hard thing to measure without a CT scan . The problem with visceral fat (the fat inside your visceral cavity, or around your organs) , is that skinny people can have visceral fat and that people with a big tummy don’t necessarily have visceral fat. It can sometimes be all subcutaneous!

Basically we have obvious fat and visceral fat.

Now we need to ask what is healthy or what is metabolically unhealthy According to Ortega (2012) .  If you crave the “metabolically unhealthy” crown, you must have one or more of these readings

  • high blood pressure (≥130/85 mmHg)
  • high blood triglycerides (≥150 mg/dL)
  • low HDL “good” cholesterol (<40 and 50 mg/dL in men and women, respectively)
  • high fasting blood sugar level (≥100 mg/dL)

Since the NHS actually started recording  the prevalence of obesity it was correlated with high blood pressure, high triglycerides, low good cholesterol and poor blood sugar. So it was quickly assumed that any overweight person would have these metabolically unhealthy markers. It wasn’t difficult to imagine the step to saying obesity causes them.

However, this is a great example that causation doesn’t necessarily mean causation.  Is it possible to be visibly overweight ( I know that’s terribly subjective, but work with me) but still have metabolically healthy readings ( good blood pressure, good  blood sugar).  


Ortega et al wrote ”The intriguing metabolically healthy but obese phenotype: cardiovascular prognosis and role of fitness ” 


They ran some tests using BMI and the 4 health markers and noted (i) metabolically healthy but obese individuals have a higher fitness level than their metabolically abnormal and obese peers; (ii) after accounting for fitness, metabolically healthy but obese phenotype is a benign condition, in terms of cardiovascular disease and mortality. this led to these conclusions (i) Higher fitness should be considered a characteristic of metabolically healthy but obese phenotype. (ii) Once fitness is accounted for, the metabolically healthy but obese phenotype is a benign condition, with a better prognosis for mortality and morbidity than metabolically abnormal obese individuals.

  • “Metabolically healthy” obese participants had a better baseline fitness level on the treadmill test compared with “metabolically abnormal” obese participants (adjusting for age, sex, examination year, smoking and alcohol consumption, and when using either BMI or body fat percentage to define obesity). The difference was the same for men and women.
  • “Metabolically abnormal” obese participants had significantly increased risk of dying from any cause during follow-up compared with “metabolically healthy” obese participants (adjusting for confounders and using either BMI or body fat percentage to define obesity).
  • When looking at cardiovascular disease outcomes, “metabolically abnormal” obese participants only had increased risk of a fatal or non-fatal cardiovascular disease event compared with “metabolically healthy” obese participants when using body fat percentage to define obesity. There was no difference in risk when using standard BMI definitions.
  • “Metabolically healthy” obese participants had no difference in risk of dying from any cause, or of fatal or non-fatal cardiovascular disease events compared with “metabolically healthy” normal-weight or fat participants.

On a narrow set of  health criteria and dubious “obesity’ assessments it’s quite possible to argue that you can be fat and fit!  However, over the years more concern has been raised about where your fat is . Research has indicated,visceral fat may be doing something  far more nasty. 

 “Visceral Fat Adipokine Secretion Is Associated With Systemic Inflammation in Obese Humans” 2007 concluded “that visceral fat is an important site for IL-6 secretion ( an inflammation causing thing) and provide a potential mechanistic link between visceral fat and systemic inflammation in people with abdominal obesity”. So there is an interesting line of experiments that indicate that visceral fat could be there, releasing nasty stuff.

The interesting thing is that you can be quite skinny and still have visceral fat and you can be obese and have no visceral fat. So based on some current evidence and where you fat is  you can be both  visibly fat and fit and skinny and ill!

(Update added 4th August 2020) However, it seems that science gallops on on! There are an increasing number of reports that suggest any sort of obesity is bad for your health. The above article looked at the narrow proposition that you can have “markers” of fitness and still be overweight. The clear answer is yes.

However there are other markers. Things like Adipokines, (which can be either pro or anti inflammatory ) It seems that the fatter you are, the more pro inflammatory they become. Which is bad.

So watch out for the next article in this series that will probably be “Can you be fat and healthy”

Before you start that diet: ask yourself some questions

I’m not really that into navel gazing. I came from a  religious family so I’ve had my fill of sitting quietly. On top of my christian praying and reflecting  experience, my mother and brother even  fell for that 1970’s transcendental meditation craze. So I had to put up with that too. Being 14 and being made to meditate wasn’t fun.

Never the less  there are some lessons to be learned from “sitting with yourself”  or  as Socrates said,  “the unexamined life is not worth living”. To sensibly ask yourself questions is actually a good idea. To actually listen to the answers is probably better!!

So you’ve decided, once again to lose weight. This time, rather than just jumping on the first weird diet you can think of, why not ask yourself some questions. Here are some useful ones.

Spend a bit of time thinking about the past ( both recent and longer term). Not too much, otherwise you can lose yourself in the mists of time. But get a handle of your history. 

Are you  overweight now?

Why are you overweight? (This is  a very stark, rude question, but was it illness, unhealthy eating, too much food, not enough exercise etc).

Have you ever lost weight before?

If so, what helped?

and what hindered?

Ok, so you have lost weight in the past! What made you put the weight back on?

Ok, thats your past, or as much as you realistically need to consider, what are your views and targets now?

Are you looking for a  short term  fix (a wedding in 2 weeks), or are you prepared to have a long term target

To be successful you need to change your approach to food, weigh and measure, change choices, record your eating habits, and exercise, and all this will no doubt make you feel uncomfortable. So, on a scale of 1 to 10 (10 is high)  answer these questions.

Be honest, as we can all want to lose weight but not have much motivation because we know it’s hard work?

How motivated are you to lose weight?

How motivated are you to change your eating habits?

How motivated are you to increase your physical activity?

Will you try new strategies/techniques for changing your eating, exercise, and other behaviours?

Are you prepared to spend time studying reading materials  about nutrition ?

Will you record your exercise  and everything you eat and drink,?

Will  you  change your eating habits?

 Will  you be able to work regular physical activity into your daily schedule?

Will  you be able to exercise  and be active most, if not everyday?.

If you make a mistake, have  a lazy day, or give into temptation, can you forgive yourself, and “get back on the programme”?

Do you have an emotional connection with food?

Do you eat more when you are upset, annoyed or miserable?

Do you eat to celebrate?

If you have  confrontation, do you seek comfort in food to calm down?

A SERIOUS BIT

Think about this question carefully?

Have you ever purged (used laxatives, diuretics, or  vomiting) to control your weight?

If yes,  is this “often” (About once a month  A few times a month  About once a week  About three times a week  Daily.)

If purging is part of your present weight loss strategy, and you feel unable to stop, you probably need to chat to your doctor who could get you some  one to one support to deal with this issue

Thats just the tip of the iceberg. If you’d like more help or thoughts on managing your weight, do join the mailing list of email me directly on Andrew@andrewstemer.com

To keep up to date with fitness, physical therapy and mindfulness tips join my mailing list here:

Measuring cups

Over the years, Ive spoken to a lot of people about food and quantities of food. Whenever I’ve checked that the would be dieter has a set of cups, everyone , everyone goes “yes”.

Just to confirm, I say ” do you have a set of cups?” they say, “Yes”.

In 9/10 times these people are lying, or are very ignorant, or very stupid.

A set of cups is a specific way of measuring quantities.  Here is a pictureandrew stemler cups

You can buy them online. Here are some cheap plastic ones and here are some more expensive stainless steel ones.

As much as I hate the smart arse phrase ” if you’re not measuring you’re guessing“: in food, its spot on.

At costs ranging from £1.35 to £12 you really do need to get some way of measuring food!

Hippy protein: the Game Changers effect.

The recently release film (documentary) the Game Changers has brought “meat free” protein sources back to the top of the nutritional agenda. It seems you no longer need to be a tree hugging hippy to see if you can get your protein from none meat sources.

For years there has been a grumble of bad PR about red meat and processed meat, although some dispute that meat has any down side.

That said, its  now worth while noting the growth of  this concern about the constant consumption of meat both from a health and environmental cost perspective . So it’s as well to experiment with plant protein and at the  very least, least mix it up a bit.

The fact that  James Cameron, Arnold Schwarzenegger and Jackie Chan all got together to support a film that promotes ” more veggie” is in itself worth noting.

So here is an outline of some useful veggie sources of protein. (BTW a CUP is a specific measure)

Green Peas. One cup is about 8 grams of protein. I love peas.

Quinoa. 8 gm a cup! Includes all nine essential amino acids . Ive never tried it. I must!

Beans.  Two cups of kidney beans, for example, contain about 26 grams. But buying them and soaking them is a bit of bind, so buy them in can form!

Tempeh and Tofu. Ive never liked these. I always though soya was a genetically modified alien that stuck to your face, laid eggs in your tummy that exploded through your abdomen. I could be wrong. Allegedly contains about 15 and 20 grams  of protein per half cup. But, I must try again.

Edamame: Soya as god intended. Boiled edamame contains 8.4 grams of protein per half cup. Must try it. Having written that, Im already anxious.

Leafy greens cabbage and stuff. I love these, but Ive never really thought of them as a protein source. Allegedly two cups of raw spinach contain 2.1 grams of protein, and one cup of chopped broccoli contains 8.1 grams.

Hemp seeds. If you can resist planting them out under high pressure sodium lights to make drugs,10 grams of protein in 3 tablespoons.

Chia seeds. 4.7 grams in 2  tablespoons. But really ” TWO TABLESPOONS”. Thats a lot to hide

Sesame, sunflower and poppy seeds. Throw these in your earth saving muesli volume, sunflower seed 7.3 grams of protein per quarter cups. Sesame seeds and poppy seeds ( per 1/4 cup) at 5.4 grams each.

Seitan. Never tried it, seen it, or heard about it until now ( 2019 really is my year)!!. But basically, it’s a wheat gluten. So whilst middle class folk are swooning from gluten intolerance,  the hippies are chowing down on it. 75gms of protein in 100 gms.

Chick peas 7.3 grams of protein in just half a cup, and are also high in fiber and low in calories.

fibre

According to the British  Nutrition foundation the government in 2015 published new guidelines with a recommendation that the population’s fibre intake should increase to 30g a day for adults (aged 17 years and over).

 Age (years)
 Recommended intake of fibre
 2-5  15g per day
 5-11  20g per day
 11-16  25g per day
 17 and over  30g per day

here is a fun fibre video

According to the British Nutrition Foundation

Fibre helps to keep our digestive system healthy and helps to prevent constipation. For example, fibre bulks up stools, makes stools softer and easier to pass and makes waste move through the digestive tract more quickly.

The European Food Safety Authority suggests that including fibre rich foods in a healthy balanced diet can improve weight maintenance. Dietary fibre can reduce your risk of:

  • Cardiovascular disease (heart disease and stroke) and type 2 diabetes
 Foods such as oats and barley contain a type of fibre known as beta glucan, which may help to reduce cholesterol levels if you consume 3g or more of it daily, as part of a healthy diet.
  • Colorectal cancer (bowel cancer)
Did you know that the World Cancer Research Fund (WCRF) estimate that 45% of bowel cancer could be prevented through diet, physical activity and weight?

Fibre and bowel cancer
We know that dietary fibre may help to protect against bowel cancer. Although the reasons for this are not fully understood, this may be because fibre increases stool size, dilutes content and moves it faster through the gut so the amount of time waste products stay in contact with the bowel is reduced. Some types of fibre may also help gut bacteria produce helpful chemicals that can have beneficial effects on the bowel (see below).

Fibre and good bacteria
Research has increasingly shown how important the bacteria in our gut may be to our health, and it has been suggested that a fibre rich diet can help increase the good bacteria in the gut.  Some fibre types provide a food source for ‘friendly’ gut bacteria helping them to increase and produce substances which are thought to be protective such as short-chain fatty acids.

Small cafes should publish calorie content of their food

According to todays telly, there are moves a foot to make small cafes and  food bars publish  (or display) the  calorie value of the food they serve.

To my surprise , the story wasn’t “about time” it was”poor small traders who will go bankrupt because they  have to workout the calorie value of the food they serve”

The poor dears.

I’d suggest that if you have a decent menu range , think old fashioned greasy spoon cafe, it could take,  maybe 2 hours to knock up this info. The reality is, if you don’t know the calorie value of the food you serve, maybe, you shouldn’t be dishing it up.

There are hundreds of easy to use calorie calculating resources.

We know we have an obesity crisis. We need to start dealing with it.

 

Bread: Lectins, Goo, Mucin, secretory IgA.3,4. and a big dose of spin

I have no idea if bread is evil. I know that I love it, and that my life without it is a misery. I do know the “vegetable lobby” is dead against bread. I thought it was because of the effect on the  Gylceymic Index (oh those happy early fitness instructor days).

As a hypertensive, I’m suspicious of bread because of  its excessive salt content: but there is, increasingly, lower salt bread available, and as I discovered in later life, I could always eat a slice a day, rather than the  loaf recommended by the state registered dietician  ( who knew!)

But apparently, its  Lectins, not Carbs are the real evil. Lets get skilled up and learn what lectins are. have a look at this article

http://www.krispin.com/lectin.html

So lectins are wolves in sheeps clothing, they sneak up on (gut ) cells, pretending to be , well sheep presumably, then they stick a dust buster into the cell wall, meaning it wants to hoover up every bit of sugar going ( so, a wolf, with a vaccum cleaner, disguised as a sheep in your intestines…..) .

So, every loaf of bread does that to every  intestine cell? ( Its, just that that’s a lot of wolves….)

No!

“Glucosamine is specific for wheat lectin and it is this specificity that may protect the gut and cartilage from cell inflammation and destruction in wheat (or gluten) responsive arthritis”

Doesn’t that mean that if you have Glucosamine, you are ok, and can eat bread?

But certainly many people tolerate these foods — why?

The answer lies in the balance of gut flora and a person’s immune system.  When you have adequate “beneficial flora” ( oooh, I sense a TV Advert) , it serves as a protective barrier against substances that travel through the intestines, including lectins.

But importantly, beneficial flora are needed to keep the production going in the intestines of two lectin-protective substances, mucin and secretory IgA.3,4.

Mucin, like lectin, is a “glycoprotein” ( use this word at parties) in the mucus lining of the intestines.  When lectins travel through the intestines, they should have mucin to bind to, rather than intestinal cells.  But if mucin is missing, lectins will bind to intestinal cells instead.  Secretory IgA also binds to lectins, preventing them from causing damage. (Buts JP, et al. Digestive Disease and Sciences. Feb 1990. 35(2): 251-56.)

According to  Cordian et al “the interaction of dietary lectins with enterocytes and lymphocytes facilitates the translocation( this is bad)  of both dietary and gut-derived bacterial antigens to peripheral tissues, which in turn causes persistent peripheral antigenic stimulation. In genetically susceptible individuals, this antigenic stimulation may ultimately result in the expression of overt  rheumatoid arthritis” (British Journal of Nutrition British Journal of Nutrition (2000), 83: 207-217 Cordain et al)

This is a useful source as it  reminds us that there are lots of things in your gut that you don’t want in you, which is why some stuff passes through us, others get “slimed”, and, more importantly,  that’s why you have a gut.

But it can break down in 3 circumstances

(1) disruption of ecological equilibrium which allows intestinal bacterial overgrowth,

(2) deficiencies in host immune defences, and

(3) increased permeability of the intestinal barrier (Berg, 1992).

Failure of intestinal barrier function resulting in the systemic spread of gut-associated bacteria has been termed bacterial translocation( I actually like this word and want to use it more at parties).

This is why, apparently,  its important to take some nice live yogurt every so often, if you are a pisshead/ fast food eater, every few days would be a good idea. Don’t fall foul of marketing. Food companies are still  the deceitful fuckers they always have been, so most probiotic yogurt is just a liquid sweet.  An interesting observation  comes from another blog writer  (http://www.good.is/post/is-yogurt-really-that-good-for-you/)

“The only problem: Some so-called probiotic bacteria don’t contain strains medically recognized as beneficial. As one expert told Tara Pope Parker, “To say a product contains Lactobacillus is like saying you’re bringing George Clooney to a party. It may be the actor, or it may be an 85-year-old guy from Atlanta who just happens to be named George Clooney.”

So just be careful, treat bread with suspicion( there’s still an addictive sugar rush, and you may be one of the unlucky ones), and eat a bit of live yogurt ( the plain boring stuff). Above all,  be conscious of the motivations of  the diet advisor. I know of  diet experts who fess up to being x vegetarians ( presumably fanatically so) and now all they can see is their mums arthritis, and they set out on a misguided mission to “save everyone” even those that don’t  need it. Mind you, if I knew someone had auto-immune issues, I’d suggest they knock out bread as a trial (but they need to have the auto-immune disease).

I was also surprised to learn that, allegedly, if you have dairy issues, its worth trying yogurt as its already partially digested and easily  available to your body.

Still, I think the real warnings are, “everything in moderation”. Notice patterns , because you could be one of those people who cannot take bread. Act on the info.  But also watch the “religious nutters” I’ve read loads of times about lectins. No one ever added the bit about how the body deals with them.

So that’s a bit “spun” isn’t it boys and girls

Any way, My name is Andrew Stemler, I work in London as a personal trainer and can be found in Bethnal Green E2  or the City of London