Saturday, November 28, 2009

Health, Diet and recovery

A paper coming out of the University of Chicago predicts that type 2 diabetes in the US will rise from 23.7 today to 44.1 million people in 24 years - an increase of 86%. The same paper claims that 30% of Americans are now obese , but predicts that number will fall to 27% by 2033 "since we can't all be obese," says the author.

These are sickening numbers, but it is apparent whenever I travel. Many people in US airports waddle through the terminal. Some are so big they need seatbelt extenders. The number of people who have to be delivered to their terminal gate by wheelchairs or beeping carts is just amazing in some places. Recently when laying over in the airport in Charlotte, NC there was a steady flow of these carts. I've never seen so many people in need of assistance.

I'm reminded of a movie I took my 6-year-old granddaughter to see a few months ago - "Wall-E." In the animated movie the citizens of Earth had gone into space while little robots on Earth cleaned up the mess we had created. In their space station these people had become so grossly overweight that they rode around in motorized wheelchairs (while sipping sugar drinks).

When I travel to other countries in Europe and Asia I don't see nearly as much of this, although the trend seems to be moving in the same direction as in the US. I just got back from Oslo and don't recall seeing a single obese Norwegian, although I am sure there are a few.

I think part of this mounting problem can be laid at the feet of nutrition scince going back to the 1970s. We have been told since then that carbohydrate was very healthy and we should eat more of it. Most Americans translate the word "carbohydrate" to mean starch - bread, bagels, potatoes, cereal, corn, rice, and more. These foods put sugar into the blood stream faster than eating table sugar. Combine that with a sedentary lifestyle and you produce obesity and eventually type 2 diabetes (among other problems).

We should have been telling people to eat more non-starchy vegetables and lay off of the starch. I've never known anyone to become obese eating a diet high in veggies. And for athletes, while some starch is good for recovery, we should also be eating more veggies as they are the most micronutrient-dense (vitamins and minerals) food we can eat.

What I tell the athletes I coach is to eat starch at the right times (during and post-workout) and otherwise eat more veggies.

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At November 28, 2009 7:24 AM , Anonymous Ted said...

Right on, Joe.
Have you seen/read Bob Seebohar's new book "Metabolic Efficiency Training?" It's not dissimilar to your "Paleo Diet for Athletes" book.

At November 28, 2009 7:46 AM , Blogger Luis Recuenco said...

Its more than type of food. Its is also related to life style and stress.

Valentin Fuster, a catalan and spanish like, me chief of cardiology at Mountain Sinai-NY tell us that we should-especially at the states implement great campaings as in the past with tabaco. Today we can say food, fatness and all the enviremont related to it kills.

The policy recomendations have to go not onlly around food but take into account life styles. For example , we have empirically evidence that in some neiborhooods in the states, specially working class places the share of McDonals is biger than in the rest.

At November 28, 2009 9:15 AM , Blogger Justin said...

Great point Joe, you really never see larger people going for seconds and thirds at the salad bar!

On a whole other topic, I was wondering if you could start writing something up on this subject. What is the best way to improve someone's biking for the 2010 season, when you are in the prebuild stage? I know the slowtwitch crowd is all about sprints, 2x20 min efforts at FTP, and all an all just HTFU. But while this might work and improve you for January, I wonder if it will cause burnout, and not good results come summer.

Just wondering what you would suggest for this.

At November 28, 2009 9:18 AM , Anonymous Wellescent Health Blog said...

It is unfortunate to see the obesity epidemic in the US, especially when the same problem does not exist elsewhere. The numbers are so bad, that the current generation being born is expected to have a shorter life expectancy than their parents.

At November 28, 2009 11:04 AM , Blogger Joe Friel said...

HI Justin--I appreciate your suggestion. I'll keep that in mind. Seems there is never a shortage of things to write about.

At November 28, 2009 11:32 AM , Anonymous Kristin L said...

In Europe there is 3x as many obese people as 20 years ago.. Two out of five of the school children are obese. You only saw athlethes and chineese turists on your trip in Oslo :) There are a lot of fat people in Oslo, but more and bigger ones in the US..

At November 28, 2009 3:05 PM , Blogger John Cutler said...

Yesterday I went to the local grocery store. I purchased two fillets of flounder, some broccoli, yellow pepper, and fruit for desert. I spent $14. That's for one relatively simple meal. Meanwhile I could have consumed just as many calories for $4 if I bought some microwavable pizza.

At penny pinching sites online people talk about feeding a family for $2 per day per person. I just can't fathom how you can eat healthy on that kind of budget.

Until our government stops subsidizing the production of unhealthy food (corn for hfcs), it will be cheaper to eat a fattening / sugar based diet.

An idea for a future topic ... Eating Paleo on a budget.

At November 28, 2009 4:56 PM , Anonymous Anonymous said...

I see this everyday working with low socioeconomic teens. It is sad to me that the kids I work with want to eat healthier but have no healthy options at school and have very little money for food at home. It is difficult to fight the fact that you can get a hamburger and fries for $2 while eating healthy costs so much (in perception). We have to educate our young people on how to buy, afford and cook healthy foods and we have to urge schools to provide healthy food and elminate soda and junk food machines.

At November 29, 2009 1:16 AM , Blogger ants said...

Hi Joe,
I am not expert and I cannot provide any evidenced based results, however, I see just what you are referring to here in New Zealand too. It seems to becoming a real problem in children too. Things that I remember having as a special treat once in a while seem to be a weekly meal now.. eg. McDs, KFC, etc...

At November 29, 2009 12:07 PM , Anonymous John La Puma, MD said...

Several good ideas here, Joe.
The best one is to eat more veggies, but for most people the challenge is how to do this. (not what to do, but how).

Changing the person's environmental clues is the easiest way for most people.

My medical practice is made up of the people you see in airports...and I find they need accountability, self-monitoring, adequate exercise and individualization of their diets.

At November 29, 2009 12:23 PM , Blogger G said...

Joe - I couldn't agree less. Carbohydrate is healthy and we all need to eat it. Yes some types of carbohydrate are more appropriate than others in day to day eating, but this is not the problem.

Quantity and convenience is the problem. The average person eats more quantity today than 30 - 40 years ago. We also eat poorer quality due to all the convenience type foods that are marketed so aggressively to compliment our "busy" lifestyles.

With those so called busy lifestyles the average person has less knowledge about food and cooking, so turn more often to convenience which is jam packed full of poor quality carbs held together with plenty of poor quality fat, and made tasty though artifical means.

That's a far more important issue to address than whether people eat potatos versus other sources of carbohydrate.

At November 30, 2009 10:01 AM , Blogger Lynchmob said...

There is nothing inexpensive about a $2.00 fast food meal. Add up the health care costs we as a nation will endure with this type of thinking.

At November 30, 2009 12:38 PM , Anonymous Anonymous said...

Joe - could you write a book on Velodrome racing and training? There seems to be none out there. Seems to be a highly secretive sport.

At November 30, 2009 12:46 PM , Blogger Joe Friel said...

anon--I've been sworn to secrecy. :) Actually, would like to be of help but the track just isn't my thing. Great place to train for roadies though, esp in winter.

At November 30, 2009 2:25 PM , Blogger Slater Fletcher said...

Amen! It is sad to see this most in the children.

I stopped at a starbucks during a ride yesterday and saw a girl (maybe 7yrs old) eat TWO bagels loaded w/ cream cheese and THEN her Mom got her a frappuccino with whip cream. The poor girl was already 40-50lbs overweight and is well on her way to type 2.

How does the responsibility from parents and businesses take shape? Parents feeding the problem and McD's selling $2 meals only complicates it...

At November 30, 2009 3:40 PM , Blogger Lance said...

I also disagree on carbohydrate. It wasn't until I sold my copy of The Paleo Diet and switched to the nutritional recommendations of Dr.s McDougall, Ornish, and Esselstyn, who all advocate a starch based diet consisting of whole, unrefined plant foods, that I have had enough energy and enthusiasm to train and recover consistently. These foods are not the same as processed sugar and flour and should not be treated as such.

At December 1, 2009 4:51 AM , Blogger Shannon said...

Sad and true....every year at my gym they host a course open to the public that offers a wide variety of activities young people (10-16) can take to become more active. It's offered at a low rate so the community can reach the lower socioeconomic groups.

I've been a part of this program every year for about 5 years~every year the class size is getting bigger with the young people being morbidly obese. When I teach a basic fitness class, many can hardly get through the one hour low intensity class. Often times the parents are sitting in the back of the room (obese as well) watching, not getting involved even with gentle prodding from me. Have you seen the PSA's the NFL are showing on children being active? I digg them!

At December 4, 2009 8:06 AM , Anonymous Anonymous said...

Unfortunately, this eating thing really should be easier than we make it out to be. In my opinion, most of the population does indeed know what is healthy to eat and what is not. For the most part, it's pretty instictive to understand that an apple or broccoli is good and a cookie, not so much.

Anyway, both my wife and I struggled with our weight and body composition through our childhood and our early adult lives, but then decided to pay more attention and live healthier. All this despite growing up in households that promoted healthy eating by providing home cooked mostly healthy meals 95% of the time.

Now, with our kids, we take the approach that everything counts. Every little bit of healthy food, everly little bit of movement and exercise, etc. And, we do this, despite both of us working fairly demanding full time jobs, both having volunteer commitments and time for ourselves for hobbies.

I get the "I don't have time" excuse all the time from people and I just don't get it. We've built exercise into everyday activities and our kids don't even realize it. We even make setting the table an aerobic exercise for our three year old. (One tip, though, don't do that with water glasses or knives...) Our kids still get television time and McDonald's, but it's all in balance (or at least we think, now that I think about it, it's been months since they've had fast food). I could go on forever, but you get it.

At December 9, 2009 9:15 AM , Anonymous Dan said...

I highly recommend a read of The China Study, for a highly interesting and scientifically based view on nutrition. As Lance mentioned, the end conclusion is simply that animal protein in our diet is extremely harmful. As a scientist, and eating what I thought was a healthy diet, I was very surprised by some of the findings, and this has really challenged me to look at what I put in my mouth. An excellent read.

At March 8, 2010 11:58 PM , Blogger Mark said...

I was overweight growing up and for many years as an adult so I just want to chime in here.

What I find is that people tend to use food as a drug for stress and, or depression (someone already mentioned this and I think this is common sense now). Foods, especially processed foods, tend to provide an instant mental and physical high, especially to an over weight person. It's similar to a drug addiction, complete with a downward spiral. My drug use to be food.

In my opinion you need to take the high out of foods, especially for those who are predisposed to type 2diabetes. So in my opinion the perfect diet pill would be one that would make food tasteless or smell really bad.


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