Showing posts with label Walter Willett. Show all posts
Showing posts with label Walter Willett. Show all posts

July 15, 2008

In The News: A Case for Calories

Oh, what a great morning!

The weather is absolutely beautiful in New York City and I wake up to a story from Time Magazine in which Harvard School of Public Health Chair Walter Willett (pictured at left) reminds us what matters most when it comes to weight gain and weight loss -- calories!

I have never been a fan of the scapegoating targeted at specific nutrients.

I do not think eating fat causes people to become fat, nor do I think carbohydrates are sent up on an express elevator from hell.

This is why, if you are a reader of Small Bites, you know that the recipes I share are not "low fat" or "low carb."

"From many kinds of studies conducted over years, we are quite confident now that a calorie from fat will cause a similar amount of weight gain as a calorie from carbohydrate," Willett affirms.

And, no, he isn't pulling this theory out of thin air; there are plenty of studies showing that diet composition isn't as important as caloric intake in determining weight.

"The best way to get to the bottom line is to look at long-term studies where we randomize people to a high-fat/low-carb diet or to a low-fat/high-carb diet and follow them for at least a year or more.

That kind of study takes into account the possibility that one kind of diet provides more satiety; so, over the long run you would see more weight loss on that diet.

But those studies — half a dozen or more such studies have been done — show quite clearly that the percentage of calories from fat has very little effect on long-term weight loss."

What Dr. Willett does stress is that the quality of fats and carbohydrates are important (i.e.: whole grains, monounsaturated fats, and Omega-3 fatty acids are nutritionally superior to refined grains, saturated fats, and trans fats).

Let's cap this off with another great quote: "We've now looked at over 250,000 men and women for up to 30 years, and we [also] haven't seen that the percentage of calories from fat or from carbohydrates in your diet makes any difference in relation to heart attacks, various cancers, or stroke."

Let the Gary Taubes fanclub hatemail begin...

June 1, 2008

You Ask, I Answer: Potatoes/Walter Willett's Healthy Eating Pyramid

I don't really know anything about the science of nutrition, so I won't state an opinion either way on the potato issue. But have you read Willett's book, Eat, Drink, and Be Healthy?

I think the pyramid is misleading by placing potatoes up there without an asterisk or something, but he does go into detail in Eat, Drink and Be Healthy about studies showing that potatoes cause a spike in blood sugar in the same way that refined grains do.

Again, not a scientist so I can't evaluate the merit of the studies and whatnot, but I'd suggest you check it out so you can decide if you agree.


Personally, I like potatoes a lot...but I mostly like them in less healthy ways (not crazy about the skin, like them mashed, etc), so I try to limit them.


Working at Harvard School of Public Health as I do, it's easy to feel a bit oppressed by the pervasiveness of Willett and the Healthy Eating Pyramid, though!


-- Daphne (last name unknown)

Via the blog

Your question brings up several issues worth mentioning (by the way, I realize you are not in favor of the "potatoes are just as bad as sugar" argument, so this is not a "response" to you).

I agree with Dr. Willett on many nutrition standpoints, but the potato issue is one I see completely differently.

I have not read Eat, Drink, and Be Healthy, but am familiar with his reasoning for placing potatoes at the top of his Healthy Eating Pyramid along with white flour, sugar, and candy.

Willett bases that decision on potatoes' high glycemic index (basically, the degree to which they raise your blood sugar upon consumption).

The problem with that reasoning is that it only truly applies if a potato is eaten entirely by itself.

Have it as a side dish to a high-protein food (salmon, chicken, tempeh, etc.), top it with a little fat, and the glycemic index decreases.

Since a potato's skin is a good source of fiber, eating it helps lower the glycemic index.

As I have mentioned before, a potato is not a potato is not a potato.

Dehydrated potato flakes from a box that turn into instant mashed potatoes are very different from French fries, which are very different to a baked potato cooked in its skin, topped with olive oil, and eaten in conjuction with grilled salmon.

Besides, the glycemic index is not a very accurate way to determine what foods are healthy.

If you go by it, ice cream is a "better" snack than watermelon.

While it is helpful for people living with diabetes, I don't see it as the most useful tool for weight loss -- it leaves calories out of the equation!

If you were looking to cut calories, would you have half a cup of ice cream as a post-dinner snack or a cup of watermelon?

May 29, 2008

You Ask, I Answer: Potato Consumption

While a baked potato with the skin left on is a healthy choice, the question is: how do the majority of North Americans eat their potatoes?

-- Kate (last name unknown)
Via the blog

Great question.

Here is what the most recent figures from the United States Department of Agriculture reveal.

In 2002, the "average American" consumed 126 lbs. of potatoes.

Of these 126 lbs., approximately 24 came exclusively from potato chips (the average American consumed 6 lbs. of potato chips in 2002; it takes 4 pounds of potatoes to make 1 pound of potato chips).

Frozen potatoes (mainly french fries) totaled 61 pounds.

Some simple addition reveals that french fries and potato chips make up two thirds of total average potato consumption!

Not exactly the picture of health.

We are still missing some vital information, though.

Although baked potatoes offer a good deal of nutrition (Harvard's School of Public Health Chair Walter Willett's claim that potatoes and candy bars are basically nutritionally identical is ludicruous), this survey does not tell us how people are eating them.

Mainly, how many calories they are being topped with. A pad of butter? Three tablespoons?

What we certainly know is that such a high consumption of French fries doesn't spell out good news for our waistlines.

While a nutritious side dish consisting of medium baked potato topped with a tablespoon of olive oil (that's quite a bit!) adds up to 280 calories, a large order of fries at McDonald's contributes 570.

May 25, 2008

In The News: Revising the Food Pyramid

The folks over at the Harvard School of Public Health -- led by Walter Willett -- don't think the traditional USDA food pyramid (officially known as MyPyramid) doles out the best advice.

So, they proactively designed their own version -- The Healthy Eating Pyramid.

You can see a nicely drawn PDF version by clicking on the link above.

I prefer this version over the USDA's, but have a few critiques.

Although I like the inclusion of "daily exercise and weight control" at the base, I would prefer that section be titled "daily exercise and portion control."

Additionally, the "healthy fats/oils" category should place more of an emphasis on fats higher in Omega-3 (i.e: olive oil, walnuts, flaxseed) and less on ones offering very high Omega-6 levels (ie: soy and corn).

As I have discussed in the past, an improper Omega 6:Omega 3 ratio has its share of health implications.

Lastly, I strongly disagree with the inclusion of potatoes in the "eat sparingly" pyramid tip (accompanied by red meat, refined grains, sugary snacks, and salt).

It is one thing to eat potatoes in their nutritionally void skinless, deep fried version.

However, a baked potato, eaten with its skin, is a great source of fiber, potassium, vitamin C, folate, and magnesium.

Clearly, current obesity and diabetes rates can not be blamed on the ingestion of healthily prepared potatoes.

Your thoughts?

August 16, 2007

Speaking With...: Lisa Sasson

Lisa Sasson has been a clinical assistant professor at New York University’s Department of Nutrition, Food Studies, and Public Health for 15 years, and has almost twenty years’ experience counseling clients in New York City with their weight management goals.

She is also co-director of NYU's Food, Nutrition and Culture summer study abroad program in Florence, Italy. It's only appropriate, then, that one of her specialties is The Mediterranean Diet.

Her knowledge of nutrition and outspoken, affable personality led to appearances on Queer Eye for the Straight Guy and A& E as well as a one-on-one nutrition counseling session with supermodel Claudia Schiffer in 2004.

Ms. Sasson is currently Nickelodeon’s nutrition consultant and has been featured in The New York Times, Reader’s Digest, Self, Time, Fitness, and was Allure Magazine’s nutrition makeover coach in 2005 and 2006.

I sat down with Ms. Sasson and picked her brain regarding the latest fad diets. The result was a candid and insightful chat.

Small Bites: How have diet fads evolved over the past few decades?

Lisa Sasson: Nutrition reminds me of fashion. If you wait long enough, a certain diet will be in vogue again.

For instance, when you look back 25 years ago, you see low-carb, high protein diets like Atkins and Scarsdale being advocated. These exact same diets resurfaced in 2003.

Then, in the 90’s, diets were advocating counting grams of fat and eliminating it from your diet. In turn, people ate lots of carbs.

Well, carbs, like all nutrients, have calories. Fat-free does not mean calorie-free.

So, people ate lots of carbs and gained a lot of weight.

SB: What themes do the most recent diet books have in common?

LS: The glycemic index is back, and so is this idea of “good” versus “bad” carbs. Whole grains are also a focus of the newest diet books.

Luckily, fat is becoming a component of most weight loss diets. Instead of calling for its elimination, the current books suggest eating healthy fats like olive oil, salmon, avocados, and nuts, which is a good push.

SB: What’s your take on “good” versus “bad” carbs?

LS: The problem I have with it is that there is no good scientific research demonstrating the importance of the glycemic index and “good” or “bad” carbs. So many factors affect the glycemic index of a food as it is. For example, the glycemic index of a potato varies depending on what you ate before, what you are eating with it, and how you prepare it.

People take it out of context. A lot of these books focus on it because it’s a catch. It makes people think, “Oh! If I eat this I am going to lose weight.” It is a great way to draw someone into believing your book is special.

SB: Which would you say is the best of the current diets?

LS: Walter Willett’s book (Eat, Drink, and Weigh Less: A Flexible and Delicious Way to Shrink Your Waist Without Going Hungry) is one of the better ones.

I liked it because he has a realistic approach. I wish he wasn’t so fixated on whole grains and the glycemic index, but he allows other carbs that may not be whole grains or “good” in the glycemic index to be incorporated.

He also recommends healthy fats, and the meals featured in the book are simple to prepare.

I liked Bob Greene’s book (The Best Life Diet) in the sense that it is done in increments and he goes into the psychological implications behind weight management.

He also stresses the importance of exercise and being more physically active.

You can’t talk about weight loss and not mention being more physically active. Not necessarily lifting weights, but just moving more. That’s the key to a healthy lifestyle.

Exercising allows you to eat more, utilize glucose better, have more muscle mass and lose weight more quickly.

SB: Are there any new diet books you aren’t too fond of?

LS: Yes, The Sonoma Diet! The woman who wrote it, Connie Guttersen, is a registered dietitian. She should be ashamed! Do you know what her first “rule” is? “Throw out anything in your house that has white flour or sugar in it”!

I mean, she takes pride in the fact that her diet mimics the Mediterranean Diet and then has the audacity to say, “Never eat pasta.”

And then she has all these phases, or “waves”, as she refers to them. The first wave is VERY restricted. There is a whole list of foods you can’t have. You can only have certain veggies, certain nuts, and certain grains.

There are also all these recipes that are so complicated. I was leafing through it and thinking, “Is someone really going to get home after a busy day and make these dishes?”

The author also makes some outrageous statements. For example, she says you can’t eat fruit during phase one because of “the carbs”.

That’s ridiculous because fruits are chock full of nutrients and fiber. Besides, they are delicious and sweet. There is absolutely no reason why people should not be allowed to eat fruit.

Should you have limits? Of course. But to restrict a natural food makes no sense. I can’t accept that anything as natural as fruit should be eliminated from a diet.

For someone to say, “I can’t eat an apple, I’m on a diet,” is just laughable.

Oh, and throughout the whole diet you can only have Barilla Plus multigrain pasta, but not regular pasta. What bothers me is that Italians aren’t eating whole grain pasta.

What matters more is what they’re putting on their pasta.

SB: What do you mean?

LS: In Italy, pasta has very little sauce on it. It’s eaten with beans and lots of vegetables, and it’s usually a side dish, not a huge meal. It is not a huge portion.

SB: What would you say to someone who critiques nutritionists as being too objective when analyzing diets? It’s easy to look at the science, but what about the personal experience?

LS: Funny you should ask that. I was looking at all these diets and thought to myself, “What does it feel like to go on these diets?” I wanted to really experience it “from the other side”, so to speak, so I decided to go on South Beach for 2 weeks. I followed it very strictly.

The good thing was that while I was on it, I had very little freedom, so I was not tempted to just pick or snack mindlessly.

So, it was easy in the sense that there wasn’t much choice. I was so hungry that whatever I ate, I enjoyed.

The bad thing is that, while dieting, I continued living my normal life. It was very difficult to exercise during these two weeks. Yoga was particularly taxing.

I was so low on carbs that I was glycogen-deprived, and glycogen is the main source of fuel. I felt light-headed, had terrible headaches, and was very moody.

It was also hard for me to look forward to the social aspect of a meal. The joy and pleasure of food was taken out.

After five days I couldn’t look at another egg because every morning I had one for breakfast. I also found it frustrating that I couldn’t just have a glass of wine with dinner.

SB: So, psychologically, it was difficult.

LS: Yeah, and what I hate about all these diet books is that none acknowledge that losing weight is not always easy.

They talk about how delicious their recipes are and all the variety they offer and how you wake up and get to eat delicious things like ricotta cheese with Sweet and Low and Cocoa powder, which, ugh, I don’t know how anyone can find that tasty. It's disgusting.

And, again, none of these books mention fatigue or boredom. They dismiss it. All they talk about is how you’re going to lose all this weight in two weeks, and how you have so much choice, and how with each phase you can eat more. Please. I wanted to search the index for “headaches” and “moodiness” to make sure I wasn’t going crazy.

SB: What about food shopping?

LS: Oh, God! I would go to the supermarket and put all these artificial food products into my cart. I had diet gellatin, diet popsicles, diet ice cream, and all these products with fifty ingredients.

Diet Jello became my best friend because I would make 2 boxes a day and make it when I was hungry. I would eat eggs, diet Jello, sugar-free pops, sugar free this, sugar free that. Meanwhile, I’m thinking, “This is expensive and I can’t have fresh fruits in my cart!”

SB: What are some common pitfalls dieters make?

LS: Setting unrealistic expectations. Rather than think of this as a change of their lifestyle, people just think of it as “I need to lose 40 pounds by my birthday.”

Healthy eating goes hand in hand with living healthfully. So, apart from eating well, people should exercise and sleep enough. All these things affect your eating habits.

Don’t look at weight loss as “I need to eat more blueberries and less salmon” or some mathematical equation.

Also, learn to listen to your body. It lets you know when you are hungry, full, or satisfied. A lot of times people can’t differentiate between hunger and boredom. You shouldn’t feel stuffed after you eat.

Also, it’s a good idea to eat BEFORE you feel famished. This will reduce your chances of overeating or choosing unhealthy foods to immediately curb hunger.

SB: How should people who want to lose weight prepare themselves psychologically?

LS: First of all, have realistic expectations. Healthy weight loss is approximately 1 pound a week. So, for twenty pounds, you are looking at four to five months.

The key is to think of this as lifestyle changes. You want to lose this weight forever, not just so you can show off your body at the beach and then not worry about it because in the winter you hide under baggy sweaters and jackets.

When you lose weight quickly and go on these ridiculous restricted diets, you slowly start breaking the rules and then ease into your normal eating habits. So, what you need to change is your eating habits, and that’s going to take time.

When you make long term commitment, you will forever have a healthier relationship with food. Weight loss will not be at the forefront, it’s going to be changing the way you eat. Eating healthfully, physical activity.

It doesn’t – and shouldn’t -- mean you can’t have desserts two times a week or pepperoni pizza a few times a month. The idea is that these foods should play less of a role. Healthy eating is not about one meal or one food, it’s about dietary patterns.

People don’t succeed on overly restrictive diets because they focus on specific nutrients instead of changing their lifestyle. People get stuck on eating less of this, more of that, and it becomes difficult to sustain socially, culturally, physically, and emotionally.

SB: Say someone is reading this and wants to start losing weight today. What would you recommend as a good starting point?

LS: The first thing I tell my clients is to get rid of liquid calories. Liquids do not satiate the way food does, so it ultimately leaves room to consume more calories.

Also, these can easily be substituted with lower calorie healthy beverages. So I would begin by replacing sodas, juices, high fat milk, beer, alcoholic beverages, cocktails, and sugary iced teas with flavored sparkling water, diluted juices, unsweetened teas, and low or non-fat milk.

Then, each day try to do more physical movement than what you currently do. It can just be an extra ten minutes of walking every day. Then, two or three weeks later, add ten more minutes. Build it up slowly.

Don’t focus on how little you are doing. Whatever you do -- even if it’s a five minute jog -- is positive.

People just see the long-term goal and lose sight of the small steps in between. They say, “I can’t get to the gym tonight. I might as well eat a whole pizza.” Well, if you can’t go to the gym, walk for 10 or 15 minutes in your neighborhood.

Also, pay attention to what you feel when you eat. Before you put something in your mouth, ask yourself, “am I hungry? Or bored?” Rate your hunger. When you feel satisfied, try to stop.

Don’t buy things that make you feel vulnerable. If potato chips are irresistible, don’t have them in your house. If you have to buy them for other family members, put them somewhere out of your way so you have some time to think before reaching for them.

Focus on fresh fruits and vegetables. Don’t get hung up on this fruit, this vegetable. If you eat close to nature, if you are eating less processed food, you are already doing a really good job. Don’t think about eliminating plums and then eating watermelon only after the third week. Fruit is healthy!

SB: How can people spot a well-rounded “diet” book versus one that is unrealistic to follow?

LS: I don’t like books that tell you, “throw out everything that has white flour or sugar! Don’t eat these foods for six weeks!” It’s so ridiculous. Telling someone to ban 30 different foods does not mean they will stick to it or lose weight.

Also, these super strict rules are unnecessary. You don’t have to subsist on whole grain pasta or brown rice to lose weight. It’s OK to eat normal pasta as long as it is cooked healthily and you aren’t having three cups of it for dinner.

If you don’t like whole grain pasta, it’s OK. It’s not the magic weight loss solution. If you’re drowing your pasta in alfredo sauce, it doesn’t matter if it’s whole grain or not.

I like books that talk about making healthy changes rather than eliminate foods.

I like books that aren’t about just seeing the top of the mountain, but rather about the steps you need to take to get there. Looking at that tall mountain can seem overwhelming and defeating. People should be encouraged to concentrate on small, continuous steps. That’s a much healthier, more realistic approach.

I also think a good plan incorporates cultural sensitivity. Not everyone drinks milk, so to tell people to get calcium from dairy, that’s very shallow. Some cultures don’t drink milk and their calcium intake is just fine.

Thanks again to Lisa Sasson for a fun and thorough interview!

Over the next few weeks, Ms. Sasson will be analyzing some of today's hottest diets. Come back to find out which ones make the honor roll and which make the hall of shame.

August 8, 2007

You Ask, I Answer: Multivitamins

What is your response to Dr. Willett, who suggests a multi-vitamin as an inexpensive form of insurance in his book Eat Drink & Be Healthy? My understanding is that a multi-vitamin is a good idea regardless of diet since aside from providing the daily minimum amounts of vitamins it also provides certain things like minerals which even for a smart eater can sometimes be overlooked?

-- Guy Betterbid
New York, NY

For those of you who don't know, Dr. Walter Willett is a professor of Epidemiology and Nutrition at Harvard's School of Public Health as well as Professor of Medicine at Harvard Medical School.

A renowned medical researcher, Dr. Willett is perhaps most famous for his revised dietary pyramid, which places exercise and weight management at the base, plant oils and whole grains on the second level, and red meat, butter, and refined grains as neighbors at the tip.

Along the side, Willett borrows from the Mediterranean food pyramid by including alcohol (in moderation) but then adds his own touch by including multi-vitamin supplements.

I'm not quite as gung-ho as Dr. Willett on the thought of people popping a Centrum once a day.

First off, there is so much fortification in today's food that getting most vitamins and minerals is not too difficult. Even the sweetest and least nutritious of children's cereals provides 100% of many of these nutrients.

On top of that, we have beverages -- such as Vitamin Water and even Diet Coke Plus -- as well as "energy bars" that also throw in a day's worth of vitamins and minerals.

It's crucial to realize that it does not take extreme amounts of food to get a daily supply of certain vitamins and minerals. As I recently posted, just half a cup of red peppers provides 100% of our vitamin C needs.

Meanwhile, half a cup of baby carrots provides 300% of our vitamin A requirements, one cup of raw spinach packs in 181% of the Vitamin K we need each day, and a sandwich made with two slices of whole wheat bread contains 60% of our daily manganese needs.


It is true that the recommended intakes for minerals like calcium, potassium, and magnesium are only achieved by having a combination of foods rich in them.

That being said, I believe it is important to recommend people get as much of their vitamins and minerals from real food as possible.

When you eat a carrot, you aren't just getting Vitamin A. You are also getting fiber, phytonutrients, carotenoids, and antioxidants that are not available in pill form.

Additionally, increasing dietary potassium often correlates with a reduction in sodium intake. That's two birds killed with one stone if vitamin and mineral consumption is first tackled via diet.

I also believe that relying on supplements tends to give people false security, thinking that popping a multi-vitamin in the morning is a free pass for going through the rest of the day without paying attention to the food they are eating.

I think it is much wiser to take a look at what vitamins and minerals one tends to be deficient in and then tackle that problem specifically (ideally by altering one's diet first).

Vitamin D is not readily available in many foods (and most people in the world do not get enough from the sun during winter months), so I do not see anything wrong with supplementation. I also think calcium supplementation is important if the diet does not provide sufficient coverage.

Additionally, people on restricted diets often need to supplement their diets appropriately (i.e.: vegans and vitamin B12).

While we're at it, I would like to clarify that vitamins do NOT provide energy. Calories provide energy. Vitamins do not contain calories.

Yes, the B vitamins are necessary for energy pathways to work properly, but they do not give a boost of energy in and of themselves.

Back to the original question: people eating balanced diets do not need to pop a multi-vitamin every day.

They are better off seeing what nutrients they are actually deficient of, see if they can get them by altering their diet, and, if that's not possible, look to supplement that specific vitamin or mineral by means of a pill.