Welcome to another wonderful Wednesday WHEE diary! Today, I'll be reviewing the first chapter of Rethinking Thin, the 2007 book by New York Times science writer Gina Kolata. I'll also be looking at a couple of recent studies of New York's menu labeling law, and giving my first impressions of a calorie counter app for Android smartphones like the Motorola Cliq and Google Nexus One.
But first, for those of you just discovering WHEE for the first time:
WHEE (Weight, Health, Eating and Exercise) is a community support diary for Kossacks who are currently or planning to start losing, gaining or maintaining their weight through diet and exercise or fitness. Any supportive comments, suggestions or positive distractions are appreciated. If you are working on your weight or fitness, please -- join us! You can also click the WHEE tag to view all diary posts.
Rethinking Thin, by Gina Kolata
Prologue
In 2003, Gary Foster, a researcher at the University of Pennsylvania, published a study in the New England Journal of Medicine that compared the low-carb Atkins Diet against a more conventional low-calorie regimen known as LEARN. In 2003, the Atkins Diet was at the height of its popularity, but most MDs believed the high-fat, high-protein diet would cause cholesterol and triglyceride levels to skyrocket. Contrary to expectations, the 2003 NEJM study showed that the low-carb dieters had lower tryglyceride levels and higher levels of HDL ("good") cholesterol, while losing as much or more weight as the LEARN dieters. However, the study lasted only one year, and included a relatively small sample size, only 63 men and women. The 2003 study was remarkable for more than its results, though. According to Kolata, this was the first time any scientific study had asked the question, "Is one diet better than another?" You would think that after years and years of obesity research, someone would have asked the question before - but, says Kolata, you would be wrong.
Based on the results of the limited 2003 study, in 2004 Gary Foster, James O. Hill, and Samuel Klein began a two-year study involving hundreds of overweight and obese men and women following either the Atkins Diet or the LEARN program. Rethinking Thin is the story of that study.
Chapter 1: Looking For Diets In All the Wrong Places
In chapter 1, Kolata first introduces one of the subjects of the new study, then discusses the origins of the two diet protocols. LEARN stands for "Lifestyle, Exercise, Attitudes, Relationships, Nutrition." It's based on the researcher's manual for a 1976 study by Kelly Brownell, a PhD candidate at Rutgers. The Atkins Diet is better known - it's based on the the work of the late Robert Atkins, MD, a New York cardiologist turned diet doctor. Unlike the consensus medical advice found in the LEARN program, the Atkins Diet has been controversial ever since Atkins first published the Dr. Atkins Diet Revolution book in 1972. In fact, in 1973 Atkins was called before the Senate Select Committee on Nutrition and Human Needs to defend his program.
Whether due to the opposition by the medical establishment or the fact that the 1972 version of the Atkins Diet was pretty strict, the diet fell from favor until after Dr. Atkins published his New Diet Revolution in 1992. [I myself first encountered the Atkins Diet in 2000, when one co-worker lost over 80 pounds. He has since gained it all back - Ed] However, it wasn't until Gary Taubes published "What If It's All Been a Big, Fat Lie?" in the New York Times magazine that the diet really caught on. In his article, Taubes introduced the public to the low-carb lipids paradox - that a diet high in cholesterol didn't necessarily lead to high blood cholesterol levels.
Kolata returns to the story of Carmen Pirollo, the 49-year-old Philadelphia man who was introduced at the beginning of the chapter. Pirollo was normal weight as a child and teenager, and weighed 165 pounds when he graduated college, but has put on weight since - and tried just about every weight loss program that has come along. After a succession of fad diets like the grapefruit diet, he called Jenny - Jenny Craig, that is. The external structure provided by the Jenny Craig program worked for Pirollo - he lost weight from 218 pounds back to his college weight of 165, and his Jenny Craig center invited him to become a part-time "counselor" (a.k.a. role model). He declined the offer - and a year after finishing the Jenny Craig program, his weight was more than when he started.
Pirollo then discovered an amazing new wonder drug, or rather a combination of two drugs, that were taking the nation by storm. The drugs were phentermine, an appetite suppressant, and fenfluramine, a drug that both suppressed appetite and raised metabolism. The combination, known as phen-fen, was thought to be safe, because the two drugs had been prescribed individually for over ten years with no serious side effects. Kolata details how the new wonder treatment spread with the help of the then-new wonder means of communication, the Internet. The combination became so popular that both Nutrisystem and Jenny Craig climbed on the bandwagon. One psychiatrist decided that since, in his opinion, overeating is an addiction, and since phen-fen worked on overeating, it would work on other addictions like cocaine abuse and alcoholism, and began prescribing the drug for those conditions too.
As we all know, the phen-fen drug combination was found to be associated with deadly heart valve disorders, and it was pulled from the market in September 1997. Carmen Pirollo, like millions of other chronically dieting Americans, was left with nowhere to turn - until Gary Taubes published his 2002 article. Pirollo tried the Atkins Diet in January 2003, and lost 40 pounds by summer - and gained it all back by the end of the year. However, when he was accepted into the larger Foster/Hill/Klein study in January 2004, he was happy to be chosen for the Atkins Diet cohort, believing that the external support offered as part of the diet study would enable him to lose the weight and keep it off.
Keep checking the Wednesday WHEE diaries for more excerpts from Rethinking Thin - Ed
Menu labeling does actually work
On January 18th, outgoing New Jersey governor signed legislation requiring menus at chain restaurants - those with more than 20 locations - to display calorie counts. New Jersey becomes the fifth state nationwide to require menu calorie counts, after California, Maine, Massachusetts and Oregon. However, the pioneer of these menu labeling laws is right next door to New Jersey - New York City, which has had a law requiring chain restaurants to prominently display calorie counts on their menus since January 2008. After two years, we're beginning to see studies that have been done on the New York City law - does it actually work?
The first study, released in October 2009, showed that menu labeling had no beneficial effect on the number of calories in meals ordered at fast food restaurants in low-income areas. Happily for menu labeling supporters, two newer studies show an actual reduction in the number of calories consumed as a result of menu labeling.
One study, done by Stanford University on Starbucks outlets in New York City, found that the number of food calories ordered (and presumably consumed) by customers dropped by 6%. This 6% drop was the average for all Starbucks stores in New York City, not just stores in low-income or upper-income hoods. Even better for supporters of menu labeling, the average Starbucks store saw no drop in revenue, and stores located near a Dunkin Donuts actually saw their revenues rise.
The other study was done in a more artificial setting - parents of children in a Seattle pediatric clinic were given two versions of McDonald's menus, and told to choose meals for themselves and the children. When parents were given the menu with calorie counts, they ordered meals with 20% fewer calories for their children, although they ordered the same number of calories for themselves.
I've been a skeptic of menu labeling, but these two studies, particularly the latter one, have made me something of a convert. If I were a legislator, I would vote for a menu labeling law. However, I don't think I personally would spend a lot of political capital to introduce such a law, since the real world results show only a small effect, at least in the studies that have been released so far. Of course, as Clio2 noted in her chapter 48 review last night, David Kessler is a strong advocate for menu labeling laws.
Calorie Counter by FatSecret - first impressions
If you've been following WHEE for the past few months, you know I've lost about thirty pounds since getting a bodybugg calorie burn armband back in July. Now that I've reached a "normal" BMI, I've turned the armband over to my wife and signed her up on the Apex Fitness web site to log her calories burned and food consumed. Happily for her, the bodybugg is working its magic once again - she's lost five pounds since starting with the bodybugg early in January. Unhappily for me, I've noticed my weight creeping up again, especially since the weather has been a bit too cold and damp to encourage bicycling to work every day. Right now, I 'm right at the upper end of the "normal" BMI range - in fact, yesterday I was actually "overweight" by 1/2 pound. Something must be done.
I think the most important part of the bodybugg program for weight loss is the calorie logging I did. The armband measured the calories I burned during the day, but it doesn't have the ability to measure how many calories I ate. For that, I had to log the food I consumed on the bodybugg website, which computed the daily calorie deficit and helped me make better food choices. Now that my wife has the bodybugg, I need to find a replacement for the food logging, at least.
I've looked at sites like SparkPeople and Livestrong.com, but I've not been able to find one with an Android app - at least, not one that's ready for prime time. I did find an Android app for Livestrong.com, but the app was still a beta version. The Android platform for smartphones is more open than Apple's version, but just because programmers can find it easier to distribute an app for one's phone doesn't mean they will.
However, in the Android market, I found Calorie Counter, by FatSecret.com. FatSecret is another diet-and-exercise site like SparkPeople or FitDay, but unlike other sites, they've made their Application Programming Interface (APE) available to people who might want to design Web sites or smartphone apps. In fact, if it weren't for the fact that the Calorie Counter app was listed in the Android Market as "Calorie Counter by FatSecret," I might think that the app was programmed by someone not actually affiliated with FatSecret.com. I was unable to find any reference to the app on the FatSecret Web site.
I downloaded the app a few weeks ago, but uninstalled it later that day. My one-star review read as follows:
Ads are annoying, EULA takes too many liberties, food diary can't find the custom food I entered. Lame, lame, lame.
However, I downloaded it again today, and it doesn't seem quite as lame now - or perhaps it's just that I'm more willing to overlook its eccentricities now that I've put on another pound or two. Whatever the reason, I am giving the app another try.
I tried using the barcode scanner function (which uses the phone's camera) to enter food - it's a little easier than searching and entering it by hand, but not much. We'll see if more familiarity makes the app more tolerable, rather than less.
Scheduled WHEE diaries
Feb. 11
Thurs AM - ???
Thurs PM - ???
Feb. 12
Fri AM - ???
Fri PM - Wee Mama (weekly diary)
Feb. 13
Sat AM - ???
Sat PM - Edward Spurlock (Kessler, A Final Word)
Feb 14-Valentine's Issues
Sun AM - ???
Sun PM - ???
Feb 15
Mon AM - NC Dem
Mon PM - ???
Feb. 9
Tues AM - ???
Tues PM - ??? (Clio2 is taking a well-deserved break from weekly diaries)
Feb. 10
Weds AM - ???
Weds PM - Edward Spurlock (weekly diary)