Saturday, April 14, 2012

Diet or Exercise to Combat Fat? It Depends on Your Goals

When I run with my friend we frequently discuss weight loss and diet strategies.  Once she shared with me that she had eaten at The Outback Steakhouse the night before. She explained that although she had substituted broccoli for a potato, she and a friend had also split an order of those yummilicious OutBack cheese fries. While running, and without the help of the internet, we laughed about how long one would have to run to burn off THOSE calories.  I confessed that I had finally concluded that only way for me to lose a few pounds is to eat less; specifically eat fewer carbohydrates.  My friend countered that life's too short.  She does not want to give up the Outback splurges, and I get that.  When I got home I found this menu which estimates the small order of cheese fries at 1300 calories, so 650 if you split it.  Supposedly someone my size burns around 75 calories every ten minutes running, so running for 85 minutes would burn off the appetizer portion of the meal.  I have several friends who have chosen not to alter their diet, but to exercise in order to maintain or lose weight.  They say they will exercise regularly, and let the calories land where they may.  All of them are accumulating more fat instead of losing it. 

 

To diet or exercise for weight loss? Of course the easy answer is "yes".  But after 30 years of exercising regularly and watching my weight I have learned a few things about what exercise does and does not do for me.  I am 100 percent confident that exercise has a positive impact on my mental health.  When you are focused on breathing, you can't worry about other things.  It's a good break. I am 80 percent confident exercise helps me sleep better.  I am 50 percent confident it helps me to improve muscle definition, however if muscles are covered by fat it is hard to see the definition.  I am also 100% confident that exercise, at least the way I exercise now, does not help me to lose weight.  Even when I was running longer distances I was a little surprised to find that I still could not eat what I wanted to eat and maintain the weight I wanted.  There *was* a time, when I was traveling for business much of the year, and when I was out of town my time was my own.  During that period I ran in the morning and took aerobics classes at night.  I lost weight then, but the truthfully, I was still eating pretty carefully. 

I have also learned that there will always be times in my life when it will be hard to exercise either due to injury or time constraints.  My friend, for example, was frustrated because as a nurse working 12 hours shifts, she found herself struggling to train for a triathlon, which is something she has always enjoyed. But, to compete in the triathlon, she will have to find enough time to train. It is one thing to exercise on your day off, but it is another to spend three quarters of the days you have off training.  I have come to accept that I do not exercise for the month of December.  One can argue that this is exactly the month that I should exercise, with Christmas treats so prevalent. But a few years ago I found that I wanted to get my Christmas cards done way more than I wanted to run in the morning, so I did.  Conscious of the fact that I wasn't exercising, I watched what I ate a little more carefully.  I was surprised to find that even without morning runs I did not gain weight. After a second year with a similar December, I decided to face the fact that I would largely abandon my exercise routine in December.  That was the beginning of my realization that I had way better luck controlling my weight with what and how much I eat than how much I exercise.   
 
Gary Taubes, a science journalist, came onto the diet scene in 2002, with an article in the New York Times, titled, "What if it's All Been a Big Fat Lie?  It coincided with some success I had had using the South Beach diet to battle post pregnancy belly fat.  He followed that article with a dense, research-filled book published in 2007 called Good Calories, Bad Calories loaded with data to support his somewhat controversial assertions.  His follow-up and easier to digest book, Why We Get Fat, and What To Do About It,  retained the controversial assertions. The assertions relevant to this post are:

1.  The calories in/calories out model for weight loss has been very damaging to understanding what makes us fat.  You won't get rid of fat strictly by counting calories and trying to use more than you consume.  
2. We don't get fat because we overeat.  We overeat because we are getting fat.  
3. Bacon and lard are not the enemies of good health that we've been hearing about constantly (since the sixties); carbs are 
4. There is not sufficient evidence to make the claim that exercise is linked to weight loss.  

Taubes certainly has nay-saysers.  He has had fairly well publicized disagreements with Dr. Oz and Jillian Michaels (The Biggest Loser). John Horgan in an editorial in Scientific American, says he is not convinced.  This 2010 article in the NYT summarizes the controversy well. 

To be clear, Taubes does not suffer from lack of data or science.  He writes well and convincingly or he wouldn't be in the spotlight.  His biggest problem is that he is going against what has been seen as common wisdom since the 1960s, and lots of people's minds are set, including most in the medical profession.  From Taubes in an interview:
The fat/cholesterol dogma is so well established that it's hard to imagine it ever going away. One thing dogmas do very well is perpetuate themselves, not through any explicit conspiracies, but because so many people are so invested in one point of view that they will always, when given the chance, act in a way that supports that view.
His other biggest problem is the "gross" factor.  People have been trained to see fat,  as in bacon fat and lard, as something that equals the rolls on our belly.  Gross.  Never mind that there is not data to show that it causes us to be fat.  Finally he is fighting the sense of moral superiority we have been taught to believe we are entitled to when we exercise and watch what we eat.  In today's world of anorexic super models, and movie stars (each with their own personal trainers) on the cover of every magazine, there is little doubt in our minds that thin is the goal, and if you are not actively demonstrating that you are trying to become thin, you are lazy.  It's really become a moral issue rather than the physical issue is actually is.  
 
Likewise, Taubes assertion that exercise will not reduce unwanted fat goes against years of "common wisdom".  Most health professionals advise their patients to include exercise as a part of their weight loss plan.  Here are just a few links on the MayoClinic.com


There seems to be at least more well publicized acceptance of Taubes claims regarding exercise than his diet. In summary, these links about exercise point out:


I love my time on the StairMaster but there's no way I could spend enough time on it to burn off the kinds of foods I would love to eat. In order to battle my very very highly unwanted belly fat, I am going to cut back on carbohydrates and keep a food diary. There is about a month before I put on a swim suit, so I guess I'll soon see exactly how unwanted it really is :)