From the Land of Oz: Hillary's Hyman and Detox Diets

Wouldn't you just love to find a cure for your struggles?

Hyman's suggestion that my diet is the reason for my

MS is beyond insulting.

Let’s give a round of applause ladies and gentleman to Dr. Mark Hyman for finding the answer to all of our weight loss troubles! Dr. Mark Hyman’s Book, The Blood Sugar Solution 10-Day Detox Diet: Activate Your Body's Natural Ability to Burn Fat and Lose Weight Fast, is a New York Times bestseller. His book is a guided weight loss and detox program that claims to be the solution in preventing disease, losing weight and reducing insulin levels in just 10 days. His book provides meal plans, recipes, shopping lists, recommended medications, supplements, and more. Written by an MD, there must be truth to his detox diet claims, right?

About that M.D. credential

A Medical Doctor, meaning “teacher of medicine” is an honorable profession that rightfully holds esteem in society. Often times, when you are diagnosed with a condition, such as Type 2 Diabetes, you see a team of clinicians with varying credentials. Understanding what an MD, RD, NP, RN, PA or PhD are and their scope of practice is important to know and understand when it comes to your treatment plan.

In a nutshell, a doctor (MD), assesses the condition, forms a plan and treats the condition. An MD has extensive education in anatomy, biology, physiology, and chemistry and is an expert on injuries, diseases and drug therapy. That being said, a doctor (as well as an NP, RN and PA) has very little education in nutrition and is far from qualified as an expert in nutrition. Unless a doctor is an RD (Registered Dietitian) or has an advanced degree in nutritional science (think PhD), they should not proclaim themselves nutrition experts. Similarly, an RD, an expert in nutrition and dietetics should not prescribe medicine or formulate a plan for surgery as this is outside their scope of practice.

The Tell Tale Signs

So, how do you know if these self-proclaimed “wholistic” MD’s (as Dr. Hyman calls himself) have gone too far? Well, Dr. Mark Hyman produced a perfect example for us to explore.

There are no shortcuts to getting healthy and fit.

The first sign of quackery is the guaranteed “quick fix” that we all secretly want. We hate to be the bearer of bad news, but anytime a doctor (yes, that includes Dr. Oz), or medical professional for that matter, guarantees over 7 lbs of weight loss in 2 weeks without vigorous physical activity, then you may want to assess whether their techniques are safe and can be maintained for the long-term. For reference, the Academy of Nutrition and Dietetics, considers healthy weight loss of ½ -2 lbs. per week with a balanced/portioned diet and regular vigorous physical activity. Even this guidance is quite controversial, as the long term data gives little support that that lost weight is maintainable. Dieting leads to deprivation and long term struggles with rebound over eating and weight gain.

In one of the first pages of Dr. Hyman’s book, he catches eager readers by telling a story of Janet, a 48 year old woman who lost 11 pounds in 10 days by eliminating fish, gluten, dairy, sugar, all grains, beans and legumes, all processed foods, all refined vegetable oils, alcohol and caffeine. Is it not obvious? Of course she lost a ton of weight in a short amount of time, virtually every food group was eliminated! But successful weight management needs to address thoughts and behaviors, so that dietary changes can be maintained. Rigid rules will only lead to failure.  Haven’t we all seen this?

You, on a diet.

The second sign of “wait, this book or treatment plan is a crock” is the all mighty powerful “DETOX”.  According to Dr. Hyman, virtually all foods lead to weight gain and illness, so a 10 day detox is warranted to get rid of decades of food toxins and promote weight loss. Makes sense, right? Well, no. The problem with this, is that our body naturally detoxifies itself. The liver, kidneys and colon filter out toxins and bacteria in the body. Therefore, eliminating essential foods and nutrients for a body cleanse/detox does not make sense at all. The last thing we need is to narrow our selection of foods for no good reason!

What happened to 'an apple a day keeps the doctor away?'

Eliminating whole categories of foods from your diet for weight loss is just absurd. It is not realistic to think you can survive a diet that is limited in variety and nutrients without serious consequences—low energy, increased thoughts and preoccupation, nutritional deficiencies, to name a few. It is also not realistic to think that you will continue to have an abundance of weight loss post “detox” as behavior and dietary changes do not magically occur in 10 days. Further, rebound overeating results from deprivation. This, combined with slowed metabolic rate from your body perceiving starvation will only result in weight regain. 

What Is The Magic Pill?

You're really gonna give these up? Until you lose weight? 

Then what?

We challenge you to realize that there is no cookie-cutter way to treat chronic conditions such as obesity, diabetes and inflammatory conditions as Dr. Hyman suggests. Standards of practice and research-proven methods exist to guide people toward health. And there is individual variation in our calorie and nutrient needs and healthy weight ranges. Self-help/”wholistic”/detox “treatment plans” are damaging—they don’t take into consideration these individual needs nor consider the impact on a person’s medical status as a whole. They offer false hope that if you just follow (this most un-followable plan) you will cure your ills and be happy. 

We challenge you to do your research, recognize what the credentials mean and be cautious of the quackery rules of advice. And by you, we include very intelligent readers who might've been pulled into believing this misinformation--like Bill and Hillary Clinton, who endorse Hyman's sensational promises.

Avoid triggering and false messages from shows like Dr. Oz and books like Dr. Hyman’s. And if it sounds too good to be true, it probably is!

This piece was written primarily by my awesome intern, Lakisha Dubar--with direction and editing by yours truly. Please share your thoughts with us! As always, thanks for reading, and sorry for the long wait--I had to travel to San Francisco for these photos!

Struggling to Manage Your Weight? Products, packaging and marketing leads to second guessing your eating.

This is a self-serving post. Really, I need to vent; because these things drive me crazy. They’re not directly harmful—except for the laxatives to be addressed in the next post—but they cause you to stumble. They mislead you. They impact your thoughts about what’s healthy and what’s allowed, and they add to your list of should and should nots.

They impact all of us, regardless of our weight. I’m just starting my list, in no special order, but I hope to inspire you to add to it—your comments, your own pet peeves. Because the more you're aware, the less you'll be mislead by the subtle, unreasonable nutrition messages. And the better you'll get at trusting your self and your body.

Almond milk: Forgive me if you are among the food allergic who can’t consume cow’s milk or soy milk. For you, almond milk is a reasonable option as a milk alternative to help meet your calcium need. But with the exception of its higher vitamin E content, it has little merit; it truly falls short as a milk alternative for those who do tolerate milk and soy. Here’s my issue: it short-changes you, because it looks like a glass of milk. But the calories don't compare, nor does the protein.

Sure, almonds, (as they proudly display on their website for Almond Breeze, one brand of almond milk) are high in protein and fiber and low in sugar. But this so-called almond milk? At 1 gram or less of protein, it is 6 or 7 grams less per cup compared to soy or cow’s milk, respectively. And a total of 1 gram of fiber. So please don’t assume that because it’s made from wholesome almonds that almond milk is anywhere near as nutritious.

Gatorade light: Why-oh-why would you choose light Gatorade? If you are consuming this sports drink for the reason it was developed—‘specifically formulated to help you perform your best’ during sports and training, then why have a reduced carbohydrate and low calorie beverage? Did I mention that calories=energy? The calories, from carbohydrate, are a convenient, easy to absorb fuel while exercising. But the light version is hardly worth it, providing minimal fuel to support physical activity.

And for the record, the electrolytes you get from Gatorade—the 160 mgs. sodium and 45 mgs. potassium from the recently increased serving size of 12 (vs. 8) ounces—is no greater than you’d get from a 12 ounce glass of milk (160 mgs. sodium and 560 mgs. potassium). 

Ok, I know you’re not about to drink milk on your run or bike ride. But unless you’re doing long duration exercise, generally more than 90 minutes, there’s little need for a sports drink anyway. You could easily replace your electrolytes when you get home, perhaps with a serving of pretzels and an orange or banana—a more generous replacement for both sodium and potassium losses. Just add any beverage to replace your fluid losses.

Sandwich thins: Made by Arnold and other companies, these seem innocuous, and are perhaps even viewed as a healthy alternative to sliced bread. And, they’re well liked, it seems. (I can't say personally—I've never tried them).

My problem? Eating one is like having just half a sandwich. And unless you are quite short in stature and quite sedentary, you likely need more than a half sandwich for a meal. Yet they look like they should be enough—there are 2 halves—but also half the calories. And, they provide little surface area to add your peanut butter or Vegemite (shout out to my Australian readers) or tuna or whatever. But if you love them and want to include them, have 2 for lunch! Or else when you get hungry later you’ll be beating yourself up thinking you’re not deserving of eating again!

Skinny Cow: I really love these ice cream sandwiches. But do you want to know a little secret? They’re no lighter than most traditional ice cream sandwiches you can buy (at perhaps a lower cost per bar!) But doesn’t Skinny Cow sound so light? All brands I looked at which are a similar size were within 20 calories (higher or lower)—and not promoted as a ‘skinny’ product. I do love their tag line, though: ‘who gives a lick about calories?’

The orange juice aisle: Maybe it’s just in US suburbs, but supermarket shopping is simply an overwhelming experience—even for me. A recent trip to the market revealed more choices than I could ever care to contemplate. Beyond the pulp options, there are orange juices fortified with calcium, and ones with fish oils (can you imagine?). It begs asking ‘Must one food item, this orange juice, meet all of my needs?’ Can’t we have orange juice for its naturally occurring vitamin C, folic acid and potassium? Must I get everything from this single item?

Similarly, must my pasta be protein fortified—or can’t I have chicken with it? Does it need to have added fiber, or won’t my eggplant, artichoke, peppers, etc. add that? Get the point?

Whey protein powder: Some of you who restrict your food intake and those vegans who plan poorly may truly benefit from boosting your protein intake. Why not use whey protein, the refuse, the left over liquid that remains when making cheese, conveniently packaged and sold at top dollar prices at health food stores, supplement sites and health clubs?

Whey protein boosts your calories—so this might be a positive for those of you trying to add some. But a whey protein shake mixed with water, in spite of it’s high protein content falls short as a meal replacement. And let me remind you about food halos. There’s nothing magical about protein. While your body requires protein to fuel your muscles and maximize recovery, from the looks of the label you might be thinking that you need whey more (sorry, couldn't resist) than you do. Even bodybuilders need little more than 1 gram of protein per kg body weight (or .45 gram per pound body weight). 

Are you a non-body builder? Then .8 grams per kg (or .36 g/lb will meet your need. (For most, a daily total of 50 or so grams is adequate.) No doubt you'll see how over the top these whey protein supplements actually are, and not without their risks. 

Shrinking packages: Why has the portion of yogurt dropped from 8 oz (one cup) to 6 oz, to in some cases 5 plus ounces? And, for the same price? And why did my half-gallon of ice cream slim down in such a deceitful way, denying me the full number of portions it used to have? (It’s now 2 cups short of the old packaging, so if you feared you were plowing through it more rapidly, fear not!) Food manufacturers should not determine what an appropriate portion is, so be sure that you allow yourself to have as much as you truly need. And that's likely to be more than a 100-calorie pack, too!

Packaged nutrients, not foods: Must we be categorizing everything we eat based on nutrient content? Can't we just eat things because we enjoy them? Because they give us pleasure? 'Protein and Fiber'? Really? Looks like sweetened, cluster cereal to me.

I'm just scratching the surface. Gentle laxatives, gelato, bottled waters and other favorites of mine will be addressed in an upcoming post! Please send me your pet peeves, too!

Allured By Diet Pills & Laxatives?

I got carded yesterday in the middle of the afternoon. Yes, in spite of my grey hair and my approaching 50^th birthday, I was forced to show my ID. This was not to buy a Chardonnay or a 6-pack, but rather to purchase something taken in much smaller doses—cough medicine. In spite of my visible maturity, the drug store required me to prove I am of legal age for such a purchase, given risks of using these products to produce methamphetamine.

Fair enough. But here's what struck me. At this same pharmacy, just 2 weeks ago, they were giving out samples of Senna laxatives, those natural-yet-lethal stimulants, which are anything but safe, especially if taken beyond the very limited time frame recommended. Use beyond the limited 7 days can result in dependency and can impact potassium balance with major consequences to your heart and other muscles. It’s not recommended in pregnancy or for nursing woman at all, nor for kids. And they certainly aren’t helpful for weight loss, yet that hasn’t stopped people from taking them with the hope that maybe these will get the pounds off.

As you might have guessed, I simply couldn’t keep my mouth shut about their promotion of this freebie back then. And here I am, getting carded to buy a bottle of Robitussin CF to legitimately control a hacking cough.

As I strolled around the store yesterday, I walked through the supplement aisle—just looking of course—lined with supposed diet products to melt the fat away and control weight. Laxatives, Sensa and other diet pills, formulas promising aid for the aging body—those were all there—with no ID required to protect our safety or our sanity.

Why aren't we in an uproar about this scam, about our being manipulated by the promise of this unrealistic dream of harmless weight loss? Why aren’t we protesting the ease of availability, alluring us to potentially damaging products that are deemed innocent enough to stock the shelves—deemed innocent until proven guilty? Why aren’t we shouting about the unwanted and unsolicited junk emails falsely promising weight loss we’re being bombarded with this time of year?

Why, instead, are we up in arms attacking soft drink manufacturers for selling Cola, Sprite and the others fearing their impact on the obesity epidemic?? They promise nothing—at least they're honest! Sure, excessive intake of regular Coke and Pepsi may contribute to obesity and may take the place of nutrients we could be eating. And excessive intake of Diet beverages, in my view, is no less concerning, as it displaces nourishment we all need and provides a false sense of fullness—which those of you struggling with anorexia clearly don’t need.

Buyer beware, is the advice I’ll leave you with. And do consider speaking up if you’re a recipient of unwanted diet promotions!

Body Wraps, Toxin Removal and More: What I Learned at the Gym Today

I'd much rather be hiking...

It's hard enough starting at a new gym. Generally, I dislike going to gyms, preferring instead to enjoy a long bike ride, a hike or a cross-country ski or snow shoe when weather permits. But living in New England, there are times, like now, when conditions are simply not favorable for either of those activities.

So off to the gym I went, attending my first spin class of the season, at a new gym with a new instructor. And I could barely get through it. No, I am not that out of spin shape—although those cycling muscles certainly needed a workout. Rather, I was feeling my blood pressure rise as I sat through the marketing pitch and endless misinformation by this supposed promoter of health—the spin instructor.

I'm still headachy from it, so in truth, I am blogging to air my annoyance and frustration.

You know me be now—I am not shy to share my opinions, particularly those I feel strongly about. But this was a challenging setting. Jane, I'll call her—no, Barbie better suits her—stood before the class of about 35 cyclists confidently spewing her crap. Misinformation spilled from her mouth with no objection from the group, until I, a newcomer there, just had to speak up. But it was hardly the forum to debate in, and my rebuttals could be endless if I countered every outrageously false claim about weight loss.

No, neither body wraps nor green
powders will remove body fat.
Sorry!

She endorsed a powder she was selling with her personal testimonial about how she believed it really helped her, as it releases the toxins from the body, those horrible things which fester and cause disease. (Toxins, by the way, are released from our bodies every day, with no need for a product to make it happen.) And it gave her natural energy and promotes weight loss. (For the record, calories are the form of energy we get from foods; a product with no calories has no energy, although you may get a short-term boost from stimulants such as caffeine.) Then I heard her endorsement of the body wraps for sale, which essentially shrink your body a size or so overnight! All without dehydrating you! And finally I learned that you should be drinking half your body weight in ounces of water each day. 300 lbs? That's 150 ounces each day of water, about 5 liters or quarts per day.

So why am I all upset, you ask? Where shall I begin?!

• because while for me it was simply an irritation (and a big one at that), I know how others will be lured by this misinformation, sold products with false claims, sucked into unhealthy thinking and potentially dangerous supplements; more misinformation makes sensible thoughts a challenge;
• because she was speaking to a group of completely normal weight individuals, none of whom could afford to lose weight;
• because no one should be sucking down water or non-caloric beverages instead of eating when they need fuel, simply to mask their hunger;
• because she's setting people up for failure and unrealistic goals, luring them for her personal financial gain, to buy a product, in the case of the wrap, that at best may contribute to a decrease in hydration for a temporary appearance or short-lived sensation of lightness;
• because if we each spoke up every time we heard something we know to be false or inaccurate, then maybe we could make a difference!

Yet another gym promotion. Uggh!

There, I feel so much better now. I think I'll go have dinner, now that I can more calmly and peacefully enjoy it.

Thanks for letting me rant!

Colonic Irrigation For Weight Loss?

Colonic irrigation may seem like a positive,
"relaxing"and necessary procedure but...

I’m okay with my weight, and with my body. Most days, that is. But what if I opened my email to find a Groupon that lured me with the promise of feeling better, of losing weight, of being cleaner, healthier? And what if I passed on it the first time, simply ignored it, but received it again, when I wasn’t in my best place? And what if I didn’t have the wisdom to know how I was being played with, manipulated, misinformed, for them to make a buck off me?

I ignored the promise of a cleaner colon and all of its wonders.

That was the first time. This time, particularly after inspiration from Carrie’s post at E-D Bites, I needed to post my rebuttal.

Won’t Colonic Irrigation (and laxatives, and diet pills) solve the obesity epidemic?

Here’s what the Groupon promised:

• Colon hydrotherapy gently purges digestive tract of debris & toxins to ease chronic pain & restore organ function
• May kick-start weight loss
• Noninvasive and relaxing treatment
• Purges body of impacted debris and toxins
• Can boost organ function and relieve pain

And the facts?

From Medicare:

“Colonic irrigation is a procedure to wash out or lavage material on the walls of the bowel to an unlimited distance without inducing defecation.  This procedure is distinguished from all types of enemas, which are primarily used to induce defecation. There are no conditions for which colonic irrigation is medically indicated and no evidence of therapeutic value.” Given its uselessness, it is not a covered service. Bummer.

From the Cleveland Clinic 

“While the idea of ridding one’s body of built-up toxins from sugar, alcohol, caffeine and meat is appealing, the truth is that the data supporting colonic cleansing and body “detoxification” have not been studied sufficiently in clinical trials.

Carol Burke, MD, Director of the Center for Colon Polyp and Cancer Prevention in Cleveland Clinic’s Digestive Disease Institute, warns of the hazards and lack of evidence to support these therapies. “There is no evidence to support their benefit; there is only evidence of their complications,” adding that complications may include rectal perforations from colonic irrigation and enema therapy, oftentimes requiring surgery.”

From Medial News Today: 

“Twenty past studies about colon cleansing published over the last decade were analyzed by researchers, and found little evidence that the procedure offers any benefits. Instead, a number of the studies noted side effects such as cramping, bloating, vomiting, electrolyte imbalance and kidney failure.”

And really, calling the procedure relaxing and noninvasive? Do we need a visual here to remind us of what the process is? (Sorry, no photos this time).

My reaction might seem targeted to colonic irrigation. But really it’s about being taken advantage of—by the media, by those who ought to know better, and by our own vulnerability. Because products promising weight loss, laxatives and colonic irrigation lying about cleansing our weight away, only cause us damage. We so desperately want to believe, to hope that something will fix our ills, will improve our weight, will help us feel better about ourselves.

We’re bombarded everywhere by media messages—as well as comments from friends and strangers, directly and in overheard conversations—about their latest, their best diet ever. Their solution, found at last, if only for this week.

It comes from people you trust—like your chiropractor, whose hands of gold and makes you feel physically better with his adjustments, perhaps. For a significant contribution to his monthly income, he encourages outrageous products such as 3 day cleanses. 

Yup, several of my patients, including those struggling with bulimia have been victim to the transfer of trust—the belief in the provider who has been trustworthy in some arena of care—but who is damaging in others.

Angie believed she had multiple allergies. What she had was the start of an eating disorder that snowballed into severe restrictive eating and reliance on products her chiropractor sold her. In spite of unhealthy behaviors and food avoidance, she was sold a line of products that contributed to her belief that cleansing was the answer. Her health deteriorated, and by the time she presented to me I knew she needed a higher level of care. Seeing her chiropractor ultimately kept her from following up with her doctor, who might have had the wisdom to see the harm she was doing to herself.

It doesn’t help that we are manipulated at every turn about what is normal and realistic, regarding our appearance. I am not saying that the media causes eating disorders—merely that it influences how we see and feel about ourselves. As we age, skin wrinkles, and hair may gray. Trust me, I know. Weight may fluctuate, as does our level of activity and eating. If we compare ourselves to our younger selves, we may yearn to change. If we look to the photos in magazines and online of individuals our age, we are misguided into believing they are real. 

Please view this amazing video, which lets you in on the secret:

http://www.youtube.com/watch?v=S_vVUIYOmJM

Your Challenge

In this post New Year’s period, have you been challenged, triggered by the pull of diets or diet aids? I’d love to see your responses to the crazy messages you’re enduring. How did you twist it to avoid the pull? What did you say to yourself to come to your senses? Please share via the comments on this post!

And if you need help knowing what something isn’t a wise choice, ask in comments as well! Again, check out E-D Bites post for examples.