Who would have imagined that my patient, Evo, would have lost 14 pounds on the “beer and sausage” diet (now called the Evo diet).

From the medical side there are two other benefits — his triglyceride level dropped by half, his cholesterol dropped by a third, and his “good” cholesterol increased.  There was never an increase or a blip in any of the liver enzymes.  His fat mass dropped, the only non-fat mass of his that decreased was that tissue associated with and supporting the fat mass (I know, sounds complicated).  His muscle mass maintained itself.

One important lesson learned: we do not know enough about science and medicine and diets to be able to say anything to anyone about which diet is healthy and which is not. But let me give you an example – we had more data points for this one month of the Evo diet than Ornish had for his diet program.

The famous Ornish line is that his data showed a decrease in “Plaques” of patients who had heart disease. This was based on less than 20 patients, including the control group.  He has since gone on to show poor data with prostate cancer, as well as aging. The data that Ornish has isn’t good, and when you look at the data we generated in one month from the Evo diet, one could assume that we would find people would do better not doing the Ornish diet and following the Evo diet.  This is said with a smile, because never has a “lifestyle” and diet – such as Ornish, been propagated with less data and more press.  Ok- there is also the China Project (a single misuse of data to say the same thing).

The second important part of Evo’s diet was this: there was a simple and yet profound control of the portion sizes that he had. It was measured, it was regulated to around 1500 calories per day.  Based on that,  Evo lost more than we would expect him to have lost. Why? No clue.

What can you take away from this: First, if you want to have a diet begin by strictly regulating portions. Portion control is a key for any weight loss, including weight loss surgery.  Limit your portions, and thus your calories, and you should lose weight.  The advantage of beer and sausages is that they come in nice units that you can measure.

Processed meats appear to increase risk of colo-rectal cancer

What you should NOT take away from this: beer and sausage are not “diet foods.” Beer and sausage were, in this case, a tool for great portion control. And Evo ate more than just sausage. He ate what came with it.  When I cooked for him he had the peppers and onions that went with my famous recipe (recipe will be on terrysimpson.com later). He had bread (yes, I know some of you think bread is the devil’s tool) – if it came with the sausage.

The final message is most important- We don’t understand food as well as Ornish, Atkins, or pick some diet guru would have you believe.

Sometimes all you want for breakfast is a cup of coffee-- and that's ok

Everyone knows:  Always   eat Breakfast

There   are   a lot   of   variations   of   this   axiom.

“Breakfast   is   the   most   important   meal   of   the day.”

“Breakfast makes it so you won’t be hungry later.”

“Breakfast jump starts your metabolism”

“You need to eat a large breakfast”

“Breakfast   is   the   most   important   meal   of   the day.”

All of those are FALSE.

Breakfast is NOT the most important meal of the day- so don’t force it. The reality is that most people are not ready to eat breakfast when they first wake up.  So why does “everyone” say this? Some of this data was based on the Iowa Breakfast study- which was more than a single paper- but a group of observations made over a number of years and published. There have been a number of other studies showing that kids who eat breakfast do better in school than kids who do not. However, there are a lot of variables not accounted for in those studies.

In addition- a few other items were not taken into account: if you wake up at 4 am to do chores until 7 am, then have breakfast and go to school, you will do better in school than someone who wakes up at 4 am, does chores and doesn’t get breakfast.

Regarding most breakfast studies — funded by, and poor research  done, from cereal companies. Doesn’t mean they are bad studies- but they all fall into poor categories of evidenced based research.

“Breakfast makes it so you won’t be hungry later.”

A recent study showed that people who eat a large breakfast are not affected by how much they eat later in the day. Meaning that eating a large breakfast won’t keep you from snacking, or eating less the rest of the day.

You wonder where people come up with this idea– but when it is put to the scientific test- the breakfast you consume does not reduce food you consume later. Not one bit. No relation- no correlation.

Breafast buffet is not your friend

“Breakfast jump starts your metabolism”

They also found that eating less in the morning contributed to overall weight loss (if you eat less calories you will lose more weight).  There is a simple truth about weight loss – if you eat more calories than you burn, you will gain weight. If you eat big breakfasts and lots of other calories you will gain weight.  Breakfast does not jump start your metabolism- your body does that.

Again- how would you measure a “jump start” to metabolism? There are ways- but activity itself increases heart rate, breathing, and over all muscle activity. If you take comatose patients and measure their oxygen consumption and carbon dioxide production- and cycle feeds – the feeds do not increase metabolism. Another study took college football players and put them into a hospital and fed them. They were allowed to do a few walks- but not much more.  It was activity that increased metabolism- not food. Any food will increase some metabolism – but a breaking of the fast does NOT do any sort of jump start.

“You need to eat a large breakfast”

Want to just have a smoothie or yogurt or some oatmeal to start your day? Go ahead. You want to wait for a couple of hours after you get up before having something to eat- that works too. But if you eat a large breakfast – you still need to work off those calories.

You think this is an important meal?

The great thing about breakfast foods: You can eat them anytime! Who doesn’t like eggs for dinner? And after a long day- nothing is more refreshing than a blueberry smoothie to take the edge off hunger, and let you relax for a bit.  We have recipes for smoothies containing micronutrients, fibers, and supplements – a simple smoothie can be a pleasant treat after a long day of work, taking the edge off hunger so you can make a great dinner.

For the smoothie and other recipes go to terrysimpson.com

I don't know much about beer - but I'll bet Evo likes this one

There is a difference between craft beers, and subpar-hoppy-inferior-tasteless ( SHIT ) domestic beers. But that difference isn’t just taste – it may be the way the body will process different beers.

Think of craft beers as whole wheat and the SHIT beers as white flour. A person who eats white bread develops a rapid rise in blood sugar, followed by the body responding with high levels of insulin—all of which serve to convert to fatty acids that end up as fat. When a person consumes less processed foods- the rise in blood sugar is much less allowing the body to utilize it as fuel, instead of fat.

Wheat berry to flour

Craft beers are less about broken down overly processed ingredients, and more about enjoying the refined taste – hence, our theory is that the body doesn’t quickly process the craft beers as quickly as SHIT beer. For a better discussion about beers that Evo drinks- see his posts at funanymore.com

There has been a controversy about beer for years.  In the South Beach Diet (another silly diet plan) they said beer-contained maltose—it doesn’t – that is long gone by the time it gets to your lips. Doesn’t it amaze you that so many diets are based on things people make up (no it doesn’t surprise me, they all are pretty awful).

Another diet NOT based on "science"

Oddly- no one has tested the glycemic index of beer – so Evo and I will be doing this. Under physician supervision we will perform the glycemic index of a proper craft beer and a SHIT beer. After all – this is science, and we are up to the task. I am speaking for Evo here, and he doesn’t realize I am going to be getting blood samples from him every fifteen minutes—don’t tell him, just say it is for science, and we will keep giving him beer.

For years beer has gotten the bad rap with every diet known to man. Starting with at the turn of the century when diabetes was blamed because of beer. One hears about the “beer gut” – and all assume it is the quantity of beer that is consumed- without thinking that the other items that are commonly consumed with beer might be the cause. In this case we know what Evo will be consuming with his beer – not pizza, but just the sausage.

Beer gut? Nope- probably pizza gut

Evo is all smiles after losing another two pounds of fat

Fat mass is what we want to lose on any diet. The scale may have stayed the same, but his fat mass, which we measure at each visit, has decreased and this is the stuff that causes the problems- not just cosmetically, but inside.

Sometimes a doctor should know better: last week, while in Mexico I had a bad clam. Now the clam was in the version of clamato that has fresh clam, shrimp, octopus, clamato juice, and beer.  What is the point? Well, that diet worked well- but if I were on the Evo diet, and just had a beer- I would not have spent a day in front of the toilet.  Bottom line- beer is highly processed, filtered, and far more healthy than many drinks you can obtain (including bottled water) from many sources.

Beer beats a bad clam

Bottom line ( I say that a lot because for most people they want to lose weight from their bottom – I could say belly line for some of us) – as with most “diets” you can and will lose some weight.  Evo is doing this under my care – which means we are keeping him out of trouble.

Since my friend Evo has started his fun diet- seemed like a good idea to show why diets work – and why they don’t. What is real and what is not. Hope you enjoy this– and my humor –TLS

A number of my patients, when deciding to get to their goal, ask, “Should I go back on Atkins or go to Weight- Watchers?” The answer is no, and the reason is simple:

Those are diets, not lifestyle changes. Sure, some of those do proclaim that they offer changes in lifestyle, in their own way, but they are really a diet. If diets worked, would we need weight loss surgery? Ask the famous question, “How does that work for ya?”

Often times we don't know we gained the weight

Diets are a set of rules imposed on you by someone else. How do you respond to someone telling you what to do? I was in a restaurant a number of years ago while on the Atkins diet when they offered me some of their fresh bread.  My response was, “No thanks, I am on Atkins.” It felt good to say that because I was following a rule-bound diet and doing a good job—but I missed the bread. I was following someone else’s rule for a diet that makes no sense. It is far better to adopt a healthy lifestyle with healthy choices.Those choices are not strange, they are simple.

The one food or one food group diet

The most famous diet, at least today, is the Atkins diet. It has been almost universally tried by all of my patients and misunderstood, perhaps even by the Atkins folks themselves. Robert Atkins made a great deal out of the body going into “ketosis” where it burns fat instead of turning food into fat. He had a complicated set of theories. None was ever proven, in fact, the reason you lose weight on that, or any low carbohydrate diet is fairly simple: you eat less. The Journal of the American Medical Association published a study showing that the average consumption of calories in low-carbohydrate diets is much less than other diets, and hence they are successful at losing the weight.

I gained weight on Atkins

—or, biology does not overcome the laws of physics

How can you gain weight on a diet that promises that you will lose weight if you avoid carbohydrates and eat meat? Because if you eat enough calories you will gain weight. Meat—or protein—contains calories, and your body is perfect at counting calories. Your body doesn’t care where the calorie come from, it will count every calorie even better than you will, and if you eat enough protein or fat, or drink enough alcohol, or eat enough carbohydrates, you will gain weight.

Most weight loss surgery patients have been on this dietor a variation of it and they know—given their pre-operative anatomy—that they really did gain weight on a diet, without cheating. After all, when you have a stomach that can hold a small mammal, you know you can eat your way into ketosis and weight gain on the Atkins diet. Simply put, a calorie is a calorie is a calorie. It doesn’t matter if you get the calorie from meat, from figs, from bread, or from alcohol. If you get a bunch of calories together you will store them, and if you store them, you will store them as fat. Eat enough steak and you will gain weight.

The Cavemen

The famous caveman diet- life wasn't so simple

Then there is the old “when we were cavemen” theories. They show how back in the old days when men hunted the wooly mammoths, lived in caves, and didn’t shower, that they were thin (now how do they know we were thin?). Back in those days, as this theory goes, we ate meat (lots of it), and didn’t gain weight. Well, there were a few other things in “the good old days” that we might want to think about—the cavemen hunted to get their meat, which meant exercise. The cavemen had famines and for long periods couldn’t eat, and the cavemen didn’t have refrigerators to store the meat so when it went bad, it went bad. If you want to go on a caveman diet, or think that eating one thing will make you lose weight, think again. The body is designed to store excess food as fat, and the body doesn’t care if those excess calories come from donuts, wooly mammoths, prime rib, tofu, or corn—the body was built to withstand a famine.

Our biology was not designed to eat just meat or just vegetables but to eat a variety of food types. So were our taste buds. Give us a single food and we will get sick of it. Sure, we might have to eat the Wooly Mammoth to survive, but can you imagine the kids in the cave, “Ah come on, dad, Wooly Mammoth again? Can’t you go get a Saber tooth tiger?”

Okay, imagine living in a cave:

Husband comes home proudly dragging the dead Wooly Mammoth, “Honey, I am home, and brought dinner. Barbecue tonight.”

“Don’t drag that thing in here, I just cleaned the cave.”

“Okay, but help me cut these ribs.”

“Cut your own ribs, I have to feed the children their ribs first.”

Days later.

”Get that old carcass out of here, it smells, and while you are at it stop drawing on the cave wall and get us some more dinner.”

“But honey, that was the biggest one I got, I want to paint this on the cave wall for all to know what a great hunter I am.”

“You will be a hunter without a cave if you don’t get that smelly carcass out of here. Why can’t you stay home and plant like the other cavemen? Why do you have to go out and bring these dead animals home? Grog stays home, he plants, their family eats, and it is easier to throw out grain that is bad than that large ugly animal.”

“But we can keep warm with the skin, and it shows my skill as a hunter, and I can provide for the whole village. We grow fat on the wooly creature but their crops fail.”

“Speaking of fat, I think it is time you stop eating all that meat and go hunt some gazelles. At least you will get some exercise. You must have put on five pounds this week. And brush your teeth, all four of them.”

Variety can lead to excess

If you are given only a single food, even if it is a food that you like, you can eat only so much of it before you don’t want anymore. I love steak—put a 16-ounce steak in front of me and I will consume 10 ounces of it and bring the rest home for my dogs. After 10 ounces I am done with the steak, can’t eat anymore. So, if I am on a low carbohydrate diet, you can bet that I am done with dinner. But, if

I am not on that diet and you put a bunch of French fries with the steak, not only will I have my 10 ounces of steak, but also I will have eight ounces of fries and maybe even think about dessert. Let us not forget the glass of wine before dinner, the glass of wine during dinner, and the after-dinner drink (since we just called a cab).

Another example of getting sick is eating ice cream. There use to be an ice cream restaurant that had a dish called “the zoo.” If you could eat it, they would not charge you for it. Try to eat twenty scoops of ice cream, it isn’t easy. But you can do it if you eat a few saltine crackers with it. The variety of flavor (salt contrasting with the sweet) allows you to eat more. Again, variety can lead to excess.

Here is the problem—if with a single food diet you lose weight, when you add variety you are less likely to moderate the food that allowed you to lose that weight. In other words, you might think of steak as being “okay” because It is a diet food. You might be under the impression if you eat this food and expand your diet that this food won’t count for calories. Most of us know that too much red meat, with its fat, is not a healthy choice. However, seeing weight loss by eating steak leads one to think it is okay to have as much as you want because one incorrectly believes it is the carbohydrates, not the steak, which causes weight gain. But let’s just put that little theory to the calorie test:

One Steak—Porterhouse of course, 442 calories

French Fries, 154 calories

Salad with blue cheese dressing, 339 calories

One big slice of bread, 80 calories

One cup of broccoli, 77 calories

One real glass of wine, 127 calories

Fat is the most dense of all macronutrients

This meal was 1219 calories—and the majority came from things allowed on the Atkins diet (Steak and salad were 781 of the calories). Of the non-allowed items—the French fries, the bread, and the broccoli—you have just over 300 calories. Now, we are not advocating white bread or French fries at all—just pointing out the majority of calories from this meal come from the meat and the fat, not from the carbohydrates.

An Atkins lover would be inclined to add more fat, more meat, and less white bread. We like the less white bread, less fat, less processed foods, but adding red meat with fat is just not a great option. The point is simple: variety can lead to excess, or variety can lead to good flavors. However, single-food diets, while controlling calories, can lead to a false sense that these foods are “okay,” that they are “diet” foods. Fat is not a diet food.

Here is another example: If you get a cheeseburger and you substitute lettuce leaves for of the bun, you have a meal of 330 calories instead of 400 calories. The bun is just 70 calories! Yet so many people think they are helping themselves by eating something that is filled with fat (about 18 grams) and avoiding a bun. It is the calories that the body counts, not where they come from.

Single-food or food-group diets are simply a complex way to control portions. If you control portions then you will consume fewer calories. If you consume fewer calories then you will lose weight.

Surgery is the most radical of portion controls. Whether you had surgery and stretched your pouch, or your stomach has grown, if you limit portions, which is not difficult, you will lose weight. How much you lose is determined by the number of calories that you eat.

We do not like single-food diets for our patients because, more than anything, we want our patients to have a variety: you deserve a lot of fine tasting food and a variety of foods tends to have a variety of nutrients. Single-group diets are probably not going to work in the long run. They become a burden even if you like the food group you try. After a year on the Atkins diet, I couldn’t look at a steak, which was good, because I stopped the Atkins diet before I went to Europe at the height of the Mad Cow infestation.

Week one:

Down six pounds- two of it fluid. One week- beer and sausage.

My assessment: he is healthy, fit, full of energy. Evo is working hard at keeping his beer and sausage calorie consumption to less than 1500 calories a day. Since he burns around 2100 a day- he should lose at least a pound a week -or over the course of the month- four pounds.

Why the big drop? Two pounds of it are from total body water – and that might be the diuretic effect of the beer. His fat loss is also about two pounds.  Those numbers are somewhat exact – the weight loss is real.

Will this “diet” work?  Yes,  much like a thousand other diets, limit your calories, use just one food group or a couple, and you will be fine.  Lets add a bit of fine print here: we are following Evo’s cholesterol level, liver chemistries, and a number of other tests to make certain he isn’t getting into trouble.  He is also going to be taking a multivitamin daily. Also some fiber daily. If “German” things come with the sausage – he can eat that.  Sausage and Peppers – for example, or sauerkraut - he can have those.  What he can’t have are the side dishes that are processed – no breads, no potatoes, no rice, no pasta.

Today in the office we discussed the huge difference between this and the Paleo-diet.  In the days of the caveman they drank water- most illness was transmitted through water. Beer is highly purified, has nutrients in it- and while some will say it is evil – it really isn’t. I suspect those who say it is evil are those who are the “pure food” people- similar to “raw” or “vegan” – there is a self-righteous superiority about people on diets.  So- if Evo drank water from the streams (we live in Arizona, so that is difficult) he would probably become ill. Sausage – another processed food- which is meat. While “processed” has a bad name (as bad as an Atheist naming their son Christian) – think about cavemen and meat.  You haul in this big bison, wildebeest, or huge creature– most of it will become rancid and cause more illness quicker. But then we became smart and learned how to process and preserve meats. We have eliminated another cause of early death of the paleo-types – death from botulinum toxin, or salmonella (much worse in those days than today).

So Evo’s diet will lead to a longer life than if he followed a true Paleo-diet. Later in this series we will take a skeptical eye to that particular diet and its failures as well as its good points.  For now- take this as the humor it is meant to be — a caveman in Phoenix would lose more weight on the Paleo-diet than Evo will because they would become sick and die.  We will make certain that doesn’t happen to Evo.

Good job, Evo- first week. Great weight loss, more than expected.

I don't know much about beer - but I'll bet Evo likes this one.

Making changes in what you eat on a day-by-day basis can make a profound difference over time about how you eat. Here are a few examples of trading up for health:

Years ago I use to have a hamburger and French fries for lunch, almost every day. The first trade up was to get rid of the French Fries. That represented 600 calories a day. Over the course of 5 days that was 3000 calories – almost one pound of fat. In three months I lost five pounds. Eventually, the hamburger went, and was replaced with a home-made chicken salad, much healthier, because I was able to include items with increased micro-nutrients.

Another patient of mine struggled with weight loss and finally realized she was drinking wine every night: 3-4 glasses. First she dropped to no more than two glasses and over two months lost 6 pounds. This last year she changed her habit from having two glasses of wine a night. Here’s what she said:

“I would come home every night and want a glass to relax. Then you talked to me about smoothies, and making my own. So I started making a simple smoothie with berries, yogurt, some flax seed, and fiber. I noticed after I drank it I felt more refreshed, and was in a better place to make dinner. I had more energy – and best of all, I lost another 10 pounds in two months and have kept it off.”

She traded alcohol, and its calories, for berries rich in fiber, vitamins, antioxidants, and the flax seed with omega-3 fatty acids. It was also a way to get more fiber in her diet.

Trading up to better food, to better quality food, means that you can enjoy life more. It gives you a chance to incorporate some of the micro-nutrients that you might be missing. Ultimately you are empowering yourself for your own health.

Nothing tastes as good as healthy food, and nothing tastes as good as slender feels.

Do Fiber Bars boost your metabolism? Do they help or hinder when it comes to battling weight loss? Dr. Terry Simpson reveals why they may not be so good for your health after all in this quick video.

When it comes to fiber – bars are not the best.  They are high in calories and they have less fiber than you typically need. If you want fiber, increase your fruits and your vegetables.  There are a whole lot of benefits to getting fiber from these “non-processed” items:

(a) The have fewer calories

(b) They taste better

(c) They have more vitamins and nutrients

(d) They will keep you feeling full longer

While fiber bars are quick and easy to pick up and eat — so is fruit – -and when it comes to meals- having a full cup of vegetables for dinner is important to your digestive health, to keep you trim – and to make you feel satisfied for a long period of time.

By the way- when I say vegetables I don’t mean the starchy ones like potatoes or rice, or corn — I mean green ones– and I certainly don’t mean salad. One further tip – why get frozen vegetables that you heat in the microwave? Get fresh vegetables – -they will taste a whole lot better.

So save some money- buy some fruit.  It will taste better — and treat your body better.

For a while it seemed that everyone was talking about the importance of fiber,  and its role in preventing a variety of diseases.  After much speculation, we now have a few answers about  what fiber really does, and what makes it an  important component of good nutrition.

Fiber is simply things that humans cannot digest.  Many vegetables and fruit have methylcellulose – the stringy stuff– and we, as humans cannot digest it.  Cows can, horses can, deer can – but not humans.  This is why it is better to cook vegetables – because by breaking down some of the fiber our bodies can get to the nutrients that are locked into the vegetables.

What we do with it is simply pass the material through our body.  If you don’t have enough fiber you can become constipated – and develop things like hemorrhoids or diverticulosis.  Fiber is also good if you have chronically loose bowel movements – it will help bulk up the stools.

Years ago a group of people thought increased fiber would lead to less colon cancer – -with the theory that fiber acts as a broom to sweep out the colon and thus keep the colon from being in contact with toxic stool.  Well- that has been tested in a number of places and just isn’t the case.  Even people with high fiber diets have no lower incidence of colon cancer than those with an average fiber diet.

Some thought fiber would increase the metabolism – so by taking more fiber in you would be able to loose weight.  That was proved to be incorrect also.

What is known is that the more bulk fiber you have- from fruits and vegetables- with higher fiber — the longer the sense of feeling full is.

This is why we recommend to patients to increase green vegetables, or squash, or beans – to increase their fiber – and to keep them feeling full for a longer period of time.

So- if you want to lose weight- increase your fiber and decrease your processed food.  If you suffer from chronic hemorrhoids – see your doctor- but before then start on a high fiber diet (I recommend to my patients they take a scoop of fiber in 12 ounces of water followed by 12 more ounces of water).

Find yourself hungry mid-afternoon — consider a high fiber snack – like fruits.

So fiber has a lot of advantages – and the best source of fiber — vegetables

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