Most diets work; and nearly all diets fail. That is, most diets do help people lose weight, but most diets do not help people to keep off the weight.On July 24 this year, Health Minister Terrence Deyalsingh announced that a policy on Non-Communicable Diseases (NCD) would be released in two weeks.
Six weeks later, there has been nary a word from the Ministry of Health.NCDs such as heart disease, strokes, diabetes and cancer are responsible for the majority of premature deaths in T&T.
Put another way, most people who die, if they took care of their health from at least their '40s, would live about ten years longer. And diet is a crucial factor in preventing NCDs.
In his book The Cure for Everything, legal scholar and fitness enthusiast Timothy Caulfield writes: "A good diet isn't just advantageous to good health, it's essential...Eating a balanced diet reduces the risk of cancer, stroke, heart problems, and many common diseases."
Writing the same week of Deyalsingh's statement, former Guardian editor-in-chief Orin Gordon in an opinion column promised: "One of the things that we at the Guardian intend to be unashamedly, unabashedly in favour of is a better Trinidad and Tobago, a theme a campaign if you will–that you'll be hearing us sounding off on in the coming weeks and months."
Organ donation has since been taken up by Guardian Media Ltd.
This article is the first in a related series on health that will be published in the Sunday Guardian over the next few months.
The series draws on the latest scientific research on diet and exercise and psychology, which can help individuals improve their health and increase their lifespans, as well as cost-effective policies that the Government can implement to achieve these goals.
The articles will also debunk many of the unsupported and false claims from alternative medicine practitioners, such as herbalists and naturopaths.
This instalment looks at diet–but not "diet" in the sense of eating less but diet in the sense of what people eat and how it affects their health. "A healthy diet is about a lifestyle, not a Spartan list of superfoods," Caulfield writes.
Nearly all the best-selling books about dieting are unreliable–ie, their claims are not supported by rigorous science and are based on false ideas about the human body and, indeed, reality.
Part of the problem is the difficulty of doing nutrition science: a rigorous study would require monitoring a randomly-selected group of people for years, indeed decades, tracking everything they eat, and then teasing out the various factors, including foods, which affect their health.
Needless to say, no such study has ever been done. The most reliable nutrition surveys track people for a few months at best, after which the researcher offer their best guess about the effects of food.
Sports journalist Matt Fitzgerald in his book Diet Cults writes: "But science has not identified the healthiest way to eat. In fact, it has come as close as possible...to confirming that there is no such thing as the healthiest diet...Adaptability is the hallmark of man as eater. For us, many diets are GOOD while none is PERFECT."
Thus, all knowledge about diet and health boil down to this: eat moderately of all things. This is simple advice to give but, for most people, extremely hard to follow.
In her book A Big Fat Crisis, American epidemiologist and medical doctor Deborah Cohen writes: "Hardwired cognitive limitations make it nearly impossible for most of us to consistently resist overeating (or to spontaneously engage in physical activity) so ending the obesity epidemic will require changing the food and activity environments or changing ourselves."
Since human nature is not going to change anytime soon, Cohen argues that, like cholera and typhoid in the 19th century, "obesity is the 21st century's public health crisis. Our major approach of exhorting individuals to be more responsible is just not working. Ending obesity requires solutions that transcend individual behaviour."
However, this is unlikely to happen in the United States, let alone T&T. Indeed, although white flour is amongthe main culprits in the fat crisis, the VAT Act of 2016 returned Value Added Tax on wheat flour and whole wheat bread.So this article will focus on what individuals can do to lose and maintain a healthy weight, rather than policy strategies.
And the first point to emphasise is that there are no shortcuts.
"If you see the word 'detoxify, 'cleanse', 'supplement' or 'metabolism' associated with a product or process, be suspicious," writes Caulfield.
"Someone is trying to sell you something that likely does not work and might, in fact, be harmful."
Which brings us to the long path. The most efficient way to lose weight is to consume fewer calories than you need for your daily activities. Caulfield lost ten pounds within a month by following a strict diet prescribed by nutritionists he consulted in writing his book.
"This was a revelation to me," he says, "but make no mistake, it was a tough slog. I was hungry...ALL THE TIME."
And herein is the fundamental problem with dieting (in the sense of eating less): few people can tolerate being continuously hungry.Caulfield, despite being an exercise fanatic, began putting back on weight as soon as he came off his diet. Fitzgerald writes: "People like us cannot sustain super-healthy eating if doing so forces us to sacrifice our reason and deny our natural omnivorousness."
Instead, he recommends a different approach: categorising foods into ten groups, and eating more at the top of the list and little or none at the bottom.
See list of foods.
Ten foods in decreasing health quality
Numbers (1) and (2) are essential in any healthy diet and should be eaten more often than the rest. The next four are recommended.And the last four are "acceptable" ie they can be eaten in small quantities without too many ill-effects.
However, this is still contingent on other factors, such as exercise. But even this flexible list shows the difficulty Trinidadians (not so much Tobagonians) will have eating healthily, since they would have to cut out or at least cut down on doubles and KFC.
Caulfield notes three traits of people who have successfully lost and kept off weight: first, they weigh themselves regularly; secondly, they eat monotonously ie, pretty much the same thing every day; thirdly, they don't change what or how much they eat on special occasions, such as Xmas or other celebrations.
"The road to good health is simpler than we are often led to believe...Ninety per cent of a healthy lifestyle is associated with a few simple truths," he writes, adding, "It is not necessarily an easy path to follow."
My weight loss testimony
"When I was 41 years old, I ran my first and only marathon. I'd been running for exercise since my '20s, but running a marathon was just a bucket list sort of decision. I trained for about seven months, going to a maximum of nine miles on any single run, although you're supposed to do at least 13 miles comfortably to ensure that you can finish the 26.2 of the marathon.
Nonetheless, I did finish in an unimpressive four hours and 27 minutes, and I had to walk and jog the last eight miles.
After the marathon, I rested for a month and then returned to my standard exercise routine, which was running three to five miles, three or four times a week. Except that I couldn't. In fact, I found that I was unable to run even three miles without walking in between.
My assumption was that the marathon and age had caught up with me. But the truth was much simpler. During my month off, I continued eating as I always had, which included a daily chocolate bar or chocolate biscuits. And I went up to 180 lbs, a weight I would stay at for years without realising that I was overweight.
As Timothy Caulfield notes: "Most of us, particularly men, overestimate our height. And almost all of us–men, women, young, old, short, tall–underestimate how, to be blunt, FAT we are."
And not only was I fooling myself, but I ignored the hints of friends about my size and even convinced myself that myprotruding stomach wasn't a real potbelly because I could suck it in. Indeed, it was only a comment by someone who didn't like me which made me realise that I had gotten fat.
Because of that, and so that my diminutive wife-to-be wouldn't be embarrassed by me in public, I decided to lose weight. My research showed that the most-effective diet for weight loss which suited my eating habits was the Atkins, or low-carbohydrate diet. Basically, this means eating just eggs, meat and salads. I cut out all sweets and soft drinks, drinking peppermint tea instead. The Atkins diet requires strict adherence for the first two weeks, after which you can loosen the restrictions. But I dropped
five lbs very quickly and ended up staying on the strict diet for three months. By the time I went down to 175, my running times returned to what they had been in my '30s. Within a year, I had lost 20 lbs, going down to 163 lbs from a maximum of 185 lbs. My stomach was flat, and I had to replace all my jeans.
However, like most people, I didn't keep my weight down, eventually going back up to 170 lbs, where I've been for over three years now. According to the Body Mass Index (BMI) measure, my ideal weight is between 147 and 159 lbs, meaning I am between 23 lbs to 11 lbs overweight. But even 159 lbs isn't a weight I will ever reach without more effort than I'm willing to make. Because, among other things, it would mean giving up chocolate entirely."