metabolism – FIT IS A FEMINIST ISSUE

If you’re interested in fitness and nutrition, the answer used to be obvious: lots and lots. If you saw a diet counselor or a sports nutritionist, they often had the same question: How much water are you drinking? And it was never enough.

We were told not use our body’s cues, that these were unreliable, By the time you’re thirsty, they said, you’re already dehydrated.

If you’re like me, you’ve carried stylish non-disposable water bottles everywhere with you. I own the one pictured on the left. I love it. But I confess that I feel virtuous drinking water and that sometimes I drink water when I’m bored in a meeting, not always because I’m thirsty.

Intuitive eating? Maybe. But intuitive drinking? Maybe not so much.

And drinking lots of water is often touted as a sure way to lose weight.

WebMD has a water based weight loss diet. They report:

“Research has also shown that drinking a glass of water right before a meal helps you to feel more full and eat less. “Many people do find that if they have water before a meal, it’s easier to eat more carefully,” says Renee Melton, MS, RD, LD, director of nutrition for Sensei, a developer of online and mobile weight loss and nutrition programs.

One study, for example, found that people who drank water before meals ate an average of 75 fewer calories at each meal. That doesn’t sound like a lot — but multiply 75 calories by 365 days a year. Even if you only drink water before dinner every day, you’d consume 27,000 fewer calories over the course of the year. That’s almost an eight-pound weight loss.”

But now it’s not so clear.

First, came the marathon deaths due to over hydration. These were usually women, often beginning runners, non elite athletes, who stopped to drink at every water station thinking they were doing their bodies good. The deaths resulted from hyponatremia, a sodium imbalance that results from drinking too much water.

From Shape Magazine’s article, Is it possible to drink too much water?

“Clinically called hyponatremia, it’s a condition in which the level of sodium — an electrolyte that helps regulate water levels in the fluid in and around your cells — in your blood is abnormally low. When this happens, your body’s water levels rise, and your cells begin to swell. This swelling can cause many health problems, from mild to severe, and can result in death. Hyponatermia has been in the news for the past few years after a study in the New England Journal of Medicine listed overhydration as a serious health issue of some runners at the Boston Marathon. “

You can read about the dangers of overhydration here and here.

You can also read Krista Scott Dixon’s Waterlogged: Interview with Dr. Tim Noakes.

Second, came the research that showed that the “8 glasses per day” recommendation is just false. It was based on a bad research funded by the manufacturers of bottled water. See the CBC’s 8 glasses of water a day ‘an urban myth’

“The common advice to drink eight glasses of water a day doesn’t hold water, say nutrition and kidney specialists who want to dispel the myth. “What drove us to drink two litres of water a day?” asks an editorial in this week’s issue of the Australian and New Zealand Journal of Public Health. The recommendation was driven by vested interests rather than health, suggests author Speros Tsindos of the department of dietetics and human nutrition at La Trobe University in Victoria, Australia.”

“What drove us to drink 2 litres of water a day?” was published in the Australia New Zealand Journal of Public Health. It begins by noting that the Saharan nomads do just fine with very little water in a very hot and dry environment.

A Scientific American piece Fact or Fiction: You Must Drink 8 Glasses of Water a Day? concludes: “There is no clear evidence of benefit from drinking increased amounts of water.” They say that the recommended amounts of fluid that we hear quoted were meant to include liquids from all sources, including those foods such as fruits and vegetables, as well as beverages such as milk and coffee. A National Academy of Science panel in 2004 wrote that “the vast majority of healthy people adequately meet their daily hydration needs by letting thirst be their guide.”

Third, came controversy over maintaining a reasonable metabolism and the over consumption of water. Listen to Matt Stone here. Read Pee All That You Can Pee? How Much Should You Drink? a guest post by Stone over at Krista Scott Dixon’s Stumptuous.

Read Cheeseslave’s 10 simple tips to raise your metabolism:

“1. Don’t Drink When You’re Not Thirsty: This sounds like common sense but most of us don’t follow it. We drink too much water because we think it’s good for us. We drink lots of coffee and soft drinks for the stimulant effect. We drink too much alcohol to relax.

None of these things are bad as long as they are done in moderation. You don’t have to avoid coffee or alcohol. Just watch how much you consume. Drinking too much and drinking for reasons other than thirst lowers your metabolism.

Limit the fluid intake, increase your body temperature, boost your metabolism.”

Me, I figure my body probably can sort this one out on its own and I’m going back to drinking when I’m thirsty.

The connection between obesity and health isn’t as straightforward as we might think.

Those of us who puzzle about the connection between obesity and health ask whether it’s possible to be fat and healthy. I’d like to think that it is.

But until recently it didn’t ever occur to me that some people could be healthy because they’re fat and that for them not only is losing weight not necessary it might even be had for their health.

It does seem though that not only can fat people be healthy, in some people it seems losing weight increases a variety of disease risks. Researchers call this the “obesity paradox” though as they come to understand it it might be a misnamed phenomena. What matters, they think, is metabolic health, not obesity after all.

I find this fascinating but it does make me worry about weight loss in my case. I’m a clear case of a metabolically healthy, significantly overweight person.

See the following story from the Vancouver Sun, http://www.vancouversun.com/health/Obesity+some+healthy+others/7607904/story.html.

I’ve italicized the bits that make me nervous!

“According to a recent study funded by the Canadian Institute for Health Research, people who are obese are less likely to die from pneumonia than people of normal or low weight. The study of patients at six Edmonton hospitals found that obese patients were 56-per-cent less likely to die, an example of what the researchers call “reverse epidemiology.”

It is far from the only example. The authors cite studies that reveal paradoxical outcomes for obese patients suffering from coronary artery disease, end-stage kidney disease and heart failure.

Other recent CIHR-funded studies have revealed that some obese people appear to be protected against the very illnesses most associated with obesity, specifically type 2 diabetes and cardiovascular disease.

These seemingly contradictory findings are fuelling research into the so-called Obesity Paradox, according to CIHR researcher Antony Karelis at the University of Quebec.

Karelis has found that about 30 per cent of obese people appear to display metabolic health indistinguishable from those of young lean individuals, including normal blood pressure, low levels of bad fats, high levels of healthy fats, high insulin sensitivity and low inflammation.

Metabolically healthy obese (MHO) adults also have less fat in their livers, muscles and around their vital organs, but more subcutaneous fat under their skin, he said.

“Some [obese] people collect fat under their skin where it is less likely to go into the liver and the heart or the pancreas and cause all kinds of trouble,” said Karelis. “Fat on their thighs is associated with health benefits, but abdominal fat is more associated with [poor health].”

Karelis argues that identifying people by their metabolic health, rather than their weight, is key for doctors making decisions about how to treat their patients.

“We know these people exist and that they have a lower risk of diabetes and cardiovascular disease,” Karelis said. “They have a better inflammation profile, a better hormonal profile and they are physically stronger.”

There are signs that weight loss may be harmful to people who are metabolically healthy but obese.

MHO individuals who participated in a six-month weight-loss study showed deteriorated insulin sensitivity, a risk factor for diabetes and heart disease. Metabolically abnormal obese study participants — those who display inflammation and unhealthy fat profiles usually associated with obesity — showed improved insulin sensitivity, suggesting their health could benefit from weight loss.

A 2009 study in the journal Epidemiology of middle- and older-aged obese adults found an increased risk of death associated with weight loss. Another CIHR study found that weight loss in obese post-menopausal women increased their risk of developing diabetes.”

Since diabetes seems to be the main risk caused by messing with a good thing, i.e. losing weight when you’re metabolically healthy to start, I think I’ll keep on eye on this in my case if I make progress to a leaner me by year 50. We’ve got a type 2 diabetic in the house so monitoring my blood sugar at least is easy.