Westernization Ain't Always a Good Thing

Got 15 minutes to spare? Then check out Terry Gross's interview of Kevin Patterson, the Canadian physician who penned a Maisonneuve article arguing that Western diets are making people everywhere both sicker and fatter. (I briefly discussed Patterson's essay last November.)



Patterson points out that "Type 2 diabetes historically didn't exist." It popped onto the medical scene "only 70 or 80 years ago," driven by the explosive rise of obesity and accumulation of abdominal fat in "Westernized" populations. "That fat induces changes in our receptors that cells have for insulin. Basically, it makes them numb to the effect of insulin."

While working at the Canadian Combat Surgical Hospital in Kandahar, Afghanistan, Patterson noticed that "[t]he Afghan soldiers, police and civilians he treated in Kandahar had radically different bodies from those of the Canadians he took care of back home."

"Typical Afghan civilians and soldiers would have been 140 pounds or so as adults. And when we operated on them, what we were aware of was the absence of any fat or any adipose tissue underneath the skin," Patterson says. "Of course, when we operated on Canadians or Americans or Europeans, what was normal was to have most of the organs encased in fat. It had a visceral potency to it when you could see it directly there."

But while Afghans aren't (yet) as prone to suffering the diseases of Western civilization, another traditional hunter-gatherer society is quickly joining the ranks of the metabolically deranged:

Patterson explains that in his Canadian practice, where he takes care of indigenous populations near the Arctic Circle, there is a marked increase in the number of diabetic patients he sees.  

"The traditional Inuit culture of relentless motion and a traditional diet consisting mainly of caribou, Arctic char, whale and seal has been abandoned over this period of time for Kentucky Fried Chicken and processed food and living a life very similar to ours," he says. "[They're] spending a lot of time in front of a glowing screen."

More here.

DEXA Body Fat Scan

We all know that BMI (Body Mass Index) is altogether unreliable as an indicator of health. It's junk science, and it doesn't tell us anything about body composition. There are plenty of better ways to measure body composition, and in Tim Ferriss' "The 4-Hour Body," he discusses a bunch of 'em -- some of which are much less accurate than others. Calipers and measuring tape only get you so far. And do you accept as gospel truth what the bio-electrical impedance bodyfat scale in your bathroom tells you? 'Cause you shouldn't.

Ferriss examined nine different methods of body composition testing, and "[a]fter dozens of trials with multiple subjects, and taking into account both constancy and convenience (including cost), there were three clear winners." The first of the three: DEXA (dual energy X-ray absorptiometry) -- the "gold standard" of body composition testing. DEXA is a full-body scan typically used to measure bone density, but it's also capable of pinpointing body fat percentage and location. In a nutshell, you plop down on a table, fully-clothed, and a movable electronic scanner X-rays your body from head to toe. It takes less than ten minutes, and you get a keepsake photo of your lumpy silhouette (think airport security pornoscan shots) showing all the fleshy parts you'd prefer to conceal with Spanx and oversized football jerseys. Fun!

Bonus: The unassuming little medical office where Ferriss gets his DEXA scans is just a few freeway exits from my home.

So for kicks, both M and I decided to give this DEXA thing a shot. This afternoon, after shelling out $65 and filling out some simple paperwork, I found myself lying on some crinkly paper, staring at the ceiling while a softly-whirring mechanical arm performed low-dose X-ray scans of my body. It took no time at all. Before I left, the friendly technician spent a few minutes going over my DEXA measurements with me.

Check me out. (Nice lungs, right?)

I'd gained about ten pounds over the past six months, so I figured my body fat percentage had gone up, too. But I'm happy (and more than a little shocked) that my low body fat level puts me in the 1st percentile for my age, meaning I'm leaner than 99 percent of other men in their mid-thirties.

Despite switching to a Paleo diet and adopting a 3-days-a-week CrossFit schedule (i.e., eating loads of saturated fat and exercising less frequently), I've maintained a sub-10 percent body fat percentage. The weight gain, it seems, is largely muscle.

I don't know if it's due to eating Paleo, lifting heavy stuff and doing short metcons a few times a week, intermittent fasting, or a combination of the above, but something seems to be working.

Reader Questions (and an Updated Photo)

First, an email from reader Prescott:

...I recently read your post "Nothing for Breakfast" and was very intrigued by the intermittent fasting concept. If you have space and time at some point, could you make a post about what a "typical" day looks like in terms of when and what you eat? Even just rough calorie counts and how everything would be great! I eat paleo/primal but have been doing 5-6 meals a day because of all the (supposed) benefits. i do feel that smaller meals make it easy on my digestive system; did you have trouble adjusting to getting in your daily calories in an 8-hour window in terms of gastrointestinal issues? IF and 3 meals a day would be much easier!

I don't weigh or measure my food, so my caloric intake's a mystery even to me. A while back, I posted about what I ate during a typical week. But if you want to get more granular, here's what I ate on a couple of days earlier in the week: Sunday (a rest day) and Monday (a workout day):

Sunday

After running some errands with the family, we grabbed lunch at the Old Port Lobster Shack. I had a "Shack Louie Salad" with lobster, crab and shrimp, which -- shameless plug alert! -- you can read about here on M's just-launched food blog, Nom Nom Paleo. (She's posting about what she cooks and eats on a regular basis -- and I pretty much eat the same stuff she does.)

In the afternoon, I snacked on a cup of dried flake coconut and a handful of macadamia nuts.

We made dinner for friends, and ate a ton that night: sous vide shortribs and carrots, cauliflower puree, braised cabbage (from the recipe that Mark Sisson stole), roasted broccoli, Creminelli salami with various cheeses from Cowgirl Creamery, spiced almonds, roasted peppers with balsamic, and fresh strawberries.

I was stuffed by 7 p.m., so I stopped.

Monday

After my 5 a.m. workout (done on an empty stomach), I swigged some coffee before heading to the office.

I got caught up with work and didn't get around to eating lunch until noon: Leftover shortribs, cabbage and carrots.

During a short break, I walked over to the Golden Gate Meat Company counter at the Ferry Building and grabbed a $2 "sausage-on-a-stick": A spicy Italian sausage link on a skewer, served with German mustard.

I also snacked on some of Alfieri Farms' Cajun-spiced almonds (I have a little bag of 'em in my desk drawer), some pistachios, and a hard-boiled egg. And when I got home for dinner, we had sous vide chicken breast with roasted delicata squash and cherry tomatoes, with a generous dollop of guacamole on the side.

Afterwards, I was still hungry, so I topped off with some flake coconut and mac nuts (my snack of choice). And at 7:30 p.m., I stopped eating for the night.

As you can see, I don't stick to a regimented meal plan. Rather, I eat whatever (as long as it's lacto-Paleo-compliant) and whenever (as long as it's not before lunch or after dinner). I eat until I'm full. And while I'm sure I end up downing a lot more calories than I'm "supposed" to, I still look, feel and perform just fine.

Next up: A question from an anonymous commenter:

You made some fantastic gains with P90X, but the progress pics stop after round 1 (unless I'm too computer illiterate to find the others). I'd like to see how far you've come now that you're doing the paleo thing along with Crossfit.

This isn't the first time I've fielded requests for more up-to-date progress photos. A few months ago, I wrote:

As for your question about putting up more recent photos, I explained in one of my posts a while back that I've decided not to post them. My goal during Round 1 was to get fit, and taking/posting my progress photos was a good way to keep me accountable. But at this point, I'm just working on maintaining what I achieved during my first 90 days -- so I don't have any visible "progress" to show off. (It's not like I've become Lou Ferrigno or anything; I look pretty much the same as in my 90 day photos.)

This remains true. There's no visible "progress" to show off because I'm not trying to lose fat at this point -- I just want to keep on keepin' on.

But I get the sense that I'll keep getting requests for updated pictures until/unless I give in. So if you must look, I posted a new photo after the jump.

Skinny-Fat?

Not surprisingly, even if your BMI's fine and you look skinny, you could be "normal weight obese." Mayo Clinic researchers report that "fat in your body can get you and your heart into trouble even if you don't look fat and if the scale tells you you're healthy."

In a study that looked at data from 6,171 Americans with normal body size, as measured by body mass index, those with a high percentage of body fat were at significantly greater risk of future heart problems than those with low amounts of fat. Their bodies "behave like they are obese, but they are not," Dr. Lopez-Jimenez says.

The natural reaction is to get one's body composition tested, despite the fact that "there isn't a consensus among medical experts about what percentage of body fat is 'normal' or what level indicates higher risk."

Some gyms have their own guidelines. At Equinox Fitness Club, trainers consider body composition and waist circumference—another indicator of body fat—more important in assessing fitness of many members than weight. The club's Ms. Coopersmith says that, based on data from the American College of Sports Medicine and the American Council on Exercise, Equinox considers body fat percentages between 25% and 31% for women, and 18% to 26% for men, as "acceptable." Women with body fat of 21% to 24%, and men with 14% to 17%, are "fit." People who reach even lower levels of body fat are considered "athletic," she says.

Still, the lesson's clear: Lose fat and gain lean muscle. And don't envy the skinny guy/gal in the next cubicle -- there's a good chance s/he's in worse shape than you.