Researchers in the United Kingdom have been studying a fibrous material in seaweed or sea kelp known as alginate. They have found this material is quite affective at preventing fat absorption. Researchers performed laboratory studies that modeled fat absorption within the human intestine and demonstrated that alginate will bind the fat and prevent its absorption into the body. The researchers believe when this material is added into commonly consumed foods such as breads and other staples that up to 75% of dietary fat would pass through the intestinal system without being absorbed into the human body.

Anyone who has taken Xenical will know that blocking absorption of fat into the body means one thing: it passes out the stool, usually in the form of diarrhea or a special greasy form of diarrhea known as steatorrhea. The appeal of fat blockers stems from the fact that fat is a very calorie dense nutrient containing 9 calories per gram of food.

However, research that has focused on reduction of fat has lead to very disappointing results for the outcomes that matter: weight loss and resolution of obesity related conditions like diabetes. Research involving fat blocking drugs such as Xenical have shown very mild weight loss and to such a low extent that most professional weight loss physicians only recommend the drug (also sold as Alli over-the-counter) when a weight loss patient is suffering from constipation.

So seaweed might have an interesting role in cutting down some calories we absorb. Reducing fat calories will help the overall cause, however it is quite unlikely that reducing fat calories is going to solve obesity for most people. The epidemiological evidence points strongly toward carbohydrate over-consumption as the main culprit so unless we discover a seaweed that is a “carb blocker “then it is unlikely to make a dent in the obesity epidemic

A real energy drink should give good, solid energy for a period of many hours.

A real energy drink should not make you jittery and “hyper” and impair your concentration; it should focus it.

A real energy drink should definitely not lead to a short spike in energy followed by a big fall in your energy level – instead it should give good, long, sustained energy that is even.

The ideal energy drink would have a few other characteristics too. It would come from natural ingredients. It would not only provide some energy, some calories, but also some other important nutrients like vitamins and minerals. And for the vast majority of us who want energy, but not in the form of empty carbohydrate calories that lead to weight gain and obesity, it should help us maintain a healthy weight and healthy, long term energy. A true energy drink should not leave you craving more food, more calories, more energy drinks shortly after you have consumed one. It ought to provide some real, solid satisfaction. Also, an energy drink can have a little caffeine, that’s fine, but not hundreds and hundreds of milligrams of caffeine. Those kinds of doses are shown to cause tremors and make one feel jittery. They also often interfere with sleeping and actually make people more tired through the course of the week.
Oh yeah, and it should taste great.
So for my money the best energy drink is going to be a nice mixture of vitamins, minerals and natural whey protein to give a clean energy boost instead of all that sugary, make you fat and tired kind of energy that the big drink companies have promoted in the past.

It’s not that we want to be fat. In fact most of us find ourselves gaining weight and are struggling to find ways to stop it. But these energy drinks, sport drinks and just plain ole’ drinks taste so good and are so cleverly marketed to us that we can’t stop drinking them. At least we can’t stop drinking them unless we think about it and use our own free will a little bit.
What a lot of people don’t realize is that big jolts of simple carbohydrates make us fat. Not immediately of course, not that day or that week even, but over time. Big doses of simple carbohydrates, say those in the sucrose and high fructose corn syrup of an energy drink or other soft drinks, the simple carbohydrates are digested quickly and enter the blood stream quickly and result in a very rapid surge of circulating blood sugar or serum glucose level. This also leads to a rapid spike in the important hormone insulin and leptin followed by a rapid fall of the blood sugar level. The next step is a sense of hunger which is often even stronger than before the jolt of sugar. It is no wonder this cycle leads to obesity as it repeats itself over and over.
The make-you-fat drinks have awesome, inspired and expensive Madison Avenue advertising and marketing. They look cool, we think they’re cool and, of course, they taste great. Some of us even like that rapid spike and jittery feeling; the surge of energy, even if it is very short lived, but with a little thought we could all do a lot better.

Free Lap-Band surgery coming in January. As some of you may have heard, our practice has decided to offer a free Lap-Band to a patient and is holding a contest to choose the winner. The contest will begin airing on the radio in January on Sunny 106.9.
I have agreed to donate my time and expertise to the contest winner and will help follow that person for the long term. Hopefully whoever the contest winner is will be very successful in losing every single pound of excess weight and achieve their ultimate weight loss goal!

The acai palm is found most commonly in Brazil, but is native to a number of Central and South American countries. Acai berries are harvested and widely consumed in Brazil in various preparations including in ice cream, mixed with granola, in smoothies, cold in a bowl or in the traditional gourds called cuias with tapioca.

The dietary supplements come in the form of powders, tablets, juice, smoothies and even some whole fruit. Various companies have promoted acai preparations as aid for everything from improved heart health to penile enlargement. Companies like MonaVie in a sophisticated multi-level marketing construct, promotes an acai juice preparation for various health ailments.

To date, there are no scientific peer reviewed, controlled studies that support any of the particular claims of health benefit. But before we throw the baby out with the bath water let’s look at what is in the acai fruit. Like other dark berries, acai fruit contains a mixture of antioxidants including chemicals called flavonoids and a small amount of anthocyanins. A tiny amount of the red wine chemical resveratrol is also found within acai. In studies, the acai fruit and preparations thereof turn out to be fairly average in terms of their antioxidant power with a variety of other fruits scoring a bit better and exhibiting higher antioxidant capacity.

Like a lot of people who follow the science of nutrition and enjoy reading some of the anti-aging potential of wonderful things like dark berries, red wine and chocolate, the truth is that very little evidence exists that would support any claim of significant health effects of these foods of these compounds. It is more like indirect evidence and profoundly hopeful thinking of lovers of red wine, chocolates and dark fruits (like myself!) that these compounds and foods will prove to be as helpful as some laboratory evidence suggests that they could be. To date, keep in mind the studies have not demonstrated any convincing benefit and we’re a long way from knowing what sort of doses, concentrations and specific compounds might provide the answers to solving the mysteries of atherosclerotic disease, heart attack, stroke and diabetes.

In a February 2008 study by Seeram, N.P. in The Journal of Agriculture Food Chemistry; volume 56, page 1415-1422, three available juice mixes of the acai juice were compared with respect to their antioxidant capacity and some number of other antioxidant beverages. Acai juice ranked below pomegranate juice, grape juice, blueberry juice and red wine and was roughly equivalent to black cherry and cranberry juice.

I am certainly not condemning the acai palm, its fruit or the preparations there-of, I just am helping to keep it all in context. By all means, enjoy them along with other healthy fruits, vegetables and whole grains.

Oxygen is a highly reactive molecular component that is important for metabolism, but also produces damage to other complex molecular structures like DNA, proteins and lipids. In chemistry terms, when electrons are transferred from one molecule to an oxidizing agent, an oxidation reaction has occurred and often can produce free radicals. Free radicals are highly reactive and usually have a free electron that will quickly form a new reaction with other molecules, often resulting in cellular damage. Antioxidants are molecules that slow or prevent the oxidation reaction. Vitamins C and E, glutathione, phials, polyphenols, the red wine molecule called resveratrol and many other substances are antioxidants.

Oxidation reactions are believed to occur in neurodegenerative disease, stroke, coronary artery disease and cancer, but it is not yet clear whether the oxidative stress is a cause or a result or simply a concomitant feature of these diseases. The clinical trial data has been far less than reassuring, with the largest recent clinical trial showing no benefit and possible harm due to excess antioxidant supplements (Bjelakovic, G. Journal of the American Medical Association. 2007; volume 297, page 842-857).

Indirect evidence suggests antioxidants may be an important and useful nutritional supplement to prevent disease, but we have not determined how to use them and in what doses, strengths and combinations to be successful. A review study in Public Health Nutrition in 2004, volume 7, page 407-422 by Stanner and Colleagues, lays out the epidemiological evidence for the antioxidant hypothesis and notes that people who eat fruits and vegetables have a lower risk of heart disease and some neurological diseases and there is suggested similar benefits with some types of cancer. These fruits and vegetables are excellent sources of antioxidants, but in the clinical trials to date antioxidant supplements have demonstrated no clear beneficial effect on the risk of these chronic diseases. Studies of vitamin E, vitamin C, beta carotene, green tea and Jiaogulan have failed to prove the hypothesis that antioxidant supplements could prevent disease. Some large meta-analysis trials have actually shown there may be an increased risk of mortality and colorectal cancer with antioxidant supplements, specifically vitamin E.

The bottom line is that laboratory and basic science research on cellular damage and DNA cell wall and protein disruption due to oxidation continues to spur efforts to find antioxidant supplements that may improve health or prevent disease. There is a logic to this science that has, this far, not been born in the sort of clinical trials we would find convincing. Nonetheless, there is indirect evidence that a healthy range of nutrients, which do contain natural antioxidants, including fruits, vegetables, whole grains, legumes, teas and red wine may contribute to reduce the risk of chronic diseases including cardiovascular disease and cancer. So, as of today, while there is interest, hope and some indirect evidence, there is no clear cut advice I can give to recommended particular antioxidant supplements, but the advice to enjoy the healthy range of whole grains, fruits, vegetables, legumes and even a bit of dark chocolate and red wine now and then, remain as strong as ever.

Before I get into the specifics about Acai berry and its usefulness in diets for weight loss or general health, let me start by offering a little perspective. I have the good fortune of working with thousands of people to lose weight and improve their health and I enjoy learning about healthy nutrition in the process. I am crazy about food and I love to eat. Let’s face it, who doesn’t. Fortunately, my job affords me the opportunity to think about foods and nutrients and how we consume them, how we interact with them.

Don’t’ get me wrong, I love the idea of “superfoods.” I think in this age of processed flour and twenty-seven different type of simple carbohydrates dominating the diet regimen of children, a dark berry superfood that contains some antioxidants offers some appeal. But here’s that perspective I promised: No exotic Brazilian berry is going to do the hard work for you. Nothing can wipe out the effects of consuming mountains of simple carbohydrates everyday. That very straightforward behavior accounts for more obesity and disease than any other single specific cause. So if you live in the United States today-or just about anywhere in the world that is not a rural third world village-then to lose weight and become healthier, you have got to set your sights on the hard work of reducing the intake of simple carbohydrates, first and foremost. Should you include Acai berries in your diet or develop an eating plan around them? Sure, if it helps you, absolutely. I also recommended blueberries and an array of other fruits and one time “Superfoods” that contain vitamins and antioxidants.

The way to put needed carbohydrates in your body is to consume berries, other fruits, legumes and whole grains. What you should avoid are all of the refined sugars, processed white flower, french fries, soda pop, white noodles, white rices and high fructose corn syrup. Make that change, and may it stick. That is the path to healthy, long term weight loss success. I have reviewed some specific studies about the Acai berries and we’ll comment on those in another post.

One of the most frustrating things for anyone who has undergone weight loss surgery is if the weight loss stalls or hits a plateau.  No matter what you do, it seems as though the scale does not budge.  There are extremely helpful methods for moving off of that plateau and jump-starting the weight loss process.

One of the most successful methods is to stop and regroup, and then imagine that this plateau weight is your new baseline weight. To then jump start weight loss involves initiating a new induction type program such as the induction weight loss diet program at iMetabolic.  This kind of program involves using meal replacement shakes and a low carbohydrate, low calorie diet in addition to some increased calorie-burning exercises.

To make this kind of effort successful, it requires not only a physical change and diet change, but also mental or psychological change.  This is a highly successful method and you can succeed with it if you put your mind to it.  I talk about how to go about this and describe the specific recommended diet that has worked for many patients of mine who have experienced weight loss plateaus in the past. And have seen the weight loss resume once they initiated the program described.

Possibly more distressing than hitting a plateau for a bariatric patient is the experience of rebound weight gain. Rebound weight gain is sometimes referred to as a relapse after weight loss surgery.  The most important thing is not to panic, but to refocus, gather information, regroup and rededicate yourself to losing the weight once again. All hope is not lost.  The tools and techniques are described in the e-book “After weight loss surgery” and suggestions about when to see your doctor, when to see your bariatric surgeon if this has occurred are discussed.  An important point to know is there is hope you still can succeed at losing the weight.  There are methods available, both nonsurgical and surgical.  So, you can restart your weight loss journey today and still be successful.

I cover both these concepts in detail in the newly released e-book “After Weight-Loss Surgery” available on Kindle through Amazon and Sony Readers and on iMetabolic and other places where e-books are sold or distributed.  For a nominal fee and download, you can learn from the experience of thousands of people who have come before you and successfully lost weight and kept it off after their weight loss operations.

Most of us do not routinely take vitamin and mineral supplements, although it is increasingly recognized that many of use are deficient in important vitamins and minerals and our health would likely be improved by taking vitamin and mineral supplements. But what specifically should you take if you are embarking upon an effort to lose weight and become healthier and fitter?

I believe the straightforward answer to that is that we should probably all be taking a multivitamin that is comprehensive and includes all the specific USRDA coverages that are outlined below.  This comprehensive multivitamin would include all of the water soluble vitamins, as well as the fat soluble vitamins, and an appropriate amount of the trace minerals that are needed including zinc, iron, selenium, iodine, copper, manganese, chromium and more.  In addition, people who are at risk for calcium and vitamin D deficiency, osteoporosis or bone loss, should be taking a calcium vitamin D supplement.

Increasingly, we have discovered a high proportion of patients with vitamin deficiencies even though they are significantly overweight.  Deficiencies in vitamins such as B12, vitamin D and iron tend to cause symptoms like fatigue, loss of energy and depression.  Vitamin D requires sunlight for conversion to its active form, so many people who do not get outside much develop severe vitamin D deficiency leading to symptoms of bone loss, fatigue and depression.

Another specific group of people are those who have previously undergone weight loss surgery and I have written about their specific vitamin and mineral needs on an earlier post.  People who have undergone the most common type of procedure, Roux-en-Y gastric bypass procedure, are more likely to develop deficiencies of vitamin B12, vitamin D and iron than the general population, as well as some additional trace elements, B complex vitamins and rarely others.  These should all be supplemented regularly.

For most people though, who have decided to lose weight and are making an effort to become healthier and fitter, I would recommend the following multivitamin and based on the science developed over years of studying overweight and obese individuals, our weight loss center, the International Metabolic Institute, played a key role in formulating what we think are the best vitamins for anyone who is undergoing a weight loss program, and they are available through iMetabolic.  I highly recommend that you try the vitamins from iMetabolic that are specifically formulated for anyone needing to lose weight and please give feedback to the folks at iMetabolic about what you like and don’t like about them including the taste, effects, price, packaging, or anything else.  It is our goal to constantly provide the best weight loss products avialable and we cannot do that with your continued input.

Okay, so here are the vitamin constituents that I recommend:

Multi-Vitamin

Many times I am asked why a medical center focused on weight loss would emphasize vitamins.  After all, some might say, the people who need to lose weight have had an excess of nutrients, not a deficiency, right?

Well, the truth is that excess fat is deposited as a result of too many calories being consumed, in excess of the calories that are burned or used up by the body.  But just because one has taken in too many calories in the form of (mostly) of carbohydrates and fats, this does not mean that the person has also had an excess of all of the essential vitamins, minerals and amino acids.  In fact, a very interesting and surprising finding of our research and the research of other centers on seriously overweight or obese individuals was that a great many of them were very deficient in a number of key vitamins.  Quite commonly, even seriously obese individuals will have profoundly low levels of vitamin D, B complex vitamins, and minerals like zinc and iron.  But why is that important?

The reason that it is highly important is that these vitamin and mineral deficiencies contribute to symptoms like fatigue, loss of energy, depression and lower quality of life.  You might recognize that these same symptoms are very likely to contribute to eating and weight gain.  In fact, these vitamin and mineral deficiencies are found so commonly among obese individuals that I have begun to think that they may be an independent risk factor for obesity.

While we have not yet conducted research to try to establish this link, the theory makes sense: a poor diet that does not include all the vitamins and minerals necessary will lead to deficiencies of some nutrients that cause fatigue, loss of energy and depression, risk factors for reduced activity, excessive eating and weight gain.

Future research will tell us which comes first, the weight gain and its many side effects or possibly the vitamin deficiencies which lead to weight gain.  You can certainly protect yourself and reduce your own risk of the side effects and symptoms of vitamin deficiency by taking vitamin supplements that we recommend.