‘Weight Is Not Everything’

LynleyShimat Lys, a 34-year-old student in Jerusalem, has fought since her college days to take off 50 extra pounds, only to see them slowly come back on.

Los Angeles writer Gordon Haber, 43, went on the South Beach diet after consuming too much beer, kielbasa and pierogi while on a Fulbright scholarship in Poland in 2002. He got down to down to 170 pounds from 195, but now he is back up to 183.

Seth Morrison, today a 60-year-old marketing and management consultant in Arlington, Va., lost 100 pounds back in 1976. He has worked extremely hard to maintain his healthy weight, but has seen the numbers on the scale creep up by 15 pounds in recent years.

These three people are not alone. With our recent celebration of the arrival of 2012 came our lists of resolutions for the New Year. For many of us, at the top of that list was the promise to lose weight to improve our health. But the reality is that so many of us diet and lose weight, only to see it come back on, either partially or entirely. We are frustrated and assume that whatever health benefits we worked so hard to attain have disappeared with the weight regain.

But it turns out that all is not lost, and that there is good reason to continue to eat healthfully no matter what number the needle on the scale is pointing to. A new Israeli-German study recently published in Diabetes Care shows that specific blood biomarkers continue to improve even after weight regain takes place, so long as a healthy diet is maintained.

The two-year Dietary Intervention Randomized Controlled Trial (DIRECT) was conducted by Ben-Gurion University of the Negev and the Nuclear Research Center Negev and was published in the New England Journal of Medicine. Three hundred twenty two participants were randomly assigned one of three different, but healthy long-term interventions: a low-fat, a Mediterranean or a low-carbohydrate diet — with all participants strictly adhering to their diets throughout the entire two-year period.

Dr. Assaf Rudich, who led the study together with BGU colleagues Dr. Iris Shai and Rachel Golan, along with Dr. Matthias Bluher from Leipzig, Germany, told The Jewish Week in an interview by e-mail that the improvements found in people who stick with their healthy diets likely signify a decreased risk for cardiovascular disease.

The biomarkers the team checked for were divided into two groups: Pattern A and Pattern B. The bad news — for those with unwanted weight gain — was that the dynamic of the markers in the Pattern A group, which included (among others) insulin, triglycerides, leptin and chemerin corresponded closely with weight level. So, for instance, if you want your triglycerides to go down, your will have to get your weight to go down, too. However, the good news was that Pattern B markers such as adiponectin, HDL-cholesterol and high-sensitive C-reactive protein showed continued improvement despite weight fluctuations.

The results were generally the same, no matter which of the three diets the participants were following.

The researchers also found in the participants a regression of the atherosclerotic plaque in the carotid artery, which has been connected to a large percentage of the cases of stroke. Previously, regression of atherosclerosis was only demonstrated with medications or with extreme dietary regimens.

“The meaning to people’s health is that if you maintain healthy diet, weight is not everything, and there are health benefits from long-term switching to healthier dietary habits that do not necessarily manifest by weight,” Rudich said.

Haber’s situation reflects what Rudich and his team observed. “My cholesterol was getting high-ish before I lost the weight,” Haber told The Jewish Week. While he has packed 13 pounds back on, he is keeping an eye on his cholesterol, and has managed to keep it within a healthy range by keeping away from the kind of fattening foods he was eating back in his Fulbright days.

The study corresponds with the strategy that Karen Astrachan, manager of Nutrition and Diabetes Services at the Palo Alto Medical Foundation in northern California has been taking with her patients. “We know from many years of clinical experiences, as well as many studies, that regardless of weight lost or not lost, eating healthfully leads to health benefits such as lower cholesterol and lower blood pressure,” she said.

Although exercise was not a part of the BGU study, Rudich stated that it is another important factor in maintaining cardiovascular health. “One of the processes that underlies regain is the decrease in metabolic rate that comes from restricting one's calories,” he said. Exercise not only burns calories, but it also kicks a person’s metabolic rate up, which makes calorie burning more efficient.

But again, it’s not all about weight loss. “The recommendation is to engage in physical exercise at least three times a week (at least once every 48 hours). Health benefits of regular exercise, in terms of cardio-metabolic health, have been reported with as little as 150 minutes per week of moderate exercise, such as brisk walking,” he explained. “And this effect is not affected by whether it is accompanied by weight loss.”

Astrachan told The Jewish Week that she has had overweight teens come to her with acanthosis nigricans, a skin condition indicating insulin resistance. Putting the teens on an exercise regimen helped clear up the rash, even if they didn’t shed any excess weight from the physical activity.

Lys, Haber and Morrison all work to include regular exercise in their plans for healthful living. “I exercise religiously for about one hour and 15 minutes, five to six days a week,” Morrison said. As the working father of a baby, it is harder for Haber to get in the requisite hours of physical activity. “I do pushups and sit ups every day to stay strong. … For me, it’s just an issue of getting enough aerobic activity,” he admitted. “I strap the baby on for a hike once or a twice a week, but it’s not enough, so I joined a gym.”

Lys shared that it is often a struggle trying to figure out the right balance between food intake and amount of exercise. The results of the BGU study validate the approach she has adopted. “I try to focus on feeling and behaving healthy now, rather than on how much I weigh,” she said.