The Twinkie Diet: Thoughts on Weight Loss and Cholesterol

You can lose weight on any diet, but is it healthy?
You can lose weight on any diet, but is it healthy? (Photo by OkayCityNate)

A few days ago, CNN reported on a nutrition professor who lost 27 pounds in ten weeks eating mostly Twinkies (link). Not only that, but health markers improved too – LDL went down and HDL went up.

Some people seem to think the results resolve the old question of whether calories are all that matter in weight loss. After all, if you can lose weight by eating Twinkies, Doritos and Oreos, what else could it be than calories? Surely that's just about the worse diet you can have.

While I'm obviously a big fan of self-experimentation, I think the results have been misrepresented in some cases. What do I mean by that? Let's look at the experiment and the results a bit more closely. Here's a quote from the article:

For a class project, Haub limited himself to less than 1,800 calories a day. A man of Haub's pre-dieting size usually consumes about 2,600 calories daily. So he followed a basic principle of weight loss: He consumed significantly fewer calories than he burned.

If we take the 2,600 calories daily as the correct figure, then for the ten weeks, Haub was running an 800 calorie deficit. It's hardly surprising that he lost weight. When you cut back enough on your energy intake, you start losing weight – in this sense, a calorie is a calorie.

But since this is an experiment with only one participant, it's impossible to say whether more or less weight would have been lost if the diet had been different. Did all the sugar he was eating prevent him from losing the maximum amount of body fat? There's no way to tell.

There are some hints, however, that it's not all about calories. The amount of calories consumed may be the primary factor in how much weight or fat is lost, but that doesn't rule out other factors. In rats, for example, green tea increases weight loss during calorie restriction. The rats consuming green tea burned more of their body fat and absorbed less fat from the diet, despite eating the same amount of calories.

In real life settings, the argument that a calorie is a calorie is difficult to examine, because the number of calories we burn is not constant – it depends on many variables. We now know, for instance, that genetics play a role. Some people have a hard time putting on weight, because the more they eat, the more calories they burn. They may get an urge to exercise more, for example. And anyone who's tried different diets knows that some foods make you more energetic than others, despite having a similar number of calories.

But that's not all. Some people don't put on weight even when exercise is forbidden. Their bodies just start using all that excess energy in other ways: increasing metabolic rate, heat production, etc. Is a calorie really a calorie in this case?

Then there's the question of how to count the absorption of calories from different macronutrients. If you divide people into two groups and feed both the same amount of calories, but have one group eating more protein and the other group eating more carbohydrates, their weights will be different. In general, high-protein diets result in more weight loss than high-carbohydrate diets.

As you can see, the question is hardly as simple as some people make it out to be. And there are more similar things that complicate the issue. Stephan from Whole Health Source has a good post on the Twinkie diet and how it relates to hormones and fat mass regulation, and I'm sure there are other health bloggers who have picked up on the same article.

Putting the calorie issue aside, perhaps the thing that aroused the most interest was the part about improved biomarkers. Sure, you can lose weight eating a terrible diet, as long as your eating very little, but shouldn't that wreck your health in other ways? Apparently not:

Haub's "bad" cholesterol, or LDL, dropped 20 percent and his "good" cholesterol, or HDL, increased by 20 percent. He reduced the level of triglycerides, which are a form of fat, by 39 percent.

But that's not really big news. You see similar things happening in many studies where the participants are put on weight loss diets, regardless of what the diets are like. Even in the studies where overweight people are put on the conventional low-fat, high-carb diet – which is not really a good approach for improving cholesterol levels, glucose and insulin – these health markers improve while they're losing weight. As a spokeswoman for the American Dietetic Association says in the article:

"When you lose weight, regardless of how you're doing it -- even if it's with packaged foods, generally you will see these markers improve when weight loss has improved," she said. 

However, as in the case of the amount of weight lost, there's really no way to tell based on this experiment whether his health markers would have changed differently on another diet with the same calories. Low-carb and low-fat diets have very different effects on cholesterol during a calorie deficit, for example (note also how the subjects lost more weight during the low-carb diet despite eating more).

Since the study only lasted for ten weeks, the fact that his LDL and triglycerides decreased while HDL increased doesn't say much about the long-term effects. I wonder what his cholesterol levels would have been after a year of following the Twinkie diet.

Also, there's more to cholesterol than just LDL, HDL and triglycerides. In the case of lipoprotein particles, size matters. A diet consisting mostly of sugary snacks is probably not going to do a whole lot of good for LDL particle sizes in the long run. And even when HDL and LDL levels look good on the surface, there's oxidized LDL and lipoprotein (a) to worry about.

What we can say with some certainty is that regardless of how you do it, returning to a normal weight seems healthier than being obese. In the maintenance phase, which lasts much longer, more things should probably be taken into consideration. Haub himself seems to have mixed feelings about his experiment:

"I wish I could say the outcomes are unhealthy. I wish I could say it's healthy. I'm not confident enough in doing that. That frustrates a lot of people. One side says it's irresponsible. It is unhealthy, but the data doesn't say that."

While the health markers are interesting, it would have been interesting to hear more about his experience in general. How did he feel before, during and after the diet? Was he feeling energetic or tired? How was his mood? Did he have any problems, digestion, bad skin, etc?

Before you kickstart your own Twinkie diet, note that professor Haub also had a multivitamin and a protein shake daily, which may have influenced the results somewhat. And if you've already tried a strange diet and managed to lose weight, drop a comment and tell us how it went.

For more information on diets and weight loss, see these posts:

Alternate-Day Feeding and Weight Loss: Is It the Calories Or the Fasting?
A Year of Intermittent Fasting: ADF, Condensed Eating Window, Weight Loss, And More
Green Tea and Capsaicin Reduce Hunger and Calorie Intake
Green Tea Extract Increases Insulin Sensitivity & Fat Burning during Exercise

Tretinoin Results After a Year – Experiment Update

Retinoids – one of the better ways of looking young.
Retinoids – one of the better ways of looking young. (Photo by eisenbahner)

Some of you have been asking for an update on my experiment with retinoids. Now that I've gone through my first tube of tretinoin, it's time to review the results.

As I mentioned in my review of the anti-aging benefits of retinoids, I have both tretinoin cream (0.05%) and tretinoin gel (0.05%). I decided to go with the cream first, applying it only on the left side of my face. The right side has therefore acted as the control side.

Looking back at the first post on this experiment, it seems it's been over a year since my order arrived. Given that I've used the cream regularly and actually stuck with the experiment more strictly than with some other experiments of mine, it strikes me as odd that I only finished the 20 gram tube a few weeks ago. Granted, I have applied only a small amount and only on one half of the face, and I've had some breaks, but still, a little really seems to go a long way in this case.

I use the cream either nightly or every other night after washing my face and before going to bed. This seems to be the most common way to use retinoids. However, contrary to what is recommended, I often apply the tretinoin after a shower. The reason why this is not recommended is because after a hot shower, the pores of the skin will be open, and the peeling and redness that sometimes result from retinoids may be worse.

For me, this is a positive thing and a good a reason to use retinoids after a shower, since the absorption of the retinoids will be increased. I don't get much redness or peeling with the 0.05% strength anyway, unless I apply it to very sensitive areas. For example, I've tried it below the eyebrows, close to the eyelids, where the skin is very thin, and it was a rather painful experience. Applying tretinoin under the eyes is not problematic, though.

In my first post on retinoids I included a list of benefits that I'd seen mentioned in the literature. Here's the list again, along with a comment on whether the claim has been true so far in my case:

  • Increased skin thickness and firmness – YES
  • Increased skin hydration – NO
  • Increased skin tolerance to external factors – NOT SURE
  • Reduced visible signs of sun damage – NOT APPLICABLE
  • Reduced fine wrinkles – NOT SURE
  • Restoration of even skin tone and reduced hyperpigmentation – YES
  • Reduction in dark circles under the eyes – NOT APPLICABLE
  • Reduced skin roughness – YES
  • Reduced irritation from shaving – NOT APPLICABLE
  • Less risk of skin cancer – NOT APPLICABLE
  • Reduced stretch marks – NOT APPLICABLE
  • A healthy, 'rosy glow' – NOT SURE

As for skin thickness, I can't really be sure, as it would have to be measured with professional equipment. Skin firmness is one of those things that I notice after applying tretinoin and even in the morning. My face just feels kind of tighter on the side where I've applied it. The feeling tends to go away after a few days of not using the cream, though.

Skin hydration is another thing I don't really know how to estimate properly. One thing I do notice is that the left side of my face is quite often dry the next morning, which is a result of the peeling effect. It's not painful, however, and putting on some moisturizer gets rid of the problem.

I assume that by "external factors", things such as pollution and maybe UV rays are meant. Since I haven't burnt in the sun lately, and there's not much pollution here, I can't really say whether there has been an effect or not. I also don't have visible signs of sun damage (although I'm sure some internal, non-visible damage does exist), so I can't comment on that. I would expect this to be one of the areas where tretinoin is most effective, however.

The reduction of fine wrinkles is a tricky one. I've been trying to observe changes in three things during the experiment: fine forehead wrinkles, crow's feet (the wrinkles next to the eyes), and nasolabial folds. The fine lines on my forehead have not changed either way. I have to look pretty close to see them, but they are the same on both sides of the face.

The crow's feet, on the other hand, have gone through various changes. They too are visible only if I look very closely, but on the left side of the face they've gone from good to worse to better. At first, it seemed like they got deeper with the peeling, but now the skin looks somehow different compared to the other side, and I'm inclined to say the fine lines are less visible. A similar thing is happening with a few fine lines on my lower eyelid, very close to the eye, where I've applied the cream only randomly. It does indeed seem worse now than the right side. I think this is consistent with how retinoids work – they thin the dry outermost layer of the skin but eventually thicken the dermis and epidermis. This, along with the exfoliation, can make things look worse in the beginning.

As for nasolabial folds, they are not very deep but nonetheless visible. I haven't seen much change there, unfortunately, and sometimes I feel like the left side looks better, while other times I see no difference. I know there are many people who wonder whether retinoids can help with nasolabial folds (and many who believe they can't), but more time will have to pass before I can make a proper evaluation.

I don't have skin cancer, stretch marks or even irritation from shaving, so I can't really comment on those. The dark circles under my eyes have changed more drastically as a result of other lifestyle changes such as diet, so it's hard to see much difference there either.

The biggest difference for me has been in skin tone and skin roughness. It may not be visible to other people without me pointing it out, but I immediately see the difference in the mirror. I never even thought about skin tone and hyperpigmentation before, but I see now that the left side of my face has a much more even tone and looks smoother than the right side. There is indeed a slight "rosy glow" on the skin over the cheek bone, but otherwise there is no redness – unlike on the right side, where the tone is less even and slightly red. The pores of the skin also seem smaller on the left side, including the nose. In general, it just looks healthier and better.

So there you have it, my experience with retinoids so far. I've tried a lot of different stuff and written about it here, but this is the clear winner. For once, the results are actually visible. I'm now going to start applying tretinoin on both sides of the face, probably trying the gel version next. Since my left side already has a head start, it'll be interesting to see how fast the right side can "catch up".

Oh, and for the Scandinavians out there looking for where to buy retinoids: I can't help you there. I ordered six tubes from alldaychemist.com over a year ago, but due to repeated problems with customs, they no longer ship to any Scandinavian countries. The same is true for other online drugstores I've tried. No luck.

That's a real shame, because their stuff was dirt cheap and of a high quality. What can I say, this is a perfect example of the long-term effects of the Scandinavian socialist mindset – no one is responsible of their own actions, the government takes care of everyone, the bureacurat knows better than you.

EDIT: I almost forgot; I've also applied tretinoin to my left temple, and it looks like there are a couple of new hairs growing. This is the same temple that had some new hair growth with retinol, the milder version of retinoids. Those hairs are still there, but they don't grow very long – not exactly like vellus hairs but not terminal either. And I think my left eyebrow has some more hairs than the right one, although the difference is slight.

For more information on skin care, see these posts:

Topical Retinoids Increase Hair Growth in Most People
BioSil, JarroSil & Beer – Silicon Experiment Conclusion
Topical Vitamin C for Skin: Re-examining the Case
Lutein for Skin Elasticity, Hydration and Photo-Protection – Experiment Begins

Restoring my sanity...

We came. We saw. We restored sanity. Our own, that is. We took a lot of pictures.

A few weeks ago I was chatting with a friend and the Rally to Restore Sanity and/or Fear came up. He immediately said, "I'm going! I need to let off some steam." Sounded like just the prescription I needed too -- a road trip to go hang out with 250,000 of my closest friends. So we all went.

What was it like? Crowded. Very. Very, very. As in, very. I don't have claustrophobia, but I may have caught it at the rally. We kept trying to get within sight of the stage and large screens, but didn't quite succeed. Jon and Stephen were overly modest. They planned for a crowd of around 60,000, but estimates peg the rally attendance around 250,000 or as Jon Stewart declared, "ten million." Too bad his attempt to have everyone "count off" didn't quite work or we'd have an exact count. The crowd spilled off the National Mall in every direction for blocks and blocks. If you look at my photos, you can get a sense for just how crowded it was or you can see whole thing on C-SPAN.

The most entertaining part was the signs. I took pictures, lots and lots of them. People were quite clever with their signs.

I think what the whole thing boiled down to is this: It's a mad, mad, mad world. It's not just the Tea-Party types to blame. It's not all Glenn Beck's fault. It's not all Obama's fault. It's not even all my fault. It's everyone's fault. Our government has just become a damn mess. It's always been fractured, and was even designed to be that way, but lately the rhetoric seems to "go to 11."

In this environment it seems that that rational middle is missing. Maybe it's not. Maybe there is some quality compromise that goes on in Congress, but you'd never know it based on the way things are reported on Fox News or MSNBC. The other side is evil and to blame.

I think this event was about stepping back, taking a breath, and saying, "Can't we all just laugh a little?" It was cathartic.

The Washington Post aptly described the event:
The event proved a mass demonstration of noncommittal cleverness, quirk and irony. Through signage, some rally-goers competed to be the most topical ("One man's socialism is another man's uninformed buzzword"), the most off-topical ("I love pineapples") and the most meta ("I am holding a sign").

Many Mall visitors toted signs with arch witticisms such as those identifying the carrier as a member of the "Decaf Party," or warning people "Don't Tread on Snakes," instead of "Don't Tread on Me." Plenty of gear from Obama's inauguration was exhumed from closets and worn again, and many posters borrowed Shepard Fairey's iconic "Hope" design from 2008 - but the visage staring out was of Stewart, not Obama.

It wasn't a singular, coherent movement on display as much as a rollicking expanse of nano-movements. Recycling enthusiasts mingled with D.C. voting rights advocates, who bumped shoulders with fusion-power activists who stepped on the heels of 9/11 truthers. One sign implored, "Vote Lawyers Out," and another insisted, "Vote Popped Collars Out." Some in the crowd wanted the troops to come home; others wanted the troops to be able to gay-marry.

And then there were the signs about signs, like one held by visiting New Yorker Beth Seltzer: "Americans for . . . oh look! A puppy!"

"There's so many people out there who are easily distracted," said the 39-year-old doctor. "And there are people who are yelling and screaming and protesting and they don't even know what they're talking about."

As a Gamecock I might get in trouble for quoting this next part of the story, but I guess I need to apply some sanity even to learning something my rivals:

"I do vote," says Teddi Fishman, 46, the director of the Center for Academic Integrity in Clemson, S.C. "But more than entertainment or politics, I just think this is a release for everyone. We've had so much tension."
Who knows what America needs. Maybe it is just more cowbell.

Aubrey de Grey Interview in Wired.com

Aubrey de Grey's life extension diet emphasizes the importance of beer.
Aubrey de Grey's life extension diet emphasizes the importance of beer.

One of my favourite people in the world, the British gerontologist Aubrey de Grey, recently did an interview with Wired Science (link). If you've read his interviews before, you pretty much know what to expect, but there were a couple of new things in there that I found interesting (he's swearing, for one thing).

The gist of Aubrey de Grey's work is keeping people healthy indefinitely. You can call this unlimited healthspans or radical life extension or rejuvenation therapies or whatever, but the idea remains the same: to cure the biological process of progressive deterioration known as aging. For most people, the word "immortality" still has something of a negative connotation. This has not gone unnoticed by de Grey:

I’ve been out there represented as an immortality merchant since forever. These days, I can afford to not just acquiesce and let journalists use phrases like “immortality,” or at least not in the title of the bloody ass thing.

The reason he doesn't like titles like "Aubrey de Grey is here to make you immortal" is because it makes biogerontology sound like science fiction; something that a handful of people are working on in their garage. The public is apparently not ready for immortality.

And yet there are a growing number of people in the world who are ready to live longer and healthier lives. To any reasonable person, the word "immortality" is a positive thing, as long as one understands what the concept of biological immortality means. What it doesn't mean is that you'll be hurling through space long after the earth has been destroyed in a nuclear war, unable to die. It also doesn't mean that you'll be able to survive getting hit by a truck (although if it did, that would be a positive thing too).

What biological immortality means is that the chronological progress of time no longer dictates when and how you die. Your health will no longer be a simple function of time. Your body will remain youthful and vigorous regardless of how old you are. You can still die – certainly so if you want to die for some reason – but it won't be because of your body deteriorating every year. How this is a bad thing to some people has been beyond me for quite some time now.

The first step in solving the problem of aging will be done in mice. From there on, says Aubrey de Grey, it'll be smooth sailing:

What’s going to happen is the curmudgeons — the card-carrying gerontologists who think it’s very dangerous to be over-optimistic — will eventually recognize the data available to us from mice is so solid we can go out publicly and say, “It’s only a matter of time.” That’s going to take a panel of interventions in mice that’s so comprehensive we actually add two whole years to the lifespan of mice that are already in middle age before we start.

That may be overcautious. We may be able to get gerontologists on board with a more modest result than that. However, at that point, game over. My job will be done. I can retire. Because that will be the point when Oprah will be all over it and the following day it will become impossible to get elected unless you have a manifesto commitment to have a war on aging.

I agree with de Grey. People like Oprah have such a big influence on public opinion that it's ridiculous. I can even imagine someone being very pro-aging before hearing someone like Oprah promoting it, and then changing their mind completely. Once you get the public behind the idea, you'll get the politicians as well. Not that I give a damn about influencing politicians – without all the bureacracy and regulations in the field of medicine, I bet we'd already made a much larger progress in rejuvenation therapies! I'd rather take care of my own health than put it in the hands of any government official.

Another crucial point about people like Oprah: they have a lot of money. And since people with lots of money tend to be interested in preserving their wealth, it makes sense that the same people are also interested in preserving their health. After all, what's the point of having billions of dollars if you're not going to be around to enjoy them?

One thing that de Grey has not really commented on before is how come he doesn't get massive donations from aging billionaires. Some of them have already made plans to cryopreserve themselves, but if you have the chance to stick around without spending five decades in an ice box, why not do that instead? The biggest reason seems to be that billionaires haven't taken the organizations seriously enough:

Wired.com: For most of the billionaire philanthropists that travel in the same circles you do, out of the three things, is it mainly that they just don’t like your organization?

de Grey: I think for a very large, a very sufficient proportion of such people, yes, it’s that third thing. Because I see these people a lot. I go to TED, and there’s no holding back when it comes to 1) the desirability of the goal, and 2) the demonstration of sufficient comprehension of what I’m talking about to understand they believe the plan is feasible. So yes, absolutely.

In other words, there's a lack of professionalism, not necessarily in what the organizations actually do but in how people view them. The Methuselah Foundation is a case in point:

In the beginning, the only thing the Methuselah Foundation did was the longevity prizes for mice. Then, we started funding research directly. We thought it was a really cool idea to have one organization with two very complementary approaches to the same mission. But in fact, it didn’t really work, especially not in terms of messaging.

The foundation has now been split into two, one for prizes and one for funding research. Hopefully this will attract more investors. Besides business and funding, Aubrey talks about some personal things as well. And his love of beer, of course:

I drink exactly the right amount of beer evidently. [laughs] It’s ridiculous, really. Yet, I have to show I’m enjoying my life. It’s public knowledge I am polyamorous as well. That’s something that goes down not so well with some of my more politically sensitive friends and colleagues. But it goes quite well with some other people. [laughs]

Polyamorous, huh? He even goes to say that the whole monogamy thing is "archaic" and will probably be a thing of the past some time in the future. I didn't know de Grey was against monogamy, but I happen to agree. I think the whole concept of jealousy is an unnecessary biological impulse that was useful in the past but will no longer be needed in the future. It certainly isn't a product of the rational side of the brain.

I guess contrarians tend to have a lot in common. When you start to question the official truth in one area, you begin to wonder about other obvious truths as well. I'm sure you've noticed the disproportionate amount of libertarians among the paleo crowd, for example. In many cases it boils down to questioning whether government really knows best.

For some reason, the paleo community is still mostly stuck in the "aging is good" dogma, however. They're determinately against diabetes, obesity, cancer, cardiovascular disease, and every other modern plague, and yet they are unwilling to strike the problem at the root.

Basically, they want to live healthy for 80 years and drop dead. To me that's nonsensical. What's your opinion?

For more information on longevity and aging, see these posts:

Russian Scientist Claims to Have Found Cure for Aging
How Do People Feel about Life Extension?
Aubrey de Grey in Helsinki, Finland
Why Aging Is a Global Disaster That Needs to Be Solved

People are People

Today is National Coming Out Day. I don't know if putting one more blog post into cyberspace will make a difference or not, but it can't hurt. And if nothing else, I want to use today as a chance to make my position unequivocally clear: I support equal rights for all.

I don't think that I've acted (and I certainly hope that I haven't) in a way that would make someone question that position. What makes today seem all the more important is the recent spate of gay teens who have committed suicide, including Tyler Clementi, a freshman at Rutgers University who was outed and harassed by his roommate. Each and every suicide is a tragedy, however, Tyler's case struck me because it happened on a college campus. I can't imagine the impact an event like this would have on me as a professor if this happened to one of my students.

Why does this kind of harassment happen? We fear that which we don't understand and we get an inflated sense of superiority when we feel we can dominate over another group. We find a group that is defenseless against weaponry and we dehumanize and enslave them; later, when they fight for equal rights, we beat them down. We don't understand those with mental disorders so we institutionalize them, putting them out of sight. Someone lacks certain abilities and we marginalize them. A person's love interest seems "unnatural" to us and we bully them.

The cruel mistreatment of people based on their complexion, mental state, or physical or mental abilities now seems foreign and totally inappropriate to most (hopefully all) of us. However, many still stand blithely by while those who are gay or lesbian are mistreated, marginalized, and even bullied.

No more. Many are speaking out. For example, more and more are "coming out" as allies. And because of the recent tragedies several celebrities have spoken out. I found Ellen's message particularly poignant.

So, is one blog post by one guy who calls himself an ally going to change the world? No, perhaps not. Do I need to do more to stand up for equal rights? Certainly. At the very least I wanted to use today as an opportunity to state where I stand.

As I thought about all this, I couldn't help but think of words from a certain song. Let's all sing along...