We recently had a chance to interview with Cate Shanahan, physician and author. We were interested in hearing her opinion on the obesity epidemic, common mistakes people make when dieting, as well as answers to several nutrition questions.

If you're trying to lose weight, and wondering whether we should limit eggs to 1-2 a week, or if we can eat as much fruit as we want, I highly recommend hearing what she has to say.

Us: How do you help people "revive their metabolism"?

Cate: My goal is to help my patients and blog/book readers who have weight issues revive the many metabolic pathways for fat-burning and lean-tissue-building that can go dormant during the process of gaining weight.

Eliminating empty calories is key to reviving your metabolism.

Most people start their day with empty calorie processed foods like oatmeal, cereal, food bars, skim milks, or high-sugar fruits and continue to drown themselves in empty-calories with sweet/starchy snacks and treats at work and before and after dinner.

Often, salads are loaded with empty-calorie bombs from store bought dressings--even organic dressings--because they are made from processed vegetable oils. (Canola, corn, soy, etc. Olive oil is one of the least processed oils and is much healthier.)

Processed foods deliver loads of empty calories to the body that can only be stored as fat. Fat storage blocks fat burn. This is just one reason that years of processed food consumption may shut down metabolic pathways including those needed for building muscle and bone, as well as others needed for making chemicals required for normal moods, healthy skin and so on.

Most people with weight issues have many enzymes that are dormant and will need to get revved up again to achieve long-term weight-loss success (and overall health and longevity). To rev them up again you absolutely need to eliminate empty calories and make room in your diet for nutrients. Key to reviving these pathways is diversifying your diet and to healthiest way to do that is to adapt the principles of a traditional diet as defined in my books

Us: We know that this country has an obesity epidemic. There's been a lot done in trying to reverse this trend. Why do you think we've failed so far?

Cate: There's been a lot of talk. What's been done has actually made healthy eating more difficult than ever. While there's plenty of talk about eating fresh and seasonal and local, pasture-raised animals and organic products, there's so little of these available that few people can find them, much less afford them.

Why are there so few of these necessary foods?

Very little media coverage has been devoted to the fact that, in the midst of this obesity epidemic, our elected officials are taking actions to shut down the few remaining family farms that can actually grow the kinds of foods we all want to eat.

100 years ago, almost all of our food was organic, local, seasonal and most farms were diversified in that they grew a variety of complementary animal and vegetable products from properly fortified soil.

This complementary crop production was key, as one crop enhanced the soil for the next. Over the past century, millions of acres of small family farms have been sold to food conglomerates or farmers chronically in their debt.

The picket fences and red barns are gone. In their place we find machine-groomed monoculture, chemically soaked, pre-industrial food products (mostly corn, soy, and wheat) that will sit on unrefrigerated shelves in the grocery store before going home to American cupboards where they will sit again for months or years without changing. Microbes don't touch them. Products that don't sustain microbial life cannot be expected to sustain your life.

Right now, most of the foods produced in this country could not be better engineered to cause obesity. When our food chain gets an extreme makeover, the American physique will too.

Us: So let's talk about cholesterol, particularly eggs. There's a lot of mixed advice out there. Some people tell you to limit your eggs to a couple at most a week, while others tell you it's OK to eat as many as you want. Where do you stand?

Cate: Eggs are a natural product and we've been eating them throughout all of known history. Why stop now? We actually have clinical research showing that eating up to 12 eggs per week does not raise cholesterol.

Eggs are particularly good for brain health. Egg yolks are rich in nerve-building compounds like lecithin, choline, biotin, other phospholipids and (when from free range chickens) long chain essential fatty acids and egg whites contain all 11 essential amino acids that enable you to make all the neurotransmitters that balance your moods.

The healthiest eggs come from pastured chickens allowed access to sunshine and forage and will have brightly colored egg-yolks that are more orange than yellow. Allowing the animals some sun promotes the production of vitamin D, and some of that D goes into the yolks.

Allowing the animals to forage enables them to catch bugs, which are a rich source of essential fatty acids including omega-3. You can also get your omega-3 from marine oils but personally, I'd rather enjoy my omega-3 in a poached egg.

When you're making your eggs, cook the white thoroughly but go easy on those yolks! The essential fats and other nutrients in the yolk are damaged by overheating, so poaching, soft boiling, and frying over easy are the healthiest ways to enjoy an egg.

Us: Next up is fruit. Do you think you should limit the amount of fruit you eat per day to 1 piece, if you're trying to eat because of the sugar content? What are the best fruits to eat, when trying to lose weight?

Cate: Fruit is natural candy. It's fast and sweet--what's faster than peeling a banana? But it's loaded with sugar and there's nothing fruit offers you that vegetables don't offer you in greater abundance.

The nutritional value of fruits is tied to the health of the soil and the plant it was picked from. Today's fruits are the products of generations of breeding for sweetness, color, and plumpness--and this seems to be at the expense of nutrients and intensity of taste.

Recently, I had some fresh-picked cherries and they were absolutely insipid. I have a hard time finding fresh fruit that tastes interesting anymore. Because drying intensifies fruit's flavor, I use dried fruit far more often than I eat fresh fruit. But dried fruit also intensifies the sugar so I use it sparingly.

I'd recommend getting 3-4 servings of veggies for each daily serving of fruit. If you gotta have some fruit, melons and berries tend to offer more nutrition per ounce, but I really dislike the maximum-volume method of deciding what to eat.

Personally, I use 1-2 Tbsp dried fruits, usually mangoes, cherries, or cranberries as a garnish over my lunchtime yoghurt-nut parfait and most days I don't eat any fruit, though I will drink fruity Kombucha.

Us: How do we determine the ideal number of carbs we should eat a day? Is there a specific macronutrient ratio you recommend for most people?

Cate: Most people needing to lose weight should keep their carbs between 30 and 70 grams daily.

The lower your go towards the bottom end of the carb range, the more you give yourself the opportunity to burn fat, lose weight, and enter the state of metabolic Nirvana called nutritional ketosis.

If you've ever done a fast and felt a kind of lightness in your body, that was probably the effect of nutritional ketosis. It turns out that our bodies are designed to burn fat for energy most of the time, not sugar.

And when we force our bodies to burn sugar the little power-packs of our cells called mitochondria can't operate at full efficiency and even start leaking free-radicals--high energy particles that can damage DNA and cellular enzymes.

It's important to understand that, while many people can go for weeks at the low end of the carb-intake range, some people may need to spend a few days each week in the upper end of the range to meet their body's need for sugar molecules. How can you tell? It seems like thyroid-like symptoms are the best gauge. I've written about it recently on my website.

Unfortunately, there's a lot more speculation on this topic than there is hard science, and you can get scared away from low-carbing if you believe some of the stories about low-carb causing hormone-deficiency symptoms that are rapidly alleviated by adding back huge amounts of carbs.

Most of this kind of reporting is anecdotal and because there is no reason I can imagine that a keto-adapted person would need more than 100gm of carb per day, there is a lot of room for alternative explanations other than some intrinsic need for carbs.

Us: What are some common mistakes you see people do when they start to eat a low carb diet?

Cate: I think mistake number one is finding some reason to give up on low-carbing. There are numerous barriers: Your doctor may try to convince you its unhealthy. It's more expensive. Sugar is addicting. Carbs are everywhere. You need to change years of habitual shopping, cooking, and eating patterns. Your body may not be ready to make the jump all at once.

And that's mistake number two: Expecting your body to make the jump from years of carb-burning to fat burning overnight and without any blowback. The longer you've been doing SAD, the more your metabolism is geared towards burning sugar and storing fat. And this is where I think many people need to find a good low-carb doctor to help them troubleshoot their own unique metabolic barriers to going low carb.

There's kind of a pendulum swing away from low-carbing at the moment and I think this is temporary and based on popular bloggers sharing problems they ran into and giving up on low carb all together instead of scaling back. It's also based on a lot of misunderstanding about the role of sugar in the body and particularly in hormone function.

It's important to remember that of all the macronutrients (fats, protein, carb being the three macronutrients) carbs play the least important role.

In terms of energy and fuel, we only need something on the order of 30 grams per day of carb, in the form of glucose molecules. This 30 grams is for cells that do not have mitochondria and therefore cannot burn fat, including red blood cells (about 3% of our body weight comes from red blood cells) and a tiny fraction of our brain and kidney cells.

We also use macronutrients for structural purposes. It's difficult to know exactly how much is needed for these structural purposes, but the structural need for sugar is far less than the structural need for protein that goes into muscle and bone or the need for fat molecules that go into all of our cell membranes and many central nervous system cells.

Us: Cravings, especially after dinner is a huge obstacle for many people that causes late night snacking. What tips do you have for people to avoid this problem?

Cate: Eliminating any sweet tooth you may have should be your primary goal. As long as you still have a sweet tooth gnawing away at your brain you are at risk for being lured back to the kitchen for a look-see whenever you get a moment of peace and your belly is not totally stuffed.

This is one reason I advise against use of low-calorie sweeteners of any kind, even natural ones such as Stevia, because all sweeteners feed your sweet-tooth dragon. Slay the dragon.

If you have extracted your sweet tooth and the dragon is dead but you still have cravings, then you need to "Asc for help." Asc stands for activity-assisted self control. It's a critically important tool for succes. The idea is that you must develop new habits so that you are simply too busy to think about food during your moments of weakness.

Cravings are my problem, too. I love to relax after work and my favorite way to do that is to watch too much HBO. But while sitting in front of the tube I am constantly wanting to be sipping or chewing on something the more I sit and watch, the more I will want to eat and drink.

So I have to be emotionally braced for that and it also helps to keep supplies of tempting snackables down to a minimum meaning your family has to be on board.

For the most part, though, I have to get away from the kitchen and the TV and go do something more productive. Then, I don't even think about what's in the kitchen. Some kind of activity-assisted self-control is essential for long term success.

Us: Any future plans such as a new book in the horizon?

Cate: Luke and I live in Napa and it turns out that the foodies here, the people who enjoy offerings from some of the best chefs in the country, are--not surprisingly--extremely healthy. It's kind of a paradox that when you eat those foods that are supposed to be indulgent or sinful you actually tap into the best nutrition available on the planet.

So we're calling it The Napa Paradox and the book will programmatically help you transition from living on the industrial food chain to living on the kinds of foods that rich and famous people get to enjoy--and doing so in the most affordable way by budgeting time efficiently. We're collecting recipes now and it should be coming out in 2013.

Dr. Cate Shanahan is a board certified Family Physician. She trained in biochemistry and genetics at Cornell University before attending Robert Wood Johnson Medical School. She practiced in Hawaii for ten years where she studied ethnobotany and her healthiest patient’s culinary habits. She has published 2 books: Deep Nutrition: Why Your Genes Need Traditional Food and Food Rules: A Doctor's Guide to Healthy Eating. She regularly blogs at her official website.


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