I am truly excited to announce that PhotoCalorie is officially licensing our software to researchers at Massachusetts General Hospital, studying childhood obesity.
It has been nearly five years of hard work to get to this point. Starting out in June 2009, all we knew was that the current gold standard of pen and paper food journals was not acceptable for our most pressing health issue.
We believe we can offer some features that other technologies currently being used cannot, including:
- 60,000 food database all standardized to one portion size for easy search
- Two step search with basic natural language processing
- All photos and nutrition information are transmitted to researcher database in realtime, freeing their precious time from data entry
- Decreasing recall bias by allowing users to take pictures of their meal and enter a description at a later time
- Decreasing portion size misestimations by allowing researchers to literally see what a study subject is eating from their photo and make adjustments accordingly
- E-mail reminders automatically sent to non-compliant subjects when they miss a meal
- Ultimate customizability – we have worked with a few research groups and all had different stipulations for the data collected, the look of the landing page, etc.
For all related inquiries, see our PhotoCalorie page or email us at firstname.lastname@example.org.
For everyone else, lets celebrate!
The Ancestral Weight Loss Registry, an international assembly of people who have tried a paleo or carb-restricted diet, just posted their first trends. It is a wordle of the responses to the question “What was the biggest challenge to adopting a paleo/carb-restricted diet?“, separated by male and female responses.
The size of each word is a function of how much it appeared in the free response question. Here they are:
The restaurant industry is a common scapegoat for health authorities and medical professionals when conjuring up contributors to the obesity epidemic. Usually filled with condescending rhetoric, the main theme is usually similar: high calorie, high fat, high sodium foods are bad for their patrons and the health of the community. These foods are contributing to the obesity-related problems that plague our society, and it is the restaurant’s responsibility to fix this. Unfortunately they rarely venture a business friendly solution.
Enter Matt Dewolf.
Along with his colleagues at UMASS medical school, Matt created WooFood, a non-profit company founded to improve the health and nutrition in the town of Worcester, Massachusetts. The concept is simple and genius. Restaurants who would like to be WooFood certified have to meet a set of certain criteria for their food options, such as healthful portion sizes, whole grain options, or healthful children’s menu foods. Depending on the level of certification each restaurant achieves, they will receive a WooFood certification of certified, silver, or gold, which can be displayed proudly in their windows. This allows the restaurant to demonstrate its healthy choices, and provides the customer with an easy tool to determine which restaurants are certified, and which are not.
The specific meals at each restaurant which meet WooFood’s standards are clearly labeled with an easily identifiable logo, signifying a healthy choice. Here are the founders describing it themselves:
There are now three WooFood certified restaurants in Worcester, and many more are in the process of becoming certified. Any potential solution to our nation’s health problems that may stifle businesses is not a real solution. WooFood is brilliant because it does just the opposite, and is a win:win for both the consumer and the restaurants. Thanks to these insanely smart, forward-thinking medical students, Worcester will be a healthier city for years to come.
The following is a guest blog post:
Some people consider easy dinners to be takeout. It’s pretty easy to call in your order to a nearby restaurant and then go and pick up your food. But doing so often isn’t necessarily easy on your pocketbook, especially if you have a spouse and kids. You can save a lot of money cooking your meals right in your very own kitchen. And it doesn’t have to be difficult. Here are three easy meals you can cook for your family:
In a separate pan, boil about 2 cups of water. Using a medium pan, brown your ground meat of choice and flip once edges turn a light brown color. While other side is cooking, season with salt and pepper or other favorite seasonings. Add a handful of egg noodles and let cook for 5-7 minutes (Instant rice may be substituted). Remove noodles from fire to drain water, rinse, and cool. Use a spatula to break down meat to ensure that it is cooked thoroughly. Add a small can of creamed chicken or mushroom soup and mix together with cooked meat. For a more saucy taste, stir in a ½ cup of milk or half & half. Let mixture sit for five minutes before serving over egg noodles.
You can eliminate a lot of time by buying a ready-made pie crust at the grocery store. Prepare as instructed by manufacturer. While crust is baking, begin with about six medium or four large eggs for one 8-inch pie crust. Using a large bowl, crack and beat eggs. Remove pie crust from oven, turn to 350 degrees, and fill with chopped ham, bacon bits, broccoli florets, chopped spinach, or any vegetable of your choice that is cut small. Follow with shredded cheese that can be one or any combination of the following – cheddar, gruyere, Monterey jack, Swiss, or parmesan. Pour beaten eggs over ingredients and place in oven for 30 minutes or until browned.
Fried Vegetable Rice
No need to order out when this can be made in less than 20 minutes. Using a large shallow pan, fill with a ½ cup of diluted chicken broth and add one cup of mixed vegetables. Cover for 10 minutes and add two cups of instant rice. Stir in one cup of hot water and let simmer for about 10 minutes. Stir from bottom after the first 5 minutes to prevent sticking. Add bean sprouts or parsley to garnish and serve as an entrée or as a side dish with fried or rotisserie chicken from your grocer’s hot deli section.
Making enough of this for a few days can make a difference in your budget as well as your time. While people are putting in longer hours at their jobs, this is a way to ensure that you will have a home-cooked meal right at your fingertips without any delays.
Harvard released their own version of the USDA’s MyPlate, based on the “latest and best science.”
Unlike the USDA, Harvard’s recommendations are not limited by the food industry lobbyists. Instead of using generalized, confusing statements like “eat less solid fats” to hint at reducing saturated fat intake while appeasing the meat and dairy council, Harvard’s plate has much more specific recommendations. Here are some differences, from the press release:
- MyPlate does not tell consumers that whole grains are better for health than refined grains
- Its protein section offers no indication that some high-protein foods—fish, poultry, beans, nuts—are healthier than red meats and processed meats
- It is silent on beneficial fats; it does not distinguish between potatoes and other vegetables
- MyPlate recommends dairy at every meal, even though there is little evidence that high dairy intake protects against osteoporosis but substantial evidencethat high intake can be harmful
- It says nothing about sugary drinks
Finally, the Healthy Eating Plate reminds people to stay active, an important factor in weight control, while MyPlate does not mention the importance of activity.
The USDA just unveiled their newest creation, MyPlate, replacing the bewildering MyPyramid of old. It is dramatically simplified from the previous recommendations, emphasizing three main things:
- Enjoy your food, but eat less.
- Avoid oversized portions.
Foods to Increase
- Make half your plate fruits and vegetables.
- Make at least half your grains whole grains.
- Switch to fat-free or low-fat (1%) milk.
Foods to Reduce
- Compare sodium in foods like soup, bread, and frozen meals ― and choose the foods with lower numbers.
- Drink water instead of sugary drinks.
This represents a HUGE improvement in the cryptic, confusing former MyPyramid:
The newest issue of Consumer Reports compared various popular diets based on how they match up to the the USDA dietary guidelines, as well as how successful they are. Coming as a surprise to many, the Atkins diet seemed to perform the best. Here is their chart (red means good, black is bad. Whole circles are better than half circles):
If a calorie is a calorie, regardless of what macronutrient it comes from, then how is it possible that the Atkins diet allows the most calories, yet they boast the best short term and long term weight loss results? Consumer reports took an average of meal plans for two weeks on each diet (taken from the published books) and found that on average, an Atkins diet suggests eating over 1900 calories per day, while the Zone and Ornish suggest eating 1260 and 1525 respectably.
According to traditional logic, if you want to lose weight, there must be a calorie deficit. In other words, you should find out how many calories your body uses each day, then eat 500 calories less each day and you will lose 1 pound per week. According to PhotoCalorie.com (which employs the widely used mifflin-St Jeor basal metabolic rate equations), for a 5’3″ 160 pound woman to lose one pound per week she should eat about 1480 calories a day. If this person went on the Atkins diet summarized in Consumer Reports, they would be predicted to GAIN a pound each week! And those consuming the Zone diet would be predicted to lose the most weight since they allow the least calories per day.
Yet this doesn’t seem to be the case. In this review of diets and the scientific literature supporting them, calories don’t predict weight loss.
This seems to be an unspoken consistent finding in the scientific literature. I have summarized this exact topic, with a link to all the recent studies in our research library.
If calories don’t predict weight loss, then what does?
To try to explain these findings, or any other weight loss questions, as Gary Taubes points out, we should figure out three things:
- What does “getting fat” mean?
- What regulates our fat cells?
- Is there anything we eat that modifies or enhances the effects of these regulators?
Of course getting fat means having more fat in your fat cells. The more fat that is stored in your fat cells located under your skin, the fatter you become. Next, we would want to find out if there is anything that causes the calories we eat to be diverted into our fat cells for storage as opposed to used by the body for energy? And the answer is yes. It is a hormone called Insulin. When insulin is high, calories are stored as fat. If it is low, calories are released from fat cells for energy.
This is uncontroversial. Any biochemistry textbook can explain this in depth.
The million dollar, controversial question then becomes: If insulin causes us to store fat in our fat cells, then does anything we eat cause insulin to spike?
Without a doubt, sugar or refined carbohydrates tend to spike insulin the most. Carbohydrates in general spike insulin levels. Protein does too, but too a lesser degree. So assuming this theory is true, then a net reduction in sugar and carbohydrates in your diet should result in more weight loss regardless of how many calories you are eating. This does seem to be true in the report above, since the Atkins group ate the most calories and the least carbohydrates. This also is suggested in dietary clinical trials, in which the various diets report eating the same amount of calories, yet the Atkins group seems to lose the most weight.
The next counter argument tends to be that a diet so high in saturated fats is bad for your heart. Here is how Consumer Reports explains this concept:
Isn’t it dangerous to eat so much fat? That’s still a subject of vigorous scientific debate, but it’s clear that fat is not the all-round villain we’ve been taught it is. Several epidemiology studies have found that saturated fat doesn’t seem to increase people’s risk of cardiovascular disease or stroke. Other studies suggest that you might be even better off if you replace saturated fat with unsaturated fat instead of with certain carbs, the ones that turn to blood sugar quickly after you eat them, such as white bread and potatoes. A nutrition researcher, Frank B. Hu, M.D., of the Harvard School of Public Health, recently wrote that he believes “refined carbohydrates are likely to cause even greater metabolic damage than saturated fat in a predominantly sedentary and overweight population.” Moreover, clinical studies have found that an Atkins or Atkins-like diet not only doesn’t increase heart-disease risk factors but also actually reduces them as much as or more than low-fat, higher-carb diets that produce equivalent weight loss.
There does not seem to be any strong evidence that saturated fats cause heart disease. You can read more about this here.
Sounding like another crazy infomercial, the Treadmill Desk is for real! The brainchild of Dr. James Levine of the Mayo Clinic, the idea is exactly what it sounds like. Walk on a treadmill instead of sitting in a chair while answering emails and writing code. The website is filled with outrageous claims, such as “lose 50-70 pounds in a single year” and “90% decreased risk of having an initial heart attack.” There are also 52 BENEFITS TO USING THIS DESK listed on their website:
1. Switches on the body’s metabolic furnace, allowing efficient calorie burning.
2. Treadmill desks stimulate the lymphatic system and wards off disease.
3. Stimulates brain function, improving memory as much as 15% in a 6 month period using a treadmill desk.
4. Increases blood flow to the brain and increases productivity.
5. Improves mood and wards off mild depression without medication.
6. Treadmill desks promotes significant weight loss and control of appetite.
7. Prevents onset of Type II Diabetes and assists with control.
8. A treadmill desk improves blood circulation throughout the body.
9. Improve lung capacity and strength walking with a treadmill desk.
10. Promotes healthy restorative sleep patterns.
11. Bolsters the immune system.
12. Treadmill desks prevent bone loss (osteoporosis).
13. Reduces the risk of coronary heart disease and stroke.
14. Treadmill desks reduce bad cholesterol (LDL).
15. Improves blood lipid profiles.
16. A treadmill desk increases good cholesterol (HDL) levels.
17. Walking at a treadmill desk reduces overall body fat.
18. Treadmill desks enhance mental well being.
19. A treadmill desk reduces the risk of colon cancer.
20. Walking with a treadmill desk may reduce the risk of breast cancer.
21. Reduces inflammation from arthritis and osteoarthritis.
22. Increases flexibility and coordination, reducing risks of falls.
23. Reduces the risk of dementia and Alzheimers.
24. Walking with a treadmill desk consistently INCREASES LIFE SPAN.
24. Relieve back pain walking on a treadmill desk.
25. Treadmill desks assist in recoveries after some surgeries.
26. Treadmill desks may reduce side effects of chemotherapy.
For the remaining list of benefits, click here.
I mean how can you not buy one now!? Here is Dr. Levine, describing his product to some excited reporters:
Lose 50-70 pounds a year? Where does he get this number from?
According to common logic, if walking at 1 mile per hour burns about 100 calories per hour, then if you walk for 8 hours a day for a year, at the end of that year you have burned 219,000 calories! Since 1 pound equals 3,500 calories, that means you would lose 62 pounds in one year! Trying to use this basic math equation to predict the complex process of human weight loss relies on one major assumption: That you will eat exactly as much as you did before walking 6 hours a day! It assumes that exercising and getting hungry (and therefore eating more) are independent variables. But anyone who lives in a city, or has walked an 18 hole golf course probably disagrees.
Later in the video, Dr. Levine says that just standing burns 20 more calories/hour than sitting. Then the reporter says that if you chew gum, that’s an extra 11 calories per hour! While it may take that much energy to stand and chew gum at the same time, if I were to say that you can lose 26 pounds a year by standing and chewing gum, It would be ridiculous.
But it is the exact same logic: If I stand (burns 20 extra calories/hour according to Dr. Levine) and chew gum (burns 11 calories per hour) for 8 hours a day, after a year I will have burned 90,520 calories and lost 26 pounds! So if this is true, why would anyone go through the hassle and social embarrassment of walking on a treadmill while checking your e-mail at work!?
This logic is fundamentally flawed. And wait a minute…this exercise at work idea sounds awfully familiar:
We are proud to annouce that our co-founder, Mark Boguski, is presenting PhotoCalorie today at Microsoft’s 2011 Connected Health Conference in Chicago. As described on their site, this annual conference brings together stakeholders from across the healthcare ecosystem for learning, networking, and discussion on the most important issues facing healthcare organizations today, including the role of technology in transforming healthcare delivery and personal health management. For a list of all the speakers, click here.
PhotoCalorie is being featured in the On the Go mobile health section, where we will be illustrating how PhotoCalorie can connect with Microsoft Health Vault to download a patient’s medical records and alert them of any dangerous diet-drug interactions.
For example, blood pressure medications such as Procardia, Adalat (Nifedipine) and Plendil (felodipine), are dangerous when combined with grapefruit or grapefruit juice, resulting in higher levels of the blood pressure medications. Some of the negative symptoms may include facial flushing, nausea, dizziness, confusion, palpitations or irregular heartbeat. If people taking these drugs are also using PhotoCalorie, potentially dangerous side effects may be avoided.
The American Heart Association (AHA) recently published a report entitled Triglycerides and Cardiovascular Disease, chronicling the rising rates of serum triglyceride levels and its role in cardiovascular disease in order to “update clinicians on the increasingly crucial role of triglycerides in the evaluation and management of CVD risk and highlight approaches aimed at minimizing the adverse public health–related consequences associated with hypertriglyceridemic states.”
This report is interesting and important for physicians to be aware of, but the major concepts are absolutely predictable with a basic understanding of serum cholesterol responses to carbohydrates in the diet. Simply stated, when people eat carbohydrates their HDL (good cholesterol) goes down and their triglycerides go up. This is uncontroversial, and so consistent that researchers use triglycerides and HDL as objective measures of carbohydrate consumption. Dr. Frank Sacks of Harvard Medical School explains in a recent paper on low carbohydrate diets that “HDL is a biomarker for dietary carbohydrate.” High triglycerides and low HDL means the subjects are eating lots of carbs. The AHA’s report confirms this as well, explaining that “very high intakes of carbohydrate (>60% of calories) is accompanied by a reduction in HDL cholesterol and a rise in triglyceride.” Perhaps the most interesting quote in the report comes in the introduction:
It is especially disconcerting that in the United States, mean triglyceride levels have risen since 1976, in concert with the growing epidemic of obesity, insulin resistance, and type 2 diabetes mellitus.
It is quite disconcerting, but it is EXACTLY what should be expected. If it is true that triglycerides increase in response to carbohydrates, then at some point around 1976, there should have been an increase in carbohydrate consumption. And there was. It was in response to the first ever Dietary Goals for the United States, issued in 1977 by the U.S. Senate Select Committee on Nutrition and Human Needs. Here are the first few recommendations:
- Increase carbohydrate consumption to account for 55 to 60 percent of the energy (caloric) intake.
- Reduce overall fat consumption from approximately 40 to 30 percent energy intake
- Reduce saturated fat consumption to account for about 10 percent of total energy intake
So the recommendation to eat more carbohydrates happened almost precisely at the same time that triglyceride levels began to increase to “disconcerting” levels. The next question is if people actually followed this advice and ate more carbohydrates. And they did:
As you can see, since about 1976 carbohydrate intake increased and dietary fat intake decreased. Here is another graph of carbohydrate intake over the past 30 years (from Gross et al 2004)
As explained in the introduction this report will be of value to the Adult Treatment Panel IV (ATP IV) of the National Cholesterol Education Program (NCEP), from which evidence-based guidelines will ensue.
So what does the NCEP recommend in order to lower our triglycerides? Why nothing more than the exact recommendation we received in 1977:
Very high intakes of carbohydrate (>60% of total calories) are accompanied by a reduction in HDL cholesterol and a rise in triglyceride …. These latter responses are sometimes reduced when carbohydrate is consumed with viscous fiber …; however, it has not been demonstrated convincingly that viscous fiber can fully negate the triglyceride-raising or HDL-lowering actions of very high intakes of carbohydrates…Carbohydrate intake should be limited to 60 percent of total calories.
You can read more about triglycerides, HDL and carbohydrates here.