1. It is good progress that Subway has changed their bread.
Anti obesogenic lifestyles do not include Subway. The food at Subway is very obesogenic because it is very low in protein and very high in grain based carbs. It is also high in plant based fats. People who are living an anti obesogenic lifestyle are not concerned over what Subway does because they never go there.
If Subway wants to swap all of their white flour bread for Ezekiel's, which they ferment themselves at the store, it wouldn't make an iota of difference. Swapping bread quality does not eliminate the bread. Bread, of any kind, does not allow you to properly regulate blood glucose unless it's at starvation levels. Starvation does not allow you to properly regulate blood glucose so you are back to square one.
On this blog, we aren't concerned one bit with what any fast food company does with their food because all fast food falls into the same category of low protein, high carbs and fat. Zero progress has been made to change that.
2. The Mediterranean Diet is a good option.
The Mediterranean Diet is a whole foods diet that consists of low to moderate carbs, lean proteins like fish/lamb and monounsaturated fats from nuts, seeds and olive oil. The diet is well tolerated by most people as it is low in dairy and saturated fats which can be problematic for some who have food allergies and/or lipid abnormalities. The carbs in this diet come primarily from non starchy vegetables but some grain based carbs and sugar are allowed and for this reason, I do not feature it as a recommended diet.
Including grain based products into a diet is a recipe for impending future disaster. Sugar and grains are a necessary requirement for any diet to eventually fail since carbs, in the form of sugar or grain, disrupt postprandial blood glucose over time. If you calorically restrict, you can sustain benefits for longer on these types of diets and this is why all diets, including the Mediterranean, come with the caveat that you should calorically restrict in some form.
But what you want to know is if it actually works. The answer is yes. Sort of. This diet has reversed overweight and metabolic dysfunction in many people but so have all other diets. Because of this, choosing a diet is mostly based on your own personal preference since their results are all the same. The long term benefits of the Mediterranean Diet, when it comes to obesity, is like all the others – negligible and not guaranteed.
If you like the Mediterranean Diet, you can improve your chances of success by eliminating all of the sugar and grains from it and making sure you are following an overall anti obesogenic lifestyle with exercise and systemic stress reduction.
3. I would like to "lower" my insulin, blood pressure, blood glucose and leptin.
Join the club.
You need to stop worrying about "lowering numbers" and focus on improving function. You will know when function is improving when you start lowering body fat. Everyone with excess body fat displays high numbers in all these markers.
Obesity is not addressed through numbers. Numbers are only used to give you a baseline idea of how bad the problem is and what you need to target but they are very easily manipulated temporarily. You need long term solutions to tackle obesity, not temporary nice numbers on a sheet of paper.
4. All diets eventually fail.
This is because no diet has been found to affect leptin expression for the long term so that it continues burning body fat. It appears as if our metabolisms are designed to reject the loss of body fat even when it's at a healthy rate. There are, of course, exceptions to this rule. We all know a person who eats constantly and can never gain weight. This is because they are super leptin sensitive but this metabolic profile is rare and usually changes with age.
The loss of body fat itself affects leptin expression adversely. So, in essence, the cure creates more of the disease. I have touched on this numerous times before in great detail but you can read my article on leptin here.
In summary, your metabolism will only allow your fat mass to be challenged up to a certain point and then it will prevent any further fat loss by under expressing leptin. This occurs to the obese at a much higher weight set point than the healthy. This is why the healthy can become lean but the obese only become less obese as they remain in endless weight plateaus. That is if they are lucky and don't begin gaining weight instead.
Like I have said before, the exact mechanism behind this is not fully understood as the body can use multiple avenues to under express leptin, from the brain to the fat cells and everything in between. Some diets affect leptin adversely much more than others. Calorically restricted diets/fasting (starvation) are the main culprits of leptin under expression. This appears to be because leptin is very sensitive to caloric information, but mostly this is due to tiny abnormalities in insulin function.
Basically, not diet can guarantee you will be able to regain and sustain normal blood glucose regulation. Without that, everything else won't happen.
5. There are always initial benefits from dieting.
The drop in total calories always lowers insulin levels. This drop in insulin levels allows the body to release excess retained water as insulin is an anti diuretic. This is why most diets promise you will lose 5 pounds in 5 days. For some, the amount of water loss can be quite dramatic depending on how much is being retained.
Of course, none of these diets affect blood glucose/insulin profoundly enough to correct their dysregulation, which would allow leptin to burn body fat, as this only occurs in the long term. So, the weight lost with dieting is water and some lean muscle mass but no body fat.
6. Why are men able to not diet or exercise and still be lean and fit?
This is one of the great examples of how calories don't work. Most men tend to not count calories nor do they "watch their figures". They rarely "watch what they eat". They actually are the main consumers of fast food but yet they tend to not have issues with weight as early on and as persistently as women do. All men have to do, when they get fed up of their tightening pants, is get a gym membership, a few protein shakes and they will start seeing muscle gain and fat loss in a few weeks. This is why most men can wait for the very last minute to "get in shape". After all, getting in shape is always an open option for them as it is so easily acquired. Even in obesity, men have an advantage. This is where you see hormones playing the main role in weight maintenance.
The testosterone in men preserves their lean muscle mass and does not allow for much fat storage. They have a body that is primed and honed for leanness and this is reflected in their metabolic state. This is especially true if the man was never overweight/obese during his lifetime.
This is not the case with men that have been overweight/obese before, particularly in childhood. Then they become estrogen dominant and they tend to lose their lean muscle mass and store a lot of subcutaneous fat. This estrogen dominance causes for men to accumulate fat in the same areas a woman does. This also begins to occur to older men, as their testosterone wanes and they start developing man boobs they can't get rid of. Estrogen is the hormone that diverts fat to the subcutaneous and away from the visceral, so in a way, it is a protective mechanism to become estrogen dominant, even if unsightly.
But, even in this state, men still have an advantage with losing weight as their metabolic profiles do not work against them. Their metabolism always prefers to be in its natural state - high muscle and low body fat.
Aside from their biology, men also have personality traits and behaviors that make them more likely to be successful with their diets. They are more consistent, have more perseverance, make less excuses and are less likely to let external things sidetrack them from their goals. When a man wants something, he will usually work to get it. It becomes competition for him rather than punishment. This in of itself causes for men to be more likely to reach their goals as they didn't spend half their life yo-yo dieting and "falling off the wagon", to then cry in a robe with a container of Ben & Jerry's. Previous starvation protocols cause for current treatments to be less likely to work.