Interesting Dieting Article in the NY Times

http://www.nytimes.com/2012/07/10/health/nutrition/q-and-a-are-high-protein-low-carb-diets-effective.html


In Dieting, Magic Isn’t a Substitute for ScienceBy GINA KOLATA
Is a calorie really just a calorie? Do calories from a soda have the same effect on your waistline as an equivalent number from an apple or a piece of chicken?

For decades the question has percolated among researchers — not to mention dieters. It gained new momentum with a study published last month in The Journal of the American Medical Association suggesting that after losing weight, people on a high-fat, high-protein diet burned more calories than those eating more carbohydrates.

We asked Dr. Jules Hirsch, emeritus professor and emeritus physician in chief at Rockefeller University, who has been researching obesity for nearly 60 years, about the state of the research. Dr. Hirsch, who receives no money from pharmaceutical companies or the diet industry, wrote some of the classic papers describing why it is so hard to lose weight and why it usually comes back.

The JAMA study has gotten a lot of attention. Should people stay on diets that are high in fat and protein if they want to keep the weight off?

What they did in that study is they took 21 people and fed them a diet that made them lose about 10 to 20 percent of their weight. Then, after their weight had leveled off, they put the subjects on one of three different maintenance diets. One is very, very low in carbohydrates and high in fat, essentially the Atkins diet. Another is the opposite — high in carbohydrates, low in fat. The third is in between. Then they measured total energy expenditure — in calories burned — and resting energy expenditure.

They report that people on the Atkins diet were burning off more calories. Ergo, the diet is a good thing. Such low-carbohydrate diets usually give a more rapid initial weight loss than diets with the same amount of calories but with more carbohydrates. But when carbohydrate levels are low in a diet and fat content is high, people lose water. That can confuse attempts to measure energy output. The usual measurement is calories per unit of lean body mass — the part of the body that is not made up of fat. When water is lost, lean body mass goes down, and so calories per unit of lean body mass go up. It’s just arithmetic. There is no hocus-pocus, no advantage to the dieters. Only water, no fat, has been lost.

The paper did not provide information to know how the calculations were done, but this is a likely explanation for the result.

So the whole thing might have been an illusion? All that happened was the people temporarily lost water on the high-protein diets?

Perhaps the most important illusion is the belief that a calorie is not a calorie but depends on how much carbohydrates a person eats. There is an inflexible law of physics — energy taken in must exactly equal the number of calories leaving the system when fat storage is unchanged. Calories leave the system when food is used to fuel the body. To lower fat content — reduce obesity — one must reduce calories taken in, or increase the output by increasing activity, or both. This is true whether calories come from pumpkins or peanuts or pâté de foie gras.

To believe otherwise is to believe we can find a really good perpetual motion machine to solve our energy problems. It won’t work, and neither will changing the source of calories permit us to disobey the laws of science.

Did you ever ask whether people respond differently to diets of different compositions?

Dr. Rudolph Leibel, now an obesity researcher at Columbia University, and I took people who were of normal weight and had them live in the hospital, where we diddled with the number of calories we fed them so we could keep their weights absolutely constant, which is no easy thing. This was done with liquid diets of exactly known calorie content.

We kept the number of calories constant, always giving them the amount that should keep them at precisely the same weight. But we wildly changed the proportions of fats and carbohydrates. Some had practically no carbohydrates, and some had practically no fat.

What happened? Did people unexpectedly gain or lose weight when they had the same amount of calories but in a diet of a different composition?

No. There was zero difference between high-fat and low-fat diets.

Why is it so hard for people to lose weight?

What your body does is to sense the amount of energy it has available for emergencies and for daily use. The stored energy is the total amount of adipose tissue in your body. We now know that there are jillions of hormones that are always measuring the amount of fat you have. Your body guides you to eat more or less because of this sensing mechanism.

But if we have such a sensing mechanism, why are people fatter now than they used to be?

This wonderful sensing mechanism involves genetics and environmental factors, and it gets set early in life. It is not clear how much of the setting is done before birth and how much is done by food or other influences early in life. There are many possibilities, but we just don’t know.

So for many people, something happened early in life to set their sensing mechanism to demand more fat on their bodies?

Yes.

What would you tell someone who wanted to lose weight?

I would have them eat a lower-calorie diet. They should eat whatever they normally eat, but eat less. You must carefully measure this. Eat as little as you can get away with, and try to exercise more.

There is no magic diet, or even a moderately preferred diet?

No. Some diets are better or worse for medical reasons, but not for weight control. People come up with new diets all the time — like, why not eat pistachios at midnight when the moon is full? We have gone through so many of these diet possibilities. And yet people are always coming up to me with another one.

Replies

  • nlhill79
    nlhill79 Posts: 60 Member
    "Eat as little as you can get away with, and try to exercise more."

    Really???
  • laus_8882
    laus_8882 Posts: 217 Member
    I loved it, eat less, more more. Simple advice with none of the gobbledegook that so often makes its way into diet pieces.
  • myofibril
    myofibril Posts: 4,500 Member
    Calories rule innit?

    Having said diets of differing macronutrient compositions may suit an individual dieter better than others (leaving aside metabolic / medical conditions) but this is more to do with one very big factor in particular: hunger control.

    Eat less calories, move more.
  • SelkieDiver
    SelkieDiver Posts: 260 Member
    This is a great article. Thanks for sharing!
  • Oishii
    Oishii Posts: 2,675 Member
    "Eat as little as you can get away with, and try to exercise more."

    Really???

    Exactly what I thought. Plus, I'm not convinced that just eating less of what you normally do is a good idea as, depending on what you normally eat, you could become quite malnourished. I was diagnosed as being anaemic for the first time in my life after behaving just like that.

    I am tempted to think that while most of what he says is backed by research, this last bit is just his personal opinion and rather irresponsible to say the least!
  • mcarter99
    mcarter99 Posts: 1,666 Member
    "Eat as little as you can get away with, and try to exercise more."

    Really???

    That's pretty much it. Most people can't psychologically "get away with" eating at dangerously low levels for long. Anorexia is rare, affecting one out of 10,000-20,000 people.
  • ElizabethRoad
    ElizabethRoad Posts: 5,138 Member
    Lol what. I eat as much as I can get away with.
  • ItsCasey
    ItsCasey Posts: 4,021 Member
    The real problem is that these experts never actually flesh out what it is that they mean when they say "Eat as little as you can get away with." I seriously doubt this person was urging anyone to starve him/herself. They just don't seem to understand that the average person wanting to lose weight has no idea what it means to "eat as little as you can get away with." You say that, and they think "Great, I'll just eat 500 calories per day, and I'll be skinny in no time."

    As little as I can get away with is about 1400 calories. If I eat less than that on a regular basis, it's nearly impossible for me to complete my workouts. But I know that from personal experience. Someone who doesn't know is just going to assume they shouldn't eat much at all.
  • Nutrition1st
    Nutrition1st Posts: 216 Member
    The author lost me at "a jillion". People who want diets turn to Atkins or Lemonade Diets instead of changing their lifestyle. Immediate gratification is a major contributor to this weight gain problem. So it can't also be the answer to weight loss (healthy weight loss). I didn't get to be 300 lbs in 10 days. So I didn't expect to lose 125lbs of it in 10 days either. I ate nearly 3x the calories to drop over 100 lbs as I did at 300 lbs. They were the properly measured portions at the properly calculated time of day to spark my metabolism through the roof. What science has taught us is that dieting does not make us healthy. Proper nutrition and proper exercise not only make us healthy, but help prevent obesity, diabetes, heart disease etc.

    It's true that energy can't be created nor destroyed. When we starve ourselves, there is plenty of energy being used. You just don't see it. When we eat these low calorie diets, our body has to spend energy to gather the nutrients it needs to continue to function. Especially if you are working out. You are in a constant state of catabolism where your body is stealing protein from muscles (which takes energy), to turn around and feed those amino acids (which takes energy) back to those starved (low cal diet) muscles. When we deny our body carbs our body goes back to our muscles (energy) and robs more protein from our muscles...but this time it converts that protein to glucose (which is spending more of that missing energy). That's why you see a malnourished child with no muscle mass, but with a little gut. They are alive b/c their body is constantly eating it's muscles to create glucose and amino acids so they can survive.
  • BuffyEat2Live
    BuffyEat2Live Posts: 327 Member
    "Eat as little as you can get away with, and try to exercise more."

    Really???

    That was my first thought, too.

    My second thought: "like, why not eat pistachios at midnight when the moon is full?" --I'm so trying this. :laugh:
  • mcarter99
    mcarter99 Posts: 1,666 Member
    That's why you see a malnourished child with no muscle mass, but with a little gut. They are alive b/c their body is constantly eating it's muscles to create glucose and amino acids so they can survive.

    If you mean kwashiorkor, the distended abdomen isn't fat.
  • Oishii
    Oishii Posts: 2,675 Member
    "Eat as little as you can get away with, and try to exercise more."

    Really???

    That's pretty much it. Most people can't psychologically "get away with" eating at dangerously low levels for long. Anorexia is rare, affecting one out of 10,000-20,000 people.

    Who (else) said anything about anorexia? Is there a long term benefit in eating as little as you can cope with for a long period of time? Not that I can think of. Why would an 'expert' spout such nonsense sound bites?
  • mcarter99
    mcarter99 Posts: 1,666 Member
    The long term benefit is getting to a healthy weight.

    I don't know why people here are so afraid they might be undereating, so I assumed it's fear of anorexia? Is it metabolic damage? Muscle loss? Deprivation? Being cranky? Whatever it is, the odds of it and the extent of it are greatly overestimated here.

    Like you, most people are smart enough to know how little they can eat and still be at a deficit yet still feel ok. They might try 500 for a few days, especially the teens, but they will soon find that doesn't work.
  • Oishii
    Oishii Posts: 2,675 Member
    The long term benefit is getting to a healthy weight.

    I don't know why people here are so afraid they might be undereating, so I assumed it's fear of anorexia? Is it metabolic damage? Muscle loss? Deprivation? Being cranky? Whatever it is, the odds of it and the extent of it are greatly overestimated here.

    Like you, most people are smart enough to know how little they can eat and still be at a deficit yet still feel ok. They might try 500 for a few days, especially the teens, but they will soon find that doesn't work.

    We clearly have very different friend lists and experiences!

    Weight loss is the benefit however rapidly or slowly you lose. My personal experience of having eaten far less than I should have been (thanks, in part, to mfp) is getting hot flushes if I ate any more than I needed, taking this to a dr and finding I was anaemic. I can't see any other likely triggers, as the hot flushes only started after using mfp.

    If anyone can find a long-term benefit to losing quickly over slowly, I would be fascinated to hear it.
  • mcarter99
    mcarter99 Posts: 1,666 Member
    The benefit is people stick to a program when they're seeing visible results. That's why virtually all published diet plans have an initial aggressive phase. Success breeds success. People are generally smart enough to know they will burn out on the aggressive phase and need to keep moving toward more moderate deficits over time. But if they can see how deficits work with some early successes, they're more likely to stick to it.
  • imaginaryplaces
    imaginaryplaces Posts: 123 Member
    The benefit is people stick to a program when they're seeing visible results. That's why virtually all published diet plans have an initial aggressive phase. Success breeds success. People are generally smart enough to know they will burn out on the aggressive phase and need to keep moving toward more moderate deficits over time. But if they can see how deficits work with some early successes, they're more likely to stick to it.

    I agree - this certainly describes my personal experience (down 70lbs over the past two years, FWIW)

    As for the quote from the NYT article ("Eat as little as you can get away with, and try to exercise more"), I think that *most* of us are able to figure out that "as little as you can get away with" refers to the amount needed to provide an adequate amount of energy and nutrients.