Not All Calories Are The Same, New Research Finds

Hey all!

I came across this article on MedScape News for Medical Students and thought I would share it with you. The original article can be found here: http://www.medscape.com/viewarticle/766443

Not All Calories Are the Same, New Research Finds
Lisa Nainggolan

June 26, 2012 (Boston, Massachusetts) — A small mechanistic study comparing three different eating patterns--a low-fat diet, a low-glycemic-index diet, and a low-carbohydrate diet--has found that participants used up the most energy with the last, but there were metabolic disadvantages to this approach [1].

The findings reinforce the message that a low-glycemic-index diet is best for weight loss and cardiovascular disease prevention and illustrate a novel concept--that not all calories are alike from a metabolic perspective, say Dr Cara B Ebbeling (New Balance Foundation, Obesity Prevention Center, Children's Hospital, Boston, MA) and colleagues in their paper published in the June 27, 2012 issue of the Journal of the Medical Association.

Senior author Dr David S Ludwig (New Balance Foundation, Obesity Prevention Center) told heartwire : "Extreme restriction of fat or carbs can have bad effects. The best long-term approach will be to avoid restriction of any major nutrient--either fat or carbohydrate--and instead focus on the quality of nutrients. This is not to say that the number of calories isn't important, but it's now saying we should also pay attention to the quality of those calories. So the argument that the food industry likes to make--that all foods can be part of a healthful diet as long as you watch calories--is really misleading at best.

"Relatively unprocessed, low-glycemic-index foods are best, things that our grandmother would recognize. Choose relatively unprocessed foods whenever you can and cut back on white bread, white rice, potato products, prepared breakfast cereals, and, of course, concentrated sugars."

"The argument that the food industry likes to make--that all foods can be part of a healthful diet as long as you watch calories--is really misleading at best."

Dr Arne Astrup (Department of Human Nutrition, University of Copenhagen), who was not involved with the study, said it adds to previous research and demonstrates that "a slight reduction in carbs (and increase in protein) with a focus on low [glycemic-index]/whole-grain carbs and 20% to 30% of calories from protein from shellfish, fish, poultry, dairy, nuts, lentils, and beans is the optimal diet today for weight control and reduction of cardiovascular risks."

To this end, Ludwig believes it's time to change recommendations. "Most of the professional nutritional associations continue to feature, expressively or implicitly, targets on fat reduction. Our work--and really many other studies--now suggest that there is absolutely no benefit by selectively targeting fat for reduction."

Low-Fat and Low-Carb Diets Both Have Important Downsides

The researchers conducted a three-way crossover design feeding study between June 2006 and June 2010 involving 21 overweight and obese young adults in Boston who were recruited by newspaper advertisements and postings.

After losing 10% to 15% of body weight during a run-in phase, participants were allocated to a low-fat diet (20% fat, 60% carbohydrate, 20% protein), a low-glycemic-index diet, and a very low-carbohydrate diet (10% carbohydrate, 60% fat, 30% protein) in random order, each for four weeks. The primary outcome was resting energy expenditure with secondary outcomes of total energy expenditure, hormone levels, and metabolic syndrome components.

Ludwig notes these type of studies are "difficult to perform," because for each participant there were seven months of feeding, "and that's about the limit you can put a human subject through, so we could only examine each diet for a month at a time."

The reduction in resting energy expenditure was greatest with the low-fat diet, intermediate with the low-glycemic-index one, and least with the low-carb diet. The decrease in TEE showed a similar pattern.

"Those on the low-carb diet burned 350 calories per day more than those on the low-fat one, even though they consumed the same amount of calories on all these diets. That's equivalent to one hour of moderate-intensity physical exercise," Ludwig said. And those on the low-glycemic-index diet lost about 150 calories per day more than those on the low-fat one, "equal to about an hour of light physical activity," he added. (Neither total physical activity nor time spent in moderate- to vigorous-intensity physical activity differed among the diets.)

But he explained that, as well as energy expenditure, "we also looked at heart disease risk factors, and the two restrictive diets both had important downsides."

Strongest Support for Concept That Not All Calories Are the Same

With the low-carb diet, the researchers observed increases in CRP, a measure of chronic inflammation, and 24-hour cortisol, the key stress hormone, "suggesting that any initial advantages were eroded over time by these biological stressors," Ludwig notes.

And the low-fat diet--as well as resulting in the least energy expenditure--"exacerbated many of the components of the metabolic syndrome, so insulin resistance, triglycerides, and HDL cholesterol were all worse on this diet," he explained.

Hence the study, despite its limitations, "provides the strongest support for a novel concept, that all calories are not alike from a metabolic perspective. This has been postulated before, but never shown in this context," Ludwig says.

"We are emphasizing mechanisms that underlie how diets affect body weight and saying that this knowledge should be used to design more effective and least-restrictive approaches to weight loss and heart disease prevention. We want to line up biology and behavior. Losing weight is hard enough for anybody. We need every advantage we can get. We've wasted a lot of energy pursuing ineffective approaches like a low-fat diet."

The authors report no conflicts of interest.

References

Ebbeling CB, Swain JF, Feldman HA, et al. Effects of dietary composition on energy expenditure during weight-loss maintenance. JAMA 2012; 307:2627-2634.


Heartwire © 2012 Medscape, LLC

Cite this article: Not All Calories Are the Same, New Research Finds. Medscape. Jun 26, 2012.
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Replies

  • igottaworkout
    igottaworkout Posts: 298 Member
    Very interesting. Thanks for posting this!
  • c2111
    c2111 Posts: 693 Member
    Thank you for sharing :)
  • cevans_rr
    cevans_rr Posts: 44 Member
    Bump! Interesting article!
  • graysmom2005
    graysmom2005 Posts: 1,882 Member
    Great article!!!
  • LessJITT
    LessJITT Posts: 11 Member
    Thanks for posting! :drinker:
  • Toumani
    Toumani Posts: 78 Member
    Interesting article. I guess this flies in the face of the people who insist that weight loss is simply a matter of calories in/calories out alone. For example Lyle McDonald - someone linked his discussion here: https://www.myfitnesspal.com/topics/show/715411-you-are-not-different. Also this might be a bit upsetting to those who swear by ketogenic diets on the long-term.

    To be fair, I'm so sick and tired of this back and forth bro science about "eat less, exercise more" vs "you need to do 20/30/40 bla bla bla" ratios. It was nice that someone here posted an actual empirical study which albeit small, sheds a little light on the subject.
  • Great info! But geez, so confusing! "One diet is better than the other BUT..."
    There is always this "BUT"...
  • FemininGuns
    FemininGuns Posts: 605 Member
    Bump for later!
  • AllTehBeers
    AllTehBeers Posts: 5,030 Member
    Interesting article. I guess this flies in the face of the people who insist that weight loss is simply a matter of calories in/calories out alone. For example Lyle McDonald - someone linked his discussion here: https://www.myfitnesspal.com/topics/show/715411-you-are-not-different. Also this might be a bit upsetting to those who swear by ketogenic diets on the long-term.

    To be fair, I'm so sick and tired of this back and forth bro science about "eat less, exercise more" vs "you need to do 20/30/40 bla bla bla" ratios. It was nice that someone here posted an actual empirical study which albeit small, sheds a little light on the subject.

    High protein diets have always been shown to be your best route because it does have a higher TEF. That said, why is "eat less, move more" bro science? Isn't that what every single person who loses weight does regardless of macronutriant ratios?
  • Elibasia
    Elibasia Posts: 211 Member
    BUMP
  • SuperstarDJ
    SuperstarDJ Posts: 442 Member
    Bump
  • riveradee
    riveradee Posts: 40 Member
    great article not sure what the responses bump memans but it shows that everything in moderation is healthier in the long run than carb depletion or server caloric deficit

    'Dr Arne Astrup (Department of Human Nutrition, University of Copenhagen), who was not involved with the study, said it adds to previous research and demonstrates that "a slight reduction in carbs (and increase in protein) with a focus on low [glycemic-index]/whole-grain carbs and 20% to 30% of calories from protein from shellfish, fish, poultry, dairy, nuts, lentils, and beans is the optimal diet today for weight control and reduction of cardiovascular risks."'

    will borrow this and post it if you don't mind'
  • Winwin101
    Winwin101 Posts: 82 Member
    Interesting article! And i couldn't agree more with everyone. It's past time to change recommendations.
  • SideSteel
    SideSteel Posts: 11,068 Member
    Interesting article. I guess this flies in the face of the people who insist that weight loss is simply a matter of calories in/calories out alone. For example Lyle McDonald - someone linked his discussion here: https://www.myfitnesspal.com/topics/show/715411-you-are-not-different. Also this might be a bit upsetting to those who swear by ketogenic diets on the long-term.

    To be fair, I'm so sick and tired of this back and forth bro science about "eat less, exercise more" vs "you need to do 20/30/40 bla bla bla" ratios. It was nice that someone here posted an actual empirical study which albeit small, sheds a little light on the subject.

    Nothing in the linked study flies in the face of thermodynamics nor does it make Lyle's article wrong.
  • Acg67
    Acg67 Posts: 12,142 Member
    Interesting article. I guess this flies in the face of the people who insist that weight loss is simply a matter of calories in/calories out alone. For example Lyle McDonald - someone linked his discussion here: https://www.myfitnesspal.com/topics/show/715411-you-are-not-different. Also this might be a bit upsetting to those who swear by ketogenic diets on the long-term.

    To be fair, I'm so sick and tired of this back and forth bro science about "eat less, exercise more" vs "you need to do 20/30/40 bla bla bla" ratios. It was nice that someone here posted an actual empirical study which albeit small, sheds a little light on the subject.

    Did you look at the actual results? Anything stand out when doing so?
  • maczope
    maczope Posts: 7 Member
    bump for later
  • Amberonamission
    Amberonamission Posts: 836 Member
    Good to know that the thoughts I have been having on how to conquer this insurmountable task of losing 100+ pounds, healthily and naturally are spot on. Yay me.
  • Cranktastic
    Cranktastic Posts: 1,517 Member
    meh.
  • Toumani
    Toumani Posts: 78 Member


    High protein diets have always been shown to be your best route because it does have a higher TEF. That said, why is "eat less, move more" bro science? Isn't that what every single person who loses weight does regardless of macronutriant ratios?

    That's what I thought. But there are threads going around on MFP where people begin arguing about "eat more and you will lose weight" vs "it's just cals in vs cals out", then there's the less sodium, more protein, etc, etc. I think I've read so many different takes on how weight loss should happen on this site it's incredible.
  • LoraF83
    LoraF83 Posts: 15,694 Member
    I'm sorry, but I'm having a hard time believe that going low carb automatically makes your body burn up to 350 more calories a day.....just from not eating as many carbs. I would like to see the data to back that up.
  • AlabasterVerve
    AlabasterVerve Posts: 3,171 Member
    Peter Attia wrote a great blog post on that study. Here's a little of what he had to say:

    "A few things stand out from these results:

    1. The group consuming a very low carbohydrate diet had a higher REE and TEE than the low GI group, which had a higher REE and TEE than the low fat group. In other words, the fewer carbohydrates in the diet, the higher the resting and overall expenditure. This is actually the sine qua non of the alternative hypothesis: something beyond the actual number of calories is playing a role in how the body expends energy.

    2. As expected, given that each subject was starting from a weight-reduced state, the REE was lower for each group, relative to their baseline. REE is highly (though clearly not entirely) dependent on body mass.

    3. There is enormous variation between subjects by diet type. For example, at least one subject saw a dramatic increase in TEE on the low GI diet versus the other two, while another saw the greatest TEE on the low fat diet. This speaks to a theme I iterate on this blog: be willing to self-experiment until you find what works for you. "

    http://eatingacademy.com/books-and-articles/good-science-bad-interpretation
  • HotMummyMission
    HotMummyMission Posts: 1,723 Member
    Bump for later
  • Acg67
    Acg67 Posts: 12,142 Member


    High protein diets have always been shown to be your best route because it does have a higher TEF. That said, why is "eat less, move more" bro science? Isn't that what every single person who loses weight does regardless of macronutriant ratios?

    That's what I thought. But there are threads going around on MFP where people begin arguing about "eat more and you will lose weight" vs "it's just cals in vs cals out", then there's the less sodium, more protein, etc, etc. I think I've read so many different takes on how weight loss should happen on this site it's incredible.

    They all boil down to a caloric deficit
  • myofibril
    myofibril Posts: 4,500 Member
    Meh.

    Just read this: http://www.nytimes.com/2012/07/10/health/nutrition/q-and-a-are-high-protein-low-carb-diets-effective.html?_r=0

    I could explain it myself but frankly, I just can't be arsed right now.
  • Sarauk2sf
    Sarauk2sf Posts: 28,072 Member
    Interesting article. I guess this flies in the face of the people who insist that weight loss is simply a matter of calories in/calories out alone. For example Lyle McDonald - someone linked his discussion here: https://www.myfitnesspal.com/topics/show/715411-you-are-not-different. Also this might be a bit upsetting to those who swear by ketogenic diets on the long-term.

    To be fair, I'm so sick and tired of this back and forth bro science about "eat less, exercise more" vs "you need to do 20/30/40 bla bla bla" ratios. It was nice that someone here posted an actual empirical study which albeit small, sheds a little light on the subject.

    The law of thermodynamics is broscience?
  • Toumani
    Toumani Posts: 78 Member

    That's what I thought. But there are threads going around on MFP where people begin arguing about "eat more and you will lose weight" vs "it's just cals in vs cals out", then there's the less sodium, more protein, etc, etc. I think I've read so many different takes on how weight loss should happen on this site it's incredible.

    They all boil down to a caloric deficit
    [/quote]

    You know, that is what I had initially thought, but when you sit down and read a lot of the stuff that is posted here, one gets the impression that's not necessarily true. Look, I'm not one to argue here (and I'm not trying to), I personally have no clue, and my field is not organic chemistry or any biological field for that matter. I'm just saying it's nice to read an empirical study that's all. People on this site like to throw information around that seems to be based on perhaps personal experience and pass it off as general fact.
  • Toumani
    Toumani Posts: 78 Member


    The law of thermodynamics is broscience?

    No I'm not saying that! Sheesh,
    I just wanted to say there seem to be so many potentially contradictory arguments towards weight loss in these forums, often based on personal experience alone. I was just thanksing OP for posting a study.

    I hope this is OK with everybody.
  • AllTehBeers
    AllTehBeers Posts: 5,030 Member


    High protein diets have always been shown to be your best route because it does have a higher TEF. That said, why is "eat less, move more" bro science? Isn't that what every single person who loses weight does regardless of macronutriant ratios?

    That's what I thought. But there are threads going around on MFP where people begin arguing about "eat more and you will lose weight" vs "it's just cals in vs cals out", then there's the less sodium, more protein, etc, etc. I think I've read so many different takes on how weight loss should happen on this site it's incredible.

    They all boil down to a caloric deficit

    This is what I was getting at. Regardless of how you spread out your macros, its a calorie deficit that makes you lose weight. High protein is best, but I can still lose (perhaps a tad bit slower) eating all carbs if I so wished.
  • chrisdavey
    chrisdavey Posts: 9,834 Member
    Is there a link to the study somewhere?
  • myofibril
    myofibril Posts: 4,500 Member


    The law of thermodynamics is broscience?

    No I'm not saying that! Sheesh,
    I just wanted to say there seem to be so many potentially contradictory arguments towards weight loss in these forums, often based on personal experience alone. I was just thanksing OP for posting a study.

    I hope this is OK with everybody.

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