Diet Trend Smackdown--and no winners?

April 5, 2009 10:32 AM

"People lose weight if they lower calories, but it does not matter how."According to recently published study in the New England Journal of Medicine, "For people who are trying to lose weight, it does not matter if they are counting carbohydrates, protein or fat. All that matters is that they are counting something."

“The effect of any particular diet group is minuscule, but the effect of individual behavior is humongous,” Dr. Sacks said. “We had some people losing 50 pounds and some people gaining five pounds. That’s what we don’t have a clue about. I think in the future, researchers should focus less on the actual diet but on finding what is really the biggest governor of success in these individuals.” [full study here]

As a big (no pun intended) fan of the work done by Gary Taubes, I find these results distressing. Fortunately for my wavering dietary faith, Taubes responds to the study.

posted by mecran01 (98 comments total)

So the human body isn't really a complex machine designed to defy the laws of physics?
posted by Inspector.Gadget at 10:34 AM on April 5 [14 favorites has favorites]

This isn't really news. I've read before that the difference between the effectiveness of different reduction diets was minimal. What really mattered was how disciplined the individual dieter was in terms of adhering to the diet. Which is why people should just find a program that is reasonably healthy and that they can stick to. The "best" diet in the world is useless if it's too strict or austere for you personally and you can't stick to it.
posted by orange swan at 10:36 AM on April 5 [1 favorite has favorites]

Case in point: The Big Mac diet.
posted by blue_beetle at 10:42 AM on April 5

On the other hand, for every other health-related issue, the type of food does matter.

I'm diabetic and I know that eating a bunch of veggies and some protein is going to be better for me than eating the equivalent number of calories in Krispy Kremes.
posted by Foosnark at 10:43 AM on April 5 [8 favorites has favorites]

Ah, darnit. The Taubes response is to this study on the mediterranean diet, also found in the New England Journal of Medicine. Sorry about that.
posted by mecran01 at 10:44 AM on April 5 [2 favorites has favorites]

Satiety is probably an underlooked factor also. It's easier to eat fewer calories if the ones you do eat are more satisfying.
posted by Foosnark at 10:44 AM on April 5 [7 favorites has favorites]

Underlooked? I need to add more caffeine to my diet this morning. Afternoon. Whatever.
posted by Foosnark at 10:45 AM on April 5 [3 favorites has favorites]

Hmm, wow. So when people pay closer attention to what they eat, they tend to lose weight and be healthier? I am certainly grateful for this ground-breaking study. It's a good thing they do it, since I can't see how anyone would come to this conclusion merely by contemplating the matter.

The sad thing to me isn't that scientists did this study; it was not naïve of them, and I'm sure they had a pretty good idea of what they would see happen. The sad thing is that it was necessary to do this study to cut through the bullshit consumerism that so pervades our culture and prove to people that consciousness of your own body is what matters, and that there is no miracle cure available at a bargain price.
posted by koeselitz at 10:49 AM on April 5 [5 favorites has favorites]

I'm sure you could lose weight on an all Snickers diet, but it can't be good for your overall health. Stepping on the scale shouldn't be the measure of your health. So yeah, pretty obvious if you actually contemplate it.
posted by HumanComplex at 10:53 AM on April 5

There's an accompanying poll in the NEJM and an editorial, which includes this:

"It is obvious by now that weight losses among participants in diet trials will at best average 3 to 4 kg after 2 to 4 years10 and that they will be less among people who are poor or uneducated, groups that are hit hardest by obesity.9 We do not need another diet trial; we need a change of paradigm.

A little-noticed study in France may point the way.11 A community-based effort to prevent overweight in schoolchildren began in two small towns in France in 2000. Everyone from the mayor to shop owners, schoolteachers, doctors, pharmacists, caterers, restaurant owners, sports associations, the media, scientists, and various branches of town government joined in an effort to encourage children to eat better and move around more. The towns built sporting facilities and playgrounds, mapped out walking itineraries, and hired sports instructors. Families were offered cooking workshops, and families at risk were offered individual counseling.

Though this was not a formal randomized trial, the results were remarkable. By 2005 the prevalence of overweight in children had fallen to 8.8%, whereas it had risen to 17.8% in the neighboring comparison towns, in line with the national trend.11 This total-community approach is now being extended to 200 towns in Europe, under the name EPODE (Ensemble, prévenons l'obésité des enfants [Together, let's prevent obesity in children]).12"
posted by mecran01 at 10:58 AM on April 5 [1 favorite has favorites]

So the human body isn't really a complex machine designed to defy the laws of physics?

No, it totally is. Otherwise being overweight would be my fault, and obviously that's not true because nothing is my fault.
posted by Mayor Curley at 10:58 AM on April 5 [4 favorites has favorites]

So the human body isn't really a complex machine designed to defy the laws of physics?

That's the only way the basic premise of The Matrix made any sense.
posted by aubilenon at 11:02 AM on April 5 [5 favorites has favorites]

"People lose weight if they lower calories, but it does not matter how."

Anorexics agree, though I doubt anyone would hold up as an example of the larger issue: good health.

Everyone knows that eating less calories results in weight loss. The problem, IMO, is that people don't understand what they're eating. You can't measure calories if you're not counting calories and if you're not counting calories, you can't be aware of just how damaging that piece that morning bagel with cream cheese is nor the caloric value of protein vs carbs vs fat. Eating the same 30 grams of protein and 30 grams of fat has different effects on the body and weight.
posted by Brandon Blatcher at 11:03 AM on April 5 [1 favorite has favorites]

Hmm, wow. So when people pay closer attention to what they eat, they tend to lose weight and be healthier? I am certainly grateful for this ground-breaking study. It's a good thing they do it, since I can't see how anyone would come to this conclusion merely by contemplating the matter.

I hate comments like this about studies with 'obvious' results. They're just so stupid. There are tons and tons of people peddling "miracle diets" that claim to work better then other diets, obviously lots of people believe it or there wouldn't be a thriving industry. This study proves they that they are B.S.

Secondly, just because something "seems obvious" doesn't mean you shouldn't actually check it. I mean what if it had turned out not to be the case? And just because you verify common sense doesn't mean you shouldn't publish your results so other people are aware of it.
posted by delmoi at 11:04 AM on April 5 [45 favorites has favorites]

One of the most effective weight-loss studies in the world had the subjects weighing themselves four times a day. Just paying attention to outcomes, often, becomes a feedback loop chock full of reinforcement.

However, I think going "laws of physics" when it comes to weight is a crock.

Sure, it makes sense if you thought that the human body was almost perfectly efficient. It is not, though. We do not perfectly convert food Calories into energy for our use. Not even close. The number given to me in my biology classes was about 14% efficiency. 14%. That's about one in seven. That seems horrifically low for me, Google is useless in trying to find a cite for that. Then I think about the efficiency of internal combustion engines and I nod a bit.

Now, with that in mind, someone whose body was even a smidgen more efficient would rack up many, many excess Calories of the course of a year as compared to the average jane. How can this happen? Well, for one, you have various levels of efficiency even at absorbing food from our gut. Look up fat malabsorption. And we haven't even gotten to the metabolism yet. Some people run higher temperatures, some run cold. If you have the right Bsx allele, welcome to fidgeting away some of your weight.

What does that mean? 2,000 Calories are not the same to two people of the same height and build; it might be a little deficient for one and excess for the other. There's no magic breaking of mass-energy conservation laws here, just varying efficiencies in an incredibly complex, sloppy, and individualistic process.

So, let's stop using that as one of those cheap lead-ins to the inevitable "YOU HAVE NO EXCUSE FOR YOUR FATNESS, DO YOU, FATTIE?" argument.
posted by adipocere at 11:14 AM on April 5 [15 favorites has favorites]

I've long been a believer in the simple physics behind the notion that if calories burned exceed calories consumed, weight loss must happen. I think that the reason many people do not like this notion is that it could be seen to imply that the difference between someone who maintains a healthy weight and someone who does not is just a matter of willpower, or lack thereof. Willpower to eat less, willpower to exercise more, or some combination of the two. And feeling that one is a failure due to lack of willpower only makes the problem worse.

I think a more useful way to look at it is that different people require different amounts of willpower to eat healthy and exercise more. So the problem is not so much that one person has less willpower than another, but that one person needs more of it than another, due to different levels of drive to eat or exercise, past history, and so on. And then the focus can be shifted from "I am weak-willed compared to those people" to "I have greater challenges compared to those people".

So the result that the different results within groups on the same diet are much greater than the results between group averages isn't surprising--everyone is different and will be able to tolerate caloric reduction on some diets better than on others. There isn't going to be a magic diet that works for everybody as long as people like different things and respond to them differently. The important thing is to keep trying different things until you find one that works for you.
posted by FishBike at 11:15 AM on April 5 [12 favorites has favorites]

The only thing I'm counting is the number of delicious chocolate chip cookies going into my belly!
posted by Saxon Kane at 11:21 AM on April 5 [3 favorites has favorites]

Paying attention to what you eat tends to result in healthier eating. Film @ etc.
posted by DU at 11:25 AM on April 5

Some of you guys are missing the point for the snark. This may sound like a no-brainer to you, Mr. Smart Internet Guy. Of course weight loss does not equal health all by itself, Ms. Snarky McSnarkerson.

There's a billion-dollar industry out there marketing the concept that eating X will result in losing weight. The people they are marketing to don't listen to you, Mr. Smart Internet Guy. They're listening to HER. And HIM. And these jokers over here.

No way, I can meet Courtney Thorne-Smith...? Tell me how!

So, the notion explained in the article is a giant harpoon aimed squarely at these snake-oil pedders.

This a colossal failure on the part of the New England Journal of Medicine to properly frame their research for public consumption.

They need better PR. Which headline is more compelling?

Study Zeroes In on Calories, Not Diet, for Loss

OR ...

Medical Journal: Oprah's Diet is a 'Double Scoop of Bullshit'

How about a quote?

“It really does cut through the hype,” said Dr. Frank M. Sacks ... “It gives people lots of flexibility to pick a diet that they can stick with.”

OR ...

“Oprah, Dr. Phil, Atkins, Ornish? A bunch of braying jackasses,” said Dr. Frank M. Sacks ... “All they're selling is a giant waste of time and money. If they've helped anyone, it's been purely by accident.”
posted by Cool Papa Bell at 11:47 AM on April 5 [14 favorites has favorites]

When I lost weight, I even had a poptart with my Kashi Golean in the mornings...it was about portion control, plenty of water, and upping my veggie intake while being mindful of everything else. That and no snacking, which got me out of the habit of mindless emotional eating.
posted by St. Alia of the Bunnies at 11:54 AM on April 5

In the mid 1990's I was working as a pharmacist here in Seattle. Pharmacists learn to expect every sort of question under the sun, but when you get asked the same question again and again, it stands out. People started coming in asking for "lipolysis test strips". This being the mid 1990's, the Internet was still in the bronze age, and I couldn't just google up the answer, because as far as I knew, there was no such thing as "lipolysis test strips".

Eventually I got lucky, as some gal brought in a book that listed the term, and suddenly it all made sense. Dr. Atkins Diet Revolution.This is where all these questions were coming from!

This actually made me angry, as evidently Dr. Atkins was indeed a real doctor, and should have known that there was NO SUCH THING AS LIPOLYSIS TEST STRIPS! What he meant was a product known as Ketostix by Bayer.

When I graduated from pharmacy school in 1987, the general medical consensus was that putting your body into ketosis was a bad thing. As I read the Wikipedia entry of 2009 on Ketosis I gather that this is still the consensus, though controversial.

Ketosis would thus be a dangerous (potentially life-threatening) state which unnecessarily stresses the liver and causes destruction of muscle tissues. This is still the view of the majority in the medical and nutritional science communities[6][7][8], but in recent years it has been challenged by a number of doctors and adherents of low-carbohydrate diets, who dispute both the body's preference for glucose and the dangers associated with ketosis.

The bottom line for me was why would a doctor, who should know better, DELIBERATLY misidentify a pharmaceutical product? This struck me as the action of liar and a con man.

As far as the research mentioned in this article goes, it worked for me. Last September I decided to start eating less. I simply settled on foods that I already enjoyed, and started eating less of them. I exercised most every day. Not sure what I started out at, but I'd guess something like 230 pounds. After several months of this, I'm down to 165 pounds. One gal claims I'm now "too skinny" but I don't see the problem...

Yes, eat less of what you are comfortable eating less off for an extended amount of time.
posted by Tube at 11:56 AM on April 5 [8 favorites has favorites]

It's not so much straight up willpower as much as it is about changing habits.

By adulthood, most of us have a diet based on what we like to eat, that we can afford, that's available, and most importantly - convenient. I've just lost 10 lbs in 2 weeks, not through willpower, but because I looked up what foods are easy to cook, low calorie, and filling and stocked my pantry with them.

It's more an exercise in logistics and buying the right stuff ahead of time, before your hunger kicks in and goes straight id with it.
posted by yeloson at 11:56 AM on April 5

Not sure if the actual study accounted for it, but the article mentions nothing about how much of the weight loss was actually FAT loss. This seems kind of important.
posted by peep at 11:58 AM on April 5 [5 favorites has favorites]

What does that mean? 2,000 Calories are not the same to two people of the same height and build;

Yes they are, and this is where dieters and fat people fail. It's all energy. It's how you burn that energy, and it's a very complex system but the results are always the same: calories in vs. calories out are all you need to know. This is what separates those who are thin vs. those who aren't: accountability. You're sloughing off accountability by saying "I'm not the same as you are, that's why I'm fat." This is a bullshit argument. Getting fat is a great feedback mechanism for telling you that you're either eating too much or not burning enough.

I'm one of those people who has always struggled with weight, and I'm a distance runner who exercises a lot. I know that if I take time off and eat like all my friends, I get fatter than they do. I was a fat kind in school, up to grade 11 when I decided to start running and starve myself for 6 months. Why? Well, my metabolism is slow because I have zero muscle, I work at a desk all day, I do jack shit except run. But, when I'm running and I eat well I lose weight. I've been 135 and 5'10" (I'm a guy) and I've been up to 175 even with moderate running.

Perception is a HUGE problem in this arena, and I see a distinct difference between my fat friends and my thin friends, and it boils down to expectation. A lot of the fat people I know stare at me in disbelief that I have to run 60 miles a week just to maintain my weight and have a few beers in a week. 60 miles. That's not 30 minutes 3 times a week. That's some myth that has been perpetuated by some pencil pusher in 1955.

I go to the gym and see people on a treadmill doing 3 miles an hour reading a magazine and I know they're thinking: I'm putting in all this work, why am I not thin? I'm the guy spraying sweat on with it on 9 for an hour. That's why I'm thinner than they are. It's just work. Work and discipline to not shove shit into your mouth all the time.
posted by jimmythefish at 12:04 PM on April 5 [7 favorites has favorites]

I've just lost 10 lbs in 2 weeks, not through willpower, but because I looked up what foods are easy to cook, low calorie, and filling and stocked my pantry with them.

I hope I'm not discouraging you when I tell you that you did not, in fact, lose 10 pounds of fat in two weeks. Most of that is water weight.

Everyone saying how obvious these results are do not read the diet questions on Ask Metafilter. I am so very tired of pointing out that the only equation that matters in terms of weight loss is calories consumed - calories expended. That a particular diet may make it easier to achieve a net calorie loss or be healthier or whatever but that the basic equation doesn't change... and then having a bunch of people start going on and on about magic carbohydrates.

Thank goodness for this study.
posted by Justinian at 12:06 PM on April 5 [1 favorite has favorites]

One thing the article does mention is that every member of the study had lost weight on almost every type of diet.

It also mentioned that every member of the study regained the lost weight. This happens with people who have gastric bypass surgery, too.

I've discovered that I can weigh exactly what I want so long as I never go off the diet, that is, never eat more than 1000 calories a day for the rest of my natural life.

Fortunately, my body is smarter than my brain, as is the case for most of us.
posted by jrochest at 12:07 PM on April 5

Yes they are, and this is where dieters and fat people fail. It's all energy.

That's not true at all. Different people really do metabolize food differently and are able to extract more calories from different kinds of food. In other words, someone might eat a salad and their body might extract 50 calories, another person might extract 100 calories, or something. People have studied this.

I would imagine as you get to higher density stuff like fat and sugar, your body can probably metabolize all of it though. here is some more info
posted by delmoi at 12:19 PM on April 5 [3 favorites has favorites]

That's not true at all. Different people really do metabolize food differently and are able to extract more calories from different kinds of food. In other words, someone might eat a salad and their body might extract 50 calories, another person might extract 100 calories, or something. People have studied this.

What I'm saying is that argument is a red herring. 2000 calories is the same thing whether I eat it or you eat it. If I get rid of it by whatever means I get rid of it, I won't get fat. Trying to figure out how and why I extract food more efficiently from my gut is a total waste of time in that you can't do anything useful with that information. The way you'll get thin is the same: eat less, or exercise more. I'll repeat that:

Eat less, or exercise more.

You can't look at other people and cry foul.
posted by jimmythefish at 12:24 PM on April 5 [1 favorite has favorites]

People metabolize foods differently...but it's more based on your current body composition than genetics. In fact if I put on 100lbs of fat I will have a higher basal metabolism than I do now because those fat cells have their own metabolic requirements.
posted by fraxil at 12:33 PM on April 5 [1 favorite has favorites]

[(energy in) - (energy spent)] * (adjust for your metabolism here) = [energy stored]. For negative values of [energy stored], loss occurs. That is all ye know on Earth, and all ye need to know.
posted by Avelwood at 12:38 PM on April 5

Damn, tube, lookin good.
posted by Slarty Bartfast at 12:39 PM on April 5

Eat less, or exercise more.

It's not that simple and the insistence on repeating that mantra doesn't help.

At this point, especially in American society, doing the above requires massive shifts in behaviors, attitudes and thinking on societal (can we ban high fructose corn syrup, please?) and individual (do you really know many calories are in that cheeseburger?) level. People aren't machines and won't simply switch or change these things on a dim. It takes work and effort which is the last thing people won't to hear on a good, let alone when they have high stress job, kids and fear of losing their job.

Eating less and exercising more does work, but like I said above, lots of people don't understand nutrition or how to exercise, so sitting there an yelling "eat less and exercise more" won't work.
posted by Brandon Blatcher at 12:39 PM on April 5 [5 favorites has favorites]

Not sure if the actual study accounted for it, but the article mentions nothing about how much of the weight loss was actually FAT loss. This seems kind of important.

You're right but if you look at one of the panels you'll see that (for example) the high-protein group that completed the study lost (eyeballing) 4.5 kg and 6.5 cm. Which (for those of us who don't hate freedom) is the same as 10 lbs and 2.5 inches. I have no expertise but I find that number staggering. My weight fluctuates a good deal but never in my life has 10 pounds on my scale equated to 2.5 inches on my waist. My uneducated guess is for the relationship in the study to hold, the lost weight has to be nearly entirely fat.
posted by Kwantsar at 12:45 PM on April 5 [1 favorite has favorites]

What I'm saying is that argument is a red herring. 2000 calories is the same thing whether I eat it or you eat it

No, the argument is not a red herring. Read what I linked too. If person A eats the same thing as person B person A may get more calories out of it. But when people count calories they don't count the actual calories their bodies metabolize, they count estimates, which are the same for everyone.

So it is literally not the case that 2000 "calories" as measured on the nutrition information is the same thing as. it is literally not the same thing. Obviously eating "less" is good, but for some people eating "less" by switching to a different kind of food (salad rather then candy bars) won't actually end up with as much of a reduction as they would expect.

Look, I think that anyone can lose weight by eating less and excersizing, sure. And I'm sure that for the vast majority of people standard calorie estimates are pretty accurate. But to say that 2000 calories is exactly the same for all people is actually factually wrong. It's just incorrect to say. Like saying the planet is square or something. It's just false has nothing to do with any argument or excuse. It's just factually wrong.
posted by delmoi at 12:54 PM on April 5 [4 favorites has favorites]

If person A eats the same thing as person B person A may get more calories out of it.

YES!
So... maybe looking at Caloric intake isn't necessarily the end-all-be-all of regulating your diet?
posted by Avelwood at 12:59 PM on April 5

I believe what jimmythefish was saying is that if person A and person B both eat the same amount of calories, and person A maintains weight while person B needs to run 60 miles a week to maintain weight, that doesn't matter because SUFFER, FATTY!
posted by fleacircus at 1:07 PM on April 5 [1 favorite has favorites]

I believe what jimmythefish was saying is that if person A and person B both eat the same amount of calories, and person A maintains weight while person B needs to run 60 miles a week to maintain weight, that doesn't matter because SUFFER, FATTY!

I would point them to this. One's body sems to find a "comfort zone." Getting out of it seems to be the problem.
posted by Avelwood at 1:14 PM on April 5

So, let's stop using that as one of those cheap lead-ins to the inevitable "YOU HAVE NO EXCUSE FOR YOUR FATNESS, DO YOU, FATTIE?" argument.

Thats the unfair statement here, not the physics statement.

The physics saying exists because people are taught by con artists that they can go on crazy diets that involve no calorie counting or calorie restriction. They have been told endlessly that they can eat whatever they want as long as they have some kind of enema or they can still continue to eat their fatty foods.

In reality, its calories in vs calories spent. There is no shortcut. Either you accept the physics or you gain wait. Your choice.

But when people count calories they don't count the actual calories their bodies metabolize, they count estimates, which are the same for everyone.

So what? Part of counting calories is figuring out at what level you gain weight. So for me its around 2400 calories but for my gf its 2000. Its personal in all cases. Physics wins again.
posted by damn dirty ape at 1:14 PM on April 5

Yeloson, you did not lose 10 pounds of fat in 2 weeks, unless you somehow managed to create a daily deficit of 2,500 calories per day for 14 days, and then somehow made sure that the entire deficit was powered by burned fat (instead of muscle). ( 2,500 * 14 = 35,000 = 3,500 * 10 ).

Almost certainly you lost less weight and you were misinformed by the daily fluctuations of water weight. You need a running weighted average to smooth this out so you can determine your "real" weight.
posted by reishus at 1:15 PM on April 5

Look, I think that anyone can lose weight by eating less and excersizing, sure. And I'm sure that for the vast majority of people standard calorie estimates are pretty accurate. But to say that 2000 calories is exactly the same for all people is actually factually wrong. It's just incorrect to say. Like saying the planet is square or something. It's just false has nothing to do with any argument or excuse. It's just factually wrong.

Yup, and what I'm saying is that this fact doesn't contain any useful information.
posted by jimmythefish at 1:16 PM on April 5

So... maybe looking at Caloric intake isn't necessarily the end-all-be-all of regulating your diet?

I think what the "see, the laws of physics do apply" camp (which includes me) is trying to say is that ultimately, losing weight does boil down to taking in fewer calories than you use.

The discussion of differences in the way people metabolize food, which is interesting and certainly new to me, seem to be arguing against the notion that a simple formula can tell you how many calories you should eat. Calorie content information is supposed to be adjusted to account for how much is absorbed, but obviously can't be adjusted 100% accurately if that varies from person to person.

The main point of the article seems to be that there is no magic diet that makes people lose weight without reducing calories. When these diets are successful, it's because they have calorie reduction as one of their side-effects, so to speak, not that there is some huge difference of metabolism that makes a high-protein (or high-carb or even high-fat) diet better for weight loss.

I guess I do actually agree with your comment. Although calorie reduction (or better: a more favorable energy balance) is ultimately the key to weight loss, counting calories is not necessarily the most effective way for everyone to achieve that. I'm just rejecting the notion that energy balance doesn't apply at all.
posted by FishBike at 1:18 PM on April 5

It blows my mind that shit like this is even news. Whats wrong with people? I mean, we're still battling creationism in schools and we still dont accept that fatty foods make us fat.
posted by damn dirty ape at 1:18 PM on April 5

So... maybe looking at Caloric intake isn't necessarily the end-all-be-all of regulating your diet?

Argh. IT IS. If you eat X calories and you're fat, you're gonna have to experiment with your diet, EAT LESS and re-assess. Why is this so hard?
posted by jimmythefish at 1:21 PM on April 5

I mean, we're still battling creationism in schools and we still dont accept that fatty foods make us fat.

What's fatty food and how much of it should be eaten?
posted by Brandon Blatcher at 1:28 PM on April 5

we still dont accept that fatty foods make us fat.
Surely you meant caloric foods, right? Cuz otherwise, rtfa.
posted by fleacircus at 1:29 PM on April 5 [1 favorite has favorites]

Filing under "Duh."
posted by Fuzzy Skinner at 1:32 PM on April 5

do you really know many calories are in that cheeseburger?

I've started paying more attention to my food intake lately, and one thing I've found useful is traffic light labelling that appears on a lot of supermarket food in the UK nowadays. You can quickly see how much fat, salt, sugar etc you're getting and how it compares to your daily RDA. It seems like widespread and consistent adoption of that could do a lot to help people see what/how they're eating in a simple way, without having to relate it to any particular diet plan.
posted by Drexen at 1:34 PM on April 5

... and to relate my comment to the article, companies that adopt that system on their packaging usually put the number of calories on there fairly clearly as well. That way you can both monitor your calorie intake and the "quality" of those calories.
posted by Drexen at 1:38 PM on April 5

So... maybe looking at Caloric intake isn't necessarily the end-all-be-all of regulating your diet?

Of course it is. If you don't lose weight on 1800 calories a day, cut back to 1600 calories. If you can't lose weight on 1600 calories a day you need to exercise more... or you're miscounting your calories.
posted by Justinian at 1:41 PM on April 5

traffic light labelling

Hey that's pretty cool. I prefer the raw numbers myself, but I can see that helping people. Haven't see it in the States though.
posted by Brandon Blatcher at 1:42 PM on April 5

> No, the argument is not a red herring. Read what I linked too. If person A eats the same thing as person B person A may get more calories out of it. But when people count calories they don't count the actual calories their bodies metabolize, they count estimates, which are the same for everyone.

I don't see how that matters. If A and B both consume a certain amount of food, and then use some general calorie amount numbers to calculate how many calories they've gotten, then it really doesn't matter if A actually got more energy out of it, because you can just see it as A requiring less calories/day than B. So you can say A and B require 2000 cal/day, and A gets 2100 cal/day and B gets 2000 cal/day from the same food. OR you can say A and B get 2000 cal/day from the food they eat, but A needs just 1900 cal/day and B 2000 cal/day.

You don't need to know how good your body is at extracting energy from food, you can get by just fine by using the numbers printed on the packets. Then you can see how much you're getting in, and you can see if you are gaining or losing weight, and based on that you can see what you need to stay the same weight.
posted by bjrn at 1:43 PM on April 5 [2 favorites has favorites]

It's very simple how to become wealthy: spend less, earn more! It's a simple matter of arithmetic and there's no magic way to beat arithmetic. The fact that some people need to spend more, or are not in a position to be able to earn as much, is not important. They're just not trying hard enough, not working enough hours, not pinching enough pennies. Probably any problems they have doing these things is because of the poor (nyuk nyuk) choices they made earlier. It's not rocket science, retards.

Poor people are unsightly and irresponsible, and frankly their excuses for not being rich are sickening. Being poor they are incurring a health risk on themselves, it's not like it's okay to be poor. I like my art, my fiction, and my social life to not include poor people except as objects of ridicule--but that goes without saying; in fact I'm not really conscious of it. It's okay to despise them because they chose to be that way. They are self-criminals. I guess I'm just in the common-sense camp with arithmetic and personal responsibility! And I think I'm lookin' pretty good.

Oops sorry! Wrong thread.
posted by fleacircus at 1:45 PM on April 5 [38 favorites has favorites]

You don't need to know how good your body is at extracting energy from food, you can get by just fine by using the numbers printed on the packets. Then you can see how much you're getting in, and you can see if you are gaining or losing weight, and based on that you can see what you need to stay the same weight.

This is what I was trying to say, only you said it better. Caloric intake is the end-all and be-all because you don't need to know if you're "really" eating 2000 calories, only whether or not you are losing weight while eating what appears to be 2000 calories based on the packaging. And adjusting your consumption/exercise accordingly.
posted by Justinian at 1:46 PM on April 5 [1 favorite has favorites]

It blows my mind that shit like this is even news. Whats wrong with people? I mean, we're still battling creationism in schools and we still dont accept that fatty foods make us fat.

Well the funny thing is that the conclusion of the article is precisely the opposite of your statement: "By 2 years, weight loss remained similar in those who were assigned to a diet with 15% protein and those assigned to a diet with 25% protein (3.0 and 3.6 kg, respectively); in those assigned to a diet with 20% fat and those assigned to a diet with 40% fat (3.3 kg for both groups); and in those assigned to a diet with 65% carbohydrates and those assigned to a diet with 35% carbohydrates (2.9 and 3.4 kg, respectively) (P>0.20 for all comparisons)." 'Fatty foods' don't make us fat, excess calories do. (Or, just to be pedantic about it: eating less fat won't necessarily make you skinny, but eating fewer calories will).

I agree with the sentiment about creationism in schools, FWIW.
posted by googly at 1:47 PM on April 5

Yeah; fatty foods don't make you fat. Lots of calories makes you fat and fatty foods are high in calories. But in terms of weight loss it matters little if you eat 2000 calories of butter or 2000 calories of spinach. It's a lot easier to eat 2000 calories of butter than 2000 calories of leafy vegetables is all.
posted by Justinian at 1:51 PM on April 5

Why is this so hard?

I don't know. I've never tried to run sixty miles every week, since I would rather pig out on chips and play video games while my ass slowly expands*, but from watching "The Biggest Loser," I know it's easy to exercise intensively when you're holding down two jobs and are already struggling to find the time of energy to fit "work," "take care of family," and "sleep" into a single day.

We already know the poor are just poor because they're lazy, so it should be obvious that they're also fatter because they're lazy, too.

* A total lie. Being fat is shameful, so I must point out in a footnote that I'm not actually fat, although that is a fairly accurate representation of my activity level once after my twelve to sixteen hours a day of stuff I have to do. The willpower I put into maintaining a healthy weight: precisely zero.
posted by Kutsuwamushi at 2:03 PM on April 5

FishBike:
I think a more useful way to look at it is that different people require different amounts of willpower to eat healthy and exercise more. So the problem is not so much that one person has less willpower than another, but that one person needs more of it than another, due to different levels of drive to eat or exercise, past history, and so on. And then the focus can be shifted from "I am weak-willed compared to those people" to "I have greater challenges compared to those people".

Yes. These diet threads interest me, because I seem to have "low drive for eating", much like some people have low drive for sex. I am curious about people who feel so strongly about eating and having to eat. Sometimes I forget to eat. Snacks are not worth the hassle. Sometimes I feel grumpy and then understand that oh yeah, that's because I'm hungry and been hungry for five hours. Better have a cookie. Of course, I'm also thin. Strict diets wouldn't require much willpower for me, as the habit I'd be changing is just not that important.

Is personal response to hunger an innate feature or a learned habit? Can a person change to be less and less interested in food and satisfying hunger? It could be that adding other rituals that have personal importance (calculating calories) to eating shifts the focus slowly from actual eating to that other activity, and that other activity has a positive feedback cycle going on. Much like it is suggested that effective way to handle pain is to not try to ignore it, but examine it in curious and analytic fashion. Calculating calories or dietary planning could do the same for hunger. Or lead to an eating disorder.
posted by Free word order! at 2:14 PM on April 5 [2 favorites has favorites]

Have any studies been done on the satiety value of foods? The real holy grail here is the foods that curb appetite.
posted by crapmatic at 2:14 PM on April 5 [1 favorite has favorites]

Secondly, just because something "seems obvious" doesn't mean you shouldn't actually check it. I mean what if it had turned out not to be the case? And just because you verify common sense doesn't mean you shouldn't publish your results so other people are aware of it.

Hear, hear. Wired Science used to have a great feature on obvious science, but sadly they don't seem to do it anymore.
posted by homunculus at 2:42 PM on April 5

As has been mentioned, counting calories is important, but you only need them as a relative measure, not an absolute. There is no way that you can say "if everyone eats 1500 calories they'll lose 1 pound a week." What you can do is note what you eat, weigh yourself over time, take a rolling average, and then look at what it says. You might get "1500 calories makes me lose nothing" or "1500 calories makes me lose 3 pounds a week." Once you have that information you can plan your diet around it.
posted by maxwelton at 2:43 PM on April 5 [1 favorite has favorites]

My cat can't count so this explains a lot. Thanks.
posted by grounded at 2:51 PM on April 5 [1 favorite has favorites]

CF the Hacker's Diet.
posted by swift at 2:52 PM on April 5

I have two indoor cats. They live similar lives of relative inactivity. Only one is fat.
posted by jfrancis at 2:54 PM on April 5 [1 favorite has favorites]

Being fat is shameful

Harsh.
posted by turgid dahlia at 3:50 PM on April 5

It's very simple how to become wealthy: spend less, earn more!

Annual income twenty pounds, annual expenditure nineteen pounds nineteen and six, result happiness. Annual income twenty pounds, annual expenditure twenty pounds ought and six, result misery.

Yes, damnit, the same principles apply to eating, people. The big question mark is simply the expenditure of calories. The fates can conspire to ensure someone has an incredibly low metabolism just as they can conspire to keep someone from employment. But the other side of the equation can be controlled. You can scrimp and save when unemployed, and you can reduce your food intake if you have low metabolism and low musculature.

Just because random factors influence one half doesn't mean a person can abdicate responsibility. Conversely, I think most people here recognize that there are limits to what can be achieved with sheer willpower.

Any personal finance site will first ask a person to actually write down all of their expenditures and try to live on a fraction of that. Dieting is no different, except that people can't as easily do the math.
posted by FuManchu at 3:55 PM on April 5 [1 favorite has favorites]

Free word order!, you might be interested in Mindless Eating: Why We Eat More Than We Think by Brian Wansink. The main conclusion is that most of us eat however much food is put in front of us, regardless of how hungry we are, how good it tastes, or anything that should make sense. (It's not a diet book, although the author gives some useful suggestions for losing weight - or gaining it, if that's your need.) It's well-written and entertaining, describing some truly fiendish experiments that show that most of us eat on autopilot and have no real idea of how much we shove into the ol' piehole.

Wansink's neatest idea about dieting is consistent with the study cited in the FPP - reduce your caloric intake. He suggests about 100 - 200 calories per day because you won't even miss this amount, so you won't feel deprived, so you're more likely to actually stick with the plan. Doesn't matter what you eat or cut out here, just ditch the calories and the weight will slowly fall off. Basically, you're just reversing the way you (probably) gained the weight in the first place: you ate about 100 - 200 calories more than you burned per day, over many weeks, and although you didn't notice the overeating, it added up. Physics FTW.
posted by Quietgal at 5:04 PM on April 5 [1 favorite has favorites]

I go to the gym and see people on a treadmill doing 3 miles an hour reading a magazine and I know they're thinking: I'm putting in all this work, why am I not thin? I'm the guy spraying sweat on with it on 9 for an hour. That's why I'm thinner than they are. It's just work. Work and discipline to not shove shit into your mouth all the time.

So not only does your diet-and-exercise plan make you thin, but it also gives you a smug sense of superiority and the ability to read the minds of fat slobs? Truly amazing. Sign me up!
posted by lunasol at 5:17 PM on April 5 [5 favorites has favorites]

... it also gives you a smug sense of superiority and the ability to read the minds of fat slobs? Truly amazing. Sign me up!

Wow. Ad hominem, Ignoratio elenchi AND an appeal to ridicule, all wrapped up into one tasty morsel!

That's a dipshit hat trick!
posted by Cool Papa Bell at 5:39 PM on April 5 [5 favorites has favorites]

Have any studies been done on the satiety value of foods? The real holy grail here is the foods that curb appetite.

I've heard (don't know where) that one of the primary roles fat plays in a diet is to curb hunger (aside from being delicious, of course).
posted by abc123xyzinfinity at 6:04 PM on April 5

So... maybe looking at Caloric intake isn't necessarily the end-all-be-all of regulating your diet?

Argh. IT IS. If you eat X calories and you're fat, you're gonna have to experiment with your diet, EAT LESS and re-assess. Why is this so hard?

I think what is being said is that this is an insufficient measure.

--Anecdotal Evidence
I can eat pretty much nothing but starches (lots of pasta!) for a long time. My system metabolizes it well, and I barely hang on to being in the "normal" body weight category. Other people cannot do this. Some people metabolize starches differently.
--End anecdotal evidence

Simply measuring the caloric content of foods is a way of measuring energy intake, but it isn't applicable to everyone equally.
posted by Avelwood at 6:10 PM on April 5

Weight loss != fat loss. A serving of protein will help create more muscle than a calorically equivalent serving of pasta. That muscle creates a bigger snowball rolling down the weight loss hill.
posted by jbickers at 6:52 PM on April 5

The Satiety Index ranked how filling different foods are (given a fixed-calorie portion) in comparison to white bread. For example, they found boiled potatoes to be one of the most filling foods.

I can't find the N for the study listed on the web site, though I suspect it was small.
posted by pengale at 7:03 PM on April 5

I think boiling it down to "Calories In Calories Out" is somewhat disingenuous. Sure, you can lose weight on 1500 calories worth of pastries, but you will feel like shit and be hungry all the time. A lower-carb, high-fat, high-protein diet that is full of lean meats, healthy fats, and green vegetables will lead to a weight-loss experience that is healthier and more satisfying.
posted by schroedinger at 7:08 PM on April 5 [1 favorite has favorites]

This a colossal failure on the part of the New England Journal of Medicine to properly frame their research for public consumption.

No it isn't. The NEJM is not Consumer Reports.

"Oprah, Dr. Phil, Atkins, Ornish? A bunch of braying jackasses," said Dr. Frank M. Sacks ... "All they're selling is a giant waste of time and money. If they've helped anyone, it's been purely by accident."

Yes, exactly the way to increase the credibility of the science published in the NEJM, which by the way is already severely compromised because of their failure to deal with pharmaceutical-subsidized research.

The Times article in the original post named names. It was a good article, good coverage, you can expect CNN to pick up the story soon. Tara Parker-Pope does a great job. Other science journalists should take the baton. Let the NEJM publish the best science they can, as isolated as possible from commercial interests.
posted by cogneuro at 7:35 PM on April 5

The NEJM is not Consumer Reports.

Come down out of the ivory tower.

The NEJM is part of the Massachusetts Medical Society. Their mission statement is:

"...to do all things as may be necessary and appropriate to advance medical knowledge ... for the health, benefit and welfare of the citizens of the Commonwealth."

They're not doing a good job of it if this is the end result of their public outreach. I'll exaggerate to make my point, but this is akin to discovering that Common Product XYZ causes instant death in children, then issuing a press release that reads, "Delta of Morbidity Curve in Pre-Adolescents Associated with Farbletygukaline Oxide Steepens Greatly."
posted by Cool Papa Bell at 8:25 PM on April 5 [1 favorite has favorites]

I've never had a problem with weight gain, so I never really though about it, but the angle about how different people have different efficiencies in extracting calories from food is really interesting.

If we take this idea a little further; what if different people have different efficiencies in extracting calories from different kinds of food?

One example comes to mind - fibre. Polished white rice, when eaten, will result in a rapid blood sugar spike. Maybe adding fibre to the diet will a) delay starch -> sugar and b) impair caloric extraction (ie., lots of herbivores who eat high-fibre feed will 'extrude' grains whole. Whole enough that people can recover calorically positive grains from animal feces (see; Japanese invasion of China).

So in developing a 'diet,' perhaps figure out what kinds of foods one has the hardest time extracting calories from (while still being able to extract other micronutrients) or to supplement one's diet with food that inhibit one's digestive ability to generally extract raw calories from "easy" food...?

Hmm, based on comments in this thread; fresh, whole, leafy, green, fibrous vegetables, replacing other foods seem to yield positive results.
posted by porpoise at 8:28 PM on April 5

cogneuro has a valid point that and I contend that it isn't a point from an 'elitist view'.

NEJM isn't Consumer Report and their (NEJM's) intended audience are not consumers (ugh - every so often I hear 'consumer' being substituted for 'citizen' which was substituted for 'ma'am/sir' or 'mister/missus') but, rather, medical practitioners and research scientists.

If there's criticism to be thrown at, it should be at medical schools to better teach their general/family practitioners how to serve their clients* better which would include instilling GPs in keeping up with literature and how they can more effectively communicate with their clients*

* in countries with universal healthcare, read: patients
posted by porpoise at 8:35 PM on April 5

A long excerpt from Taubes' article "The Scientist and the Stairmaster":

For the last 60 years, researchers studying obesity and weight regulation have insisted on treating the human body as a thermodynamic black box: Calories go in one side, they come out the other, and the difference (calories in minus calories out) ends up as either more or less fat. The fat tissue, in this thermodynamic model, has nothing to say in the matter. Thus the official recommendations to eat less and exercise more and assuredly you’ll get thinner. (Or at least not fatter.) And in the strict sense this is true—you can starve a human, or a rat, and he will indeed lose weight—but that misses the point. Humans, rats, and all living organisms are ruled by biology, not thermodynamics. When we deprive ourselves of food, we get hungry. When we push ourselves physically, we get tired.

Our bodies, like all living organisms, have evolved a fantastically complex web of feedback loops. These physiological mechanisms serve fundamentally to work against the inevitable pull of thermodynamics (which is entropy, a.k.a. death) and so make life possible. The necessary condition of life, as the great French physiologist Claude Bernard noted 140 years ago, is to keep the internal environment of an organism stable and conducive to life, regardless of what’s happening on the outside. This is what the Harvard physiologist Walter Cannon, in the thirties, called homeostasis—or the “wisdom of the body,” as he put it. “Somehow the unstable stuff of which we are composed,” Cannon wrote, “had learned the trick of maintaining stability.”

The key is that among the many things regulated in this homeostatic system—along with blood pressure and blood sugar, body temperature, respiration, etc.—is the amount of fat we carry. From this biological or homeostatic perspective, lean people are not those who have the willpower to exercise more and eat less. They are people whose bodies are programmed to send the calories they consume to the muscles to be burned rather than to the fat tissue to be stored—the Lance Armstrongs of the world. The rest of us tend to go the other way, shunting off calories to fat tissue, where they accumulate to excess. This shunting of calories toward fat cells to be stored or toward the muscles to be burned is a phenomenon known as fuel partitioning.

The job of determining how fuels (glucose and fatty acids) will be used, whether we will store them as fat or burn them for energy, is carried out primarily by the hormone insulin in concert with an enzyme known technically as lipoprotein lipase—LPL, for short. (Sex hormones also interact with LPL, which is why men and women fatten differently.)

In the eighties, biochemists and physiologists worked out how LPL responds to exercise. They found that during a workout, LPL activity increases in muscle tissue, and so our muscle cells suck up fatty acids to use for fuel. Then, when we’re done exercising, LPL activity in the muscle tissue tapers off and LPL activity in our fat tissue spikes, pulling calories into fat cells. This works to return to the fat cells any fat they might have had to surrender—homeostasis, in other words. The more rigorous the exercise, and the more fat lost from our fat tissue, the greater the subsequent increase in LPL activity in the fat cells. Thus, post-workout, we get hungry: Our fat tissue is devoting itself to restoring calories as fat, depriving other tissues and organs of the fuel they need and triggering a compensatory impulse to eat. The feeling of hunger is the brain’s way of trying to satisfy the demands of the body. Just as sweating makes us thirsty, burning off calories makes us hungry.

This research has never been controversial. It’s simply been considered irrelevant by authorities, all too often lean, who have been dead set on blaming fatness on some combination of gluttony, sloth, and perhaps a little genetic predisposition thrown in on the side. But contemplating the means by which we might lose weight without considering the hormonal regulation of fat tissue is like wondering why children grow taller without considering the role of growth hormones. Or, for that matter, like trying to explain the record-breaking triumphs of modern athletes—Barry Bonds, say—and never considering the possibility that steroid hormones (or human growth hormone or insulin) might be involved.

If it’s biology, and not a lack of willpower, that explains why exercise fails so many of us as a weight-loss tool, then we can still find reason for optimism. Since insulin is the primary hormone affecting the activity of LPL on our cells, it’s not surprising that insulin is the primary regulator of how fat we get. “Fat is mobilized [from fat tissue] when insulin secretion diminishes,” the American Medical Association Council on Foods and Nutrition explained back in 1974, before this fact, too, was deemed irrelevant to the question of why we gain weight or the means to lose it. Because insulin determines fat accumulation, it’s quite possible that we get fat not because we eat too much or exercise too little but because we secrete too much insulin or because our insulin levels remain elevated far longer than might be ideal.

To be sure, this is the same logic that leads to other unconventional ideas. As it turns out, it’s carbohydrates—particularly easily digestible carbohydrates and sugars—that primarily stimulate insulin secretion. “Carbohydrates is driving insulin is driving fat,” as George Cahill Jr., a retired Harvard professor of medicine and expert on insulin, recently phrased it for me. So maybe if we eat fewer carbohydrates—in particular the easily digestible simple carbohydrates and sugars—we might lose considerable fat or at least not gain any more, whether we exercise or not. This would explain the slew of recent clinical trials demonstrating that dieters who restrict carbohydrates but not calories invariably lose more weight than dieters who restrict calories but not necessarily carbohydrates. Put simply, it’s quite possible that the foods—potatoes, pasta, rice, bread, pastries, sweets, soda, and beer—that our parents always thought were fattening (back when the medical specialists treating obesity believed that exercise made us hungry) really are fattening. And so if we avoid these foods specifically, we may find our weights more in line with our desires.

As for those people who insist that exercise has been the key to their weight-loss programs, the one thing we’d have to wonder is whether they changed their diets as well. Rare is the person who decides the time has come to lose weight and doesn’t also decide perhaps it’s time to eat fewer sweets, drink less beer, switch to diet soda, and maybe curtail the kind of carb-rich snacks—the potato chips and the candy bars—that might be singularly responsible for driving up their insulin and so their fat.
posted by mecran01 at 9:10 PM on April 5 [5 favorites has favorites]

I'll exaggerate to make my point, but this is akin to discovering that Common Product XYZ causes instant death in children, then issuing a press release that reads, "Delta of Morbidity Curve in Pre-Adolescents Associated with Farbletygukaline Oxide Steepens Greatly."

So, are you saying that a highly technical medical journal should write all their articles at a level that people who have no training in medicine or research or really science of any kind will understand, while simultaneously making them useful for people actually working in the field?

Do you understand the purpose of a research journal?
posted by dirigibleman at 9:21 PM on April 5 [1 favorite has favorites]

I have a particular perspective on this issue: used book-store owner.

A decade ago I bought a used bookstore in a small town; it came with a stock of books from all eras. One particular section was about dieting and it had books from the 50's on up.

An interesting thing I noticed is that the first diet books said *exactly the same things* that the latest modern study based books say. Basically nothing has changed in over 50 years but marketing slogans. Every lose-weight fast angle you see today had a predecessor from decades before.

Now, I think when the diet craze took off back then, the number of truly fat people was less than now and being thin was more about fashion than health. It sort of looks like the obesity epidemic in America trails the diet craze. The more books written about dieting, the fatter Americans got! I'm not necessarily saying that diets cause obesity, but it does appear that the correlation is reverse of what one might expect.

In any event, those that say that the solution to weight problem is obvious because 'energy in=energy out' are ignoring decades of evidence that this long known 'solution' has had no positive impact on actual rates of obesity?
posted by Osmanthus at 9:22 PM on April 5

Actually, it's us guys in the "ivory tower" who DO the studies.

The editors at the NEJM cannot possibly do a competent job evaluating all the societal implications of the studies they publish. I would rather see topics like diets handled by Consumer Reports or Michael Pollan. The NEJM editors have their hands full publishing a journal that isn't corrupted by industry-funded studies.
posted by cogneuro at 11:22 PM on April 5

I'm the skinny kid. People (including myself) used to be completely amazed that I would routinely eat two dinners and not gain weight.

It wasn't until I actually started thinking yeah, WTF is up with that anyway (which took many, many years) that I noticed I was just like Free Word Order! above - I never really thought about food until I was starving, then ate. Sure, I'd eat a huge dinner, but that accounted for nearly all of my caloric intake that day.

Other friends of mine are actually trying to lose weight, and going through lots of agony choosing the right things off of menus and such (when we go out). It doesn't help, because they're grazing all day anyway.

I guess what I'm saying is, what the study said. But it's not obvious to everybody.
posted by ctmf at 2:17 AM on April 6

In any event, those that say that the solution to weight problem is obvious because 'energy in=energy out' are ignoring decades of evidence that this long known 'solution' has had no positive impact on actual rates of obesity?

No, the solution remains the same. Those people saying that energy in = energy out are correct because it's simple physics. The reason so many people are fat is that eating less than you burn is very hard to do.

This is one of those situations where the rubber really does hit the road, and you can't hide behind it. For the vast majority of us who don't have severe health problems, if you want to be thin, it's just eating less or exercising more. It's hard, slow, boring and often requires a major life change. But, it's something you can't hide behind. Until you really arrive at that point you won't be able to get thinner, and no amount of bargaining or rationalization is going to change that fact.
posted by jimmythefish at 5:54 AM on April 6

The body isn't ruled by simple physics--it is ruled by hormones and other complex interactions. I would take issue with the "vast majority" portion of your claim. Exercise is important and good in all kinds of ways, but it is not going to affect everyone the same.

Again, from Taubes article on exercise, linked above: "My favorite study of the effect of physical activity on weight loss was published in 1989 by a team of Danish researchers. Over the course of eighteen months the Danes trained nonathletes to run a marathon. At the end of this training period, the eighteen men in the study had lost an average of five pounds of body fat. As for the nine women subjects, the Danes reported, “no change in body composition was observed.” That same year, F. Xavier Pi-Sunyer, then director of the St. Luke’s–Roosevelt Hospital Obesity Research Center in New York, reviewed the studies on exercise and weight, and his conclusion was identical to that of the Finnish review’s eleven years later: “Decreases, increases, and no changes in body weight and body composition have been observed,” Pi-Sunyer reported."
posted by mecran01 at 6:55 AM on April 6

The body isn't ruled by simple physics

What type of physics then? Newtonian physics? Quantum physics? Hormones plus exercise plus absorption rates plus mood plus what's on Oprah plus what colour the sky is plus how many kids you have plus how much work you have to do = calories burned. I don't give a shit how you do it, it's burning and it's up to the individual. It's physics. Burning calories = losing weight. If you're not changing your body composition you're taking in as much as you're burning. The marathon example is a perfect example. Odds on these people were eating more when running more.

Under conventional dieting wisdom people in concentration camps in WW2 and 80s Ethiopians would have been little fatties because 'calorie deprivation = starvation mode'. Yeah, right.
posted by jimmythefish at 7:17 AM on April 6

"Starvation mode" has very little science behind it. If you've cut down on your calories and are not losing weight, it may be because you're getting more calories that you realize (it's a pretty rough science) or because you've reached a typical plateau and your weight loss will resume in a week or so (you may still be burning fat even if your scale shows no weight loss; even something like eating more salt before you weight yourself can dramatically skew what the scale says), or because you actually need less calories than you imagine, and should adjust your diet according. "Starvation mode" is one of the great bugaboos of the diet scene, but it wouldn't kick in until you're actually starving -- that is, when your body has worked its way through all your fat and started to consume muscle -- and, in studies with anorexics, they have found starvation sometimes actually speeds up their metabolism, which is the opposite of the supposed "starvation mode."

In actual studies, the less calories you consume, the faster you lose weight, across the board. Sometimes people lose less than the rough math of calories to weight loss might suggest, but this does not necessarily indicate that some mythical "starvation mode" has kicked in. People tend to underestimate the amount they eat and overestimate the amount they exercise by as much as 30 percent. That seems a likelier culprit.

Weight loss isn't easy, because it takes time, and, generally, the amount you will be reducing your calories won't really be that much below what you need to maintain your weight, so little snacks here or there, or misinterpreting the amount of calories a food contains (easily done), or decreasing the amount of exercise you do, can deter weight loss. But, generally, if you get a good rough estimate on how many calories you need to support your current weight, and go below it by twenty percent or so, approximately, you will slowly but constantly lose weight over time, until you reach the weight that is supported by your new caloric intake. It's all rough, and adjustments need to be made as you see how the diet works for you, but counting calories works.
posted by Astro Zombie at 8:41 AM on April 6

Under conventional dieting wisdom people in concentration camps in WW2 and 80s Ethiopians would have been little fatties because 'calorie deprivation = starvation mode'. Yeah, right.

I never said anything about starvation mode. Here's a shortened version: "Over the course of eighteen months the Danes trained nonathletes to run a marathon. At the end of this training period, the eighteen men in the study had lost an average of five pounds of body fat. As for the nine women subjects, the Danes reported, “no change in body composition was observed.”"

So you're saying the men didn't cheat, and the women did, by secretly eating more?
posted by mecran01 at 9:21 AM on April 6

So you're saying the men didn't cheat, and the women did, by secretly eating more?

I'm saying that they ate what they burned, and the men ate less than they burned. Or, they didn't measure body composition properly (ie fat was traded for muscle and they didn't account for that effectively). Or, their actual activity levels didn't change as a result of their marathoning - ie they stopped walking/riding in favour of their running.

Are you proposing a revision to the laws of conservation of energy and mass? Because that's what you're essentially saying. To say this another way, you're talking bogus nonsense.
posted by jimmythefish at 9:43 AM on April 6

I'll be back.
posted by mecran01 at 12:32 PM on April 6

Of course its "physics", its just not simple physics. There are all sorts of feedback loops and nonlinear responses and local minima and maxima, complicated by the fact that the system is running in an entirely different environment than it was originally optimized for and is fighting attempts at changing the inputs.

We like to think that we're in control of our bodies, but we really aren't. You can try to reason your way into "don't blink" as long as you like, but eventually you're going to blink. Some people need to blink sooner. Are they just weak-willed?

Similarly, some people are more easily addicted to nicotine than others. I'm lucky in that regard, I can smoke as much as I want, and then not smoke for a year, without feeling any cravings whatsoever.

But put a ginormous bag of salt and vinegar potato chips in front of me, and I'll eat the whole thing. Sure, I'll tell myself I should stop. And yet then I find myself sneaking another bite. And another. And then licking the greasy crumbs off my fingers.

Am I weak? That's one way of looking at it. Maybe I'm just wired to be easily addicted to the brain happy-chemicals that chips give me? Its probably a great reaction when you've just discovered a delicious wildebeeste that will be your only significant fatty meal for the next month. Modern life? Its a bit of an anachronism.

So yes, the equation of "eat less, exercise more" does indeed work. Works for me pretty well, all I really need to do is eat slowly enough that I actually notice my body's "I'm satisfied" signal, and then stop there, rather than waiting for the "I'm gorged" signal. I lost 40lbs about 6 years ago doing nothing but notching down consumption and notching up exercise. Back up about 15, working it back off again at about .5lb/week.

I've given up trying to deduce the truth in the carb connection, but I have noticed that I lose weight faster if I reduce the simple carbs. Less beer, less pizza, less pasta, less bread. Which totally sucks, because my brain happy-chemicals go off the chart with a rustic baguette from La Farine... om nom nom nom
posted by argh at 12:44 PM on April 6 [2 favorites has favorites]

Here is one of the figures from the NEJM study: http://content.nejm.org/content/vol360/issue9/images/large/05f1.jpeg.

There is an obvious trend going on here, even if it isn't quite statistically significant. I have a hunch that if the researchers looked at body fat loss instead of weight loss and waist circumferences (which is really just a proxy for fat loss), they'd find the high protein diets to be superior for fat loss -- which is really what we should be concerned about anyway.
posted by AceRock at 1:13 PM on April 6

I've given up trying to deduce the truth in the carb connection, but I have noticed that I lose weight faster if I reduce the simple carbs. Less beer, less pizza, less pasta, less bread.

Correct, and that's largely because these forms of food are highly processed and contain lots of easily consumed, easily digested and easily stored calories. I agree totally with the evolutionary aspect, and it's why we crave fat and sugar - because up until very recently we didn't get fat or sugar nearly as much as we do now (and never ate anything resembling pasta or bread or candy or chocolate) and so we're programmed to eat it all and store it as energy in order to simply survive. Recognizing this is the first step. If you just ate foods that are less calorie dense and ate like we would have eaten in hunter/gatherer times (mostly vegetables, a bit of meat and a few fruits and berries) and skipped processed high-carb food entirely it'd be much harder to eat a lot of calories, and much easier to lose weight. Again, though, it boils down to calories.

I'm not trying to be an asshole, it's just that a lot of discussions surrounding weight loss contain a lot of extraneous, irrelevant arguments centering on the individual nature of food absorption. I agree 100% that people may absorb calories more efficiently than other people, but I maintain that this is only one of the many contributors in burning calories. This study is helpful because it's telling us that only calories matter, whether they be from butter or from carrots. If you make an argument that I'm too fat because I gain weight eating X type of food and I gain weight quicker than other people, then eat less of that food until your weight is where you want it to be. If you think your body hangs on to fat when others don't and no amount of diet and exercise will change that, you're wrong. It's that you're really not burning enough. You may have to work harder than other people, but if you put the energy out and don't take as much in, weight MUST come off. It's a guaranteed, proven fact that energy must come from somewhere. Your body can't defy that. Trying to figure out the inner workings of your own body is entirely useless when really all that matters is that if you're getting fatter, eat less or burn more. Trust that basic, basic (yes basic) law of the universe that tells you that a calorie deficit MUST over time make you lose mass.
posted by jimmythefish at 6:21 PM on April 6

A lot of the low-carbers out there found bones to pick with this study, cf: the protein power writeup. I haven't done that much looking into it myself, but I will say that 35% of calories from carbs is not a low-carb diet as I know it, hell, I don't eat explicitly low-carb and I eat a lower percentage carbs than that in a given day.
posted by ch1x0r at 6:47 PM on April 6 [1 favorite has favorites]

argh You can try to reason your way into "don't blink" as long as you like, but eventually you're going to blink. Some people need to blink sooner. Are they just weak-willed?

Isn't that the whole point of a staring contest? That the person whose mind can over power their body for longer is, indeed, the possessor of the stronger will?
posted by paisley henosis at 7:14 PM on April 6

Am I weak? That's one way of looking at it.

(Hypothetically speaking) you're weak, but not in the way you're describing. Most anyone will eat chips if they have them in front of them. You're weak for putting yourself in that position in the first place. You're weak for not recognizing this. You're weak for not coming up with a plan to eat better, to exercise, to monitor your weight, to find a routine that's healthy and that you can live with. Success in something doesn't come in a vacuum, and success at something difficult requires planning, patience, consistency and dedication. The weakness is in not setting yourself up to succeed, and for not knowing yourself well enough to do so.
posted by jimmythefish at 8:19 PM on April 6

PS - and yes, I wasn't talking about you, specifically, argh. Just in general terms, for those who can't figure this out.
posted by jimmythefish at 8:23 PM on April 6

All that matters is that they are counting something.

You know who else likes to count something?
posted by Smedleyman at 8:26 PM on April 6

Ru Paul?
posted by Brandon Blatcher at 11:38 AM on April 7