The FastDay Forum

Sean C Lucan and James J DiNicolantonio. How calorie-focused thinking about obesity and related diseases may mislead and harm public health. An alternative. Public Health Nutrition, available on CJO2014. doi:10.1017/S1368980014002559.
http://journals.cambridge.org/download. ... 857fd4885c

Suppversity on Facebook reproduces a thought-provoking graphic that lists notions in the left-hand column and the challenge to them in the right-hand column: https://www.facebook.com/SuppVersity/ph ... =1&theater

Abstract: "The present commentary discusses various problems with the idea that ‘a calorie is a calorie’ and with a primarily quantitative focus on food calories. Instead, the authors argue for a greater qualitative focus on the sources of calories consumed ...and on the metabolic changes that result from consuming foods of different types.

In particular, the authors consider how calorie-focused thinking is inherently biased against high-fat foods, many of which may be protective against obesity and related diseases, and supportive of starchy and sugary replacements, which are likely detrimental....[A] central argument of the paper is that obesity and related diseases are problems due largely to food-induced physiology (e.g. neurohormonal pathways) not addressable through arithmetic dieting (i.e. calorie counting).

The paper considers potential harms of public health initiatives framed around calorie balance sheets – targeting ‘calories in’ and/or ‘calories out’ – that reinforce messages of overeating and inactivity as underlying causes, rather than intermediate effects, of obesity.

Finally, the paper concludes that public health should work primarily to support the consumption of whole foods that help protect against obesity-promoting energy imbalance and metabolic dysfunction and not continue to promote calorie-directed messages that may create and blame victims and possibly exacerbate epidemics of obesity and related diseases."

I think the arguments are familiar to a number of us and there are some interesting discussions. I liked the section about the children and the cheese v. potato chips study (fat/calories v. rapidly absorbable carbohydrates) and what it might reveal about different ways of thinking and responses as well as how they feed into reinforcement loops.

PR Web has a time-limited useful summary: http://www.prweb.com/releases/2014/11/prweb12339572.htm

NB: I think the authors are a tad trite/facile at some points (we're rarely going to be in wholehearted agreement on such topics) and I haven't checked their references to see if they've used them appropriately. I've no reason to think they haven't but I haven't checked.

I dunno. All the popular fad diets claim calories don't count. A generation of stalled Atkins dieters have learned, the hard way, how misleading that is.

Eating too much carbohydrate can make people very hungry, but it isn't the carbs, its what is eaten in response to the hunger that causes weight gain. People who have very high blood sugars will experience a significant increase in insulin resistance if they eat a lot of carbs and will find it much easier to lose weight if they cut back on them, but again, I haven't seen anything to suggest that the weight loss is caused by anything except cutting back on how many calories are eaten.

I have logged my food intake for long periods of time to see if there was any magic in a ketogenic diet that produced more than expected weight loss. There didn't seem to be. The loudest online proponents of the magic of ketogenic dieting refuse to log or measure their caloric intake to support their claim that ketogenic states burn more fat.

So I think it is a mistake to confuse "cutting calories" with "eating a diet of junk food" which seems to be what is going on here. Cutting calories while ensuring that the calories you eat include vegetables and high quality protein is a very good way to lose weight. But there is zero evidence that there is any kind of fat out there that, if you add it to your diet will improve your weight loss. I've been through all the research used to support this argument for coconut oil and CLA and it doesn't hold up to scrutiny. Eating good quality butter, olive oil, and a bit of coconut oil INSTEAD of the damaged omega-6 oils used for frying, yes. But adding these better oils to an existing oil intake, no.

Number of calories matters. Quality of calories matters.

Having said that, though, whenever this topic comes up, I vaguely recollect reading about a study which showed that people on a low carb diet lost more than low fat when eating the same number of calories (they ate prepared meals to guarantee compliance), and in fact, even those on higher calories, but low carb, lost more than the low fat group. Searching around for it on the web, I managed to find this: http://news.harvard.edu/gazette/story/2 ... n-low-fat/ but I can't find any publication of the study in the scientific literature. I'm guessing it didn't get through the review process...

They probably forgot to account for glycogen loss. That alone explains the difference in the studies I've seen. The great advantage to low carb diets is that they can eliminate physiological hunger. But people can and do overeat for emotional reasons on those diets and when they do, they stall. Half of the messages on the big low carb forums used to be from people lamenting stalls while the other half were recipes made with cups of heavy cream--that explained those stalls

That said, it may be true that it is harder to gain on LC diets, though there is no research on this that I know of. It is often reported anecdotally, though.

As a dedicated logger of food intake, my experience is that a calorie is a calorie. For sure if you can use those calories on high quality nutrition, you will be more healthy, but from my experience, that makes not a jot of difference to weight loss. Carbs can trigger binges which sends the calorie level up, so my conclusion is that if you can stick to good quality nutrition, you are more likely to stick to your calorie intake.

[carorees]

My view is that while the laws of thermodynamics must apply (a calorie is a calorie) the problem comes with accurately measuring your calorie expenditure and intake (and by intake I mean how many calories are actually absorbed into the body). As the article points out, the way the body handles those calories varies according to whether they are sugars or fats (and it varies hugely between people too) and so it is hard to predict exactly how much of any food taken in will be turned into fat and how much burned to provide energy and heat. As Karen says, carbs make you hungrier and the cheese vs chips experiment shows how the presence of carbs can boost energy intake. Thus, it is better to create the energy deficit through eating the right foods (and in our case by simply not eating at certain times/days) rather than starting from the calorie count.

If you see a nice precise number as in the progress tracker's TDEE calculation, it is easy to think that you just have to keep under that number to lose weight, but the chances that the number given is exactly right for you are low. Your TDEE may be much lower or higher than this, and will vary from day to day. Too much focussing on the calories is, therefore, unwise.