Written by: Tom Nikkola – Director of Nutrition & Weight Management
Many of the articles on this site, and information in our weight management programs, clearly show why controlling weight is not just about counting calories or moving more. A new article published in the European Journal of Clinical Nutrition (EJCN) provides further support to this position. Even though the article is published in a prestigious journal, you shouldn’t expect it to make many headlines. If the authors’ perspectives were acknowledged publicly, it would mean changing public health recommendations and would go against much of the advertising found in the food industry.
The research review is titled Obesity and energy balance: is the tail wagging the dog?[i] One of the major themes in the review is the point that rather than looking at lack of activity (sloth) or overeating (gluttony) as causes of obesity, it’s quite possible these may be results of something going awry with our metabolisms. In other words, we don’t get fat just by eating more and moving less. What’s making us fat, also gives us an insatiable appetite and makes us lethargic.
The premise behind the calorie balance equation is that if the calories we burn each day are less than the calories we eat, we gain weight. Yet, when people consciously decrease calorie intake, weight loss is frequently less than would be predicted — cutting back on calories does not result in expected weight loss.
In addition, when people move more, by adding structured exercise programs or engaging in other regular activity, they technically burn more calories. Yet, research shows this rarely impacts weight loss with any significance. However, studies do show people who eat lower-carbohydrate diets lose more weight, even without counting calories. The impact can even be greater when these individuals add exercise to their program. If weight loss occurs by lowering carbohydrate intake without reducing total calories, there’s more than calorie counts affecting weight loss or gain.
As long as we continue focusing on controlling calories, foods often containing processed carbohydrates and artificial ingredients will be viewed as appropriate for weight loss nutrition programs. But the evidence doesn’t support this. Instead, these low-calorie, low-nutrient food products could be one of several reasons we’re gaining weight.
Insulin
So if it isn’t just excess calories that are causing the obesity problem around the country, and the world for that matter, what is it? One obvious answer the EJCN experts referenced is constantly high insulin levels. It’s only been in the past few generations as humans that we’ve had access to granola bars, processed breakfast cereals, crackers, and other pre-made, processed junk food.In fact, when was the last time you saw an advertisement for fresh vegetables or fruit? It’s probably been a while, yet fruit juice is advertised everywhere, making people think it is a sufficient replacement for whole foods.
These modern foods drive up our blood sugar. Elevated blood sugar causes high insulin. In fact, some people can disrupt their hormones so that their insulin levels will be elevated even if they haven’t eaten much carbohydrate in a while. They may also secrete much more insulin than necessary. Aside from leading to a lot of other health problems, elevated insulin shuts down the body’s ability to burn fat. Even on a low-calorie diet, if insulin is too high, fat won’t be burned efficiently. Instead, the body may use its muscle tissue for energy. Translation: Someone can lose some scale weight, yet their body fat remains at unhealthy levels. Even people who appear thin in street clothes may have a very high percentage of body fat.
Leptin
Another possible suspect in the battle against body fat could be the hormone leptin. Leptin is a hormone that signals us that we’re full. When leptin levels are elevated following a meal, we should get the sense to stop eating. Studies show leptin is elevated in many obese individuals, which means they may become leptin resistant the way they become resistant to insulin. The body keeps secreting the hormone to say, “Hey, you don’t need to eat anymore.” Yet, the brain doesn’t get the signal. There are many theories around this phenomenon, including the idea that processed foods may block leptin signaling.Healthy bacteria
The balance of good and bad bacteria may influence not only the nutrients we extract from our diet, but they may also influence the amount of caloric energy we derive from our foods. There is emerging evidence that certain bacteria can increase the caloric value we receive. Simply having more of the right bacteria may allow us to limit the calories we get from the foods we eat. Probiotics may become one of the recommended nutritional supplements in the near future, as additional research begins supporting their use.Fructose
Looking specifically at our diets, the authors discussed a couple likely factors in weight gain. The first is the fructose content in a diet. While the total sugar consumed by the average American outrageous, fructose is a sugar that’s metabolized quite differently than other sugars. The body’s ability to properly manage blood sugar becomes more disrupted from this sugar than others. If this causes elevated insulin, again the body becomes limited it its ability to burn fat.In addition, because of how fructose is metabolized, it doesn’t give the body the same sense to stop eating either. As a result, people may consume far more calories from fructose-containing foods than they would from other sugars. High-fructose corn syrup, corn syrup, sucrose (often labeled as “natural sugar”), agave nectar and many other “natural” sugars have a significant amount of fructose. Even if the label suggests the product is “natural” or seemingly healthy, be sure to check the ingredient list.
Macronutrients
The authors also acknowledged the importance of where daily calories come from. The majority of support in this area is for higher-protein , lower-carbohydrate , higher-fiber diets. However, this is not what you find in the majority of foods at the grocery store. Instead, high-carb, low-fat, low-protein foods are generally the types of food found in ready-to-eat packaging.At some point in the near future, public health professionals and the food industry are going to have to admit that convenience foods dominate grocery store shelves — and that no matter how they’re fortified or modified, they do not support health or weight management.
Sleep
Finally, the EJCN review covered sleep and its effect on weight gain. Studies show those who don’t get enough sleep tend to gain more weight. Again, if weight management was about calorie-burning, you’d think that being awake would burn more calories and help with weight loss — but that’s not the case at all. Missing out on sleep actually disrupts the metabolism in many ways and it’s one of the first things we address with clients. Getting enough sleep also helps in stress management, another factor in a healthy metabolism.Summary
I’m glad I paid for the full access to this journal article as it was a thorough review of many of the areas we must address if we’ll hope for success in reversing the obesity epidemic. Seven out of 10 people weigh too much. The answer is not to count total calories and move a little more!Based on the research in the EJCN review, and many other studies, the answers actually seem quite simple:
Get a regular lab assessment on your body’s metabolic chemistry to see if any issues need to be addressed.
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Eat real food: plenty of vegetables and other plants which provide a ton of nutrients.
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Eat enough protein with each meal, each day.
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Stop looking at fat as bad.
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Get enough sleep every night and manage stress.
We also have to admit that some people have metabolic dysfunctions that must be addressed before they start focusing on their diet. As we always say, weight management is more than just calories in, calories out.SM
This article is not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Use of recommendations in this and other articles is at the choice and risk of the reader.
[i] Wells JCK, Siervo M. Obesity and energy balance: is the tail wagging the dog? EJCN. 2011 July. Advance online publication. Doi:10.1038/ejcn.2011.132
