Tag Archive for: calorie restriction

The Cause of Obesity

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On Tuesday, I said that I couldn’t get past the word disease in the statement from CDC Head of Disease Prevention and Health Promotion: “Obesity is a disease caused by many factors, including eating patterns, physical activity levels, sleep routines, genetics, and certain medications.” While we can agree that there may be a genetic or medication contribution to obesity, there is only one real cause.

The definition of disease is a disorder of structure or function in a human, animal, or plant, especially one that has a known cause, and a distinctive group of symptoms, signs, or anatomical change. There’s no question that obesity has anatomical changes that result in symptoms.

But understand the numbers of obesity. Not everyone is massively oversized; the average height for a man in the U.S. is 5’9” and over 202 pounds to be considered obese, while for the average height of a women is 5’4” and over 173 pounds. There are many people who can hide that weight well. My point is that it’s not the largest individuals who are tipping the scales in the increase in obesity; it’s all of us above normal weight contributing our share.

The disorder part of the definition is one that is clear.

The Cause of Obesity

The cause of obesity is the systematic overconsumption of calories, usually taking years, if not decades, to manifest itself.

The Evidence for the Cause

There are two examples I’ll cite, both related to World War II. The first was the Minnesota Starvation Experiment. Male conscientious objectors had to lose 25% of their body weight in six months. They were normal weight when the study began, and their caloric intake was adjusted weekly to maintain the required weight loss. The result was a linear loss of 25% of their weight in six months.

This one is extreme but applies nevertheless. No one walked out of concentration camps overweight after being liberated—no one. They were systematically starved until they no longer had the energy to work.

In both cases, there was not a change in structure or function; the people were simply starved. The result was weight loss. There’s no change in structure or function when we systematically overeat. However, once we’re overweight and obese, there are changes in the structure and function of our bodies that must be dealt with. But it still comes down to this: a calorie is a calorie. No matter what genetics we have or what medications we take or how little we move, we won’t get fat if we don’t overeat.

The Bottom Line

We are obese because we consistently eat too many calories. We can reduce our weight if we systematically eat less. Yes, there are challenges to overcome because of those structure and function changes caused by chronically overeating. You just have to find the way to reduce your caloric input that works for you. Eat less. Eat better. Move more.

I frequently am asked which calorie-counting app is best, and I don’t have an answer. Do you? Have you found one that’s easy to use? Drop me an email and let me know which app you like and why. I’ll give them a try and let you all know which ones perform best.

What are you prepared to do today?

        Dr. Chet

Reference: https://www.cdc.gov/obesity/data/prevalence-maps.html

Lessons from the Starvation Study

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The analysis of data in the Minnesota Starvation Study was immense—1,385 pages in two volumes—but I found two fascinating quotes from interviews with the subjects and lead author Dr. Ancel Keys. Let’s begin with a quote from one of the subjects in an interview 40 years later.

Lesson 1: How You Know You’re Restricting Food Too Much

“I don’t know many other things in my life that I looked forward to being over with any more than this experiment. And it wasn’t so much . . . because of the physical discomfort, but because it made food the most important thing in one’s life. . . food became the one central and only thing really in one’s life. And life is pretty dull if that’s the only thing. I mean, if you went to a movie, you weren’t particularly interested in the love scenes, but you noticed every time they ate and what they ate.”
Harold Blickenstaff, Study Subject

If you try to restrict calories, and you’re obsessed with food all day long, you’re restricting calories too much. For most of us, lowering our intake 10% to 15% by making better choices should not be that noticeable. Yes, it takes a little time to get used to eating a different way, but it shouldn’t create an obsession with food.

Lesson 2: Post-Weight Loss Honeymoon Period

“Enough food must be supplied to allow tissues destroyed during starvation to be rebuilt . . . our experiments have shown that in an adult man, no appreciable rehabilitation can take place on a diet of 2,000 calories a day. The proper level is more like 4,000 calories daily for some months. The character of the rehabilitation diet is important also, but unless calories are abundant, then extra proteins, vitamins, and minerals are of little value.”
Dr. Ancel Keys, Lead Scientist

Caloric restriction is used to lose weight as well as to try and attain the many benefits of long-term caloric restriction. Eventually you reach a point of unity; you achieve your goal weight and that’s where you maintain.

But if you’ve ever reached a weight loss goal, chances are you’ve tempted fate: you experiment to find out if you can eat a little more of your favorite foods. You add little at a time, and you don’t see the scale move—at first. But eventually, the honeymoon period ends and you begin to gain back the weight. It’s happened to me several times. Be aware that it will happen to you. Remember, it’s always about the calories. Keep that in mind and you’ll abandon that weight permanently.

The Bottom Line

One more item from those interviews 40 years later: to a man, the subjects all said they’d do it again. In spite of the deprivation they went through, they knew the knowledge gained was important. I think it speaks to their character to know they would make those sacrifices again.

These two quotes provide us with guidelines. Keep them in mind so you know when you may be overdoing restricting or eating. We’re after the long-term benefits, so keep adjusting until you make it your way of life.

What are you prepared to do today?

        Dr. Chet

Reference: J. Nutr. 135: 1347–1352, 2005.

The Right Meal Plan for You

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“On Day 1 of semistarvation, February 12, 1945, the men sat down to a meal that included a small bowl of farina, two slices of toast, a dish of fried potatoes, a dish of jello, a small portion of jam, and a small glass of milk.”

This was a quote from the Minnesota Starvation Experiment to give an example of the meals the subjects ate during the six-month study. In our carbs-obsessed society, that’s just about the worst meal imaginable. Remember, the purpose was to lose 25% of their body weight in six months. They could eat only the foods that would be available during WWII; the non-combatants in the areas where the war was fought had been semi-starved for years, and we had to know how to begin to feed them so they didn’t get sick from overconsumption.

When I said it’s all about the calories, I really meant it. If you’re ready to try calorie restriction, eat exactly what you’re eating now but reduce it by 11% to 15%. It’s also a great time to eat better with more vegetables and fruit and less fried food, but it’s not mandatory. The Right Meal Plan is one you’re willing to maintain for the rest of your life.

I’ll cover a couple more lessons from the Minnesota study on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: J. Nutr. 135: 1347–1352, 2005.

Semifinal Thoughts on the CALERIE Study

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In case you’re thinking, “Wow, I can’t believe he’s still talking about this one study”—I know! I don’t typically spend this much time reviewing a single study, but this one answered a lot of questions about the benefits of cutting calories. Even with 60 publications so far from the Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) clinical trial, there’s still a lot more info to come and two big questions still to be answered.

More Results from the CALERIE Study

In this first controlled study of calorie restriction in healthy humans, researchers found that:

  • Fasting insulin decreased
  • Triglycerides, total cholesterol, and LDL-cholesterol decreased
  • HDL-cholesterol increased
  • Glucose tolerance increased
  • Working memory improved
  • Inflammation markers such as C-reactive protein and TNF-alpha decreased

As more data is examined and new analytics are discovered to test more variables, I’ll be bringing you more results that may help you be healthier.

What We Don’t Know

The most important thing we don’t know yet is whether calorie restriction is an effective way to lose weight and whether all those great benefits would still apply. By definition all diets restrict calories, but this is not a diet; this is changing your lifestyle to maintain a calorie restriction of 11% to 15% for a long time, preferably for life. If you want to maintain the benefits, such as better insulin control and reducing the risk of heart disease, you never stop.

The other question is whether one type of eating style would be more effective than others to sustain the diet and its effects. Mediterranean? Keto? Vegan? We still don’t know for sure, but my opinion is that it doesn’t matter—it should be one that you can live with long term using the healthiest foods you can afford.

The Bottom Line

The CALERIE Study has demonstrated specific health benefits for calorie restriction of 11% to 15% for normal weight people. I think it will apply to overweight people as well. In the next few weeks, I’m going to drop my caloric intake by 12.5%, and I’ll keep you posted on how you can do it as well.

What are you prepared to do today?

        Dr. Chet

Reference: Nutrition Reviews 2020: Vol. 79(1):98–113.

It’s All About the Calories!

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One of my long-held beliefs is that where weight is concerned, it’s all about the calories—and I’m happy to say that this study reinforces my belief.

But when I’m wrong, I’ll tell you. Case in point: as I continued to examine the CALERIE trial, it became apparent I had made a mistake in the number of subjects and the percentage of caloric restriction. One paper reported 11% caloric restriction over two years, another 15.9%, and a third 14.1%; I referred to that one in Tuesday’s Memo on caloric restriction and immunity. This was a five-year data collection study that began in 2007 and finished in 2012. Different papers covered different time periods, and the data set used was appropriate for the time period examined; there were additions and dropouts until two years before study ended in 2012.

The Purpose of the Study

The primary purpose of the study was to develop a program that would help people maintain a 25% decrease in calories by using technology and a continuous support system. They also had a variety of physiological, psychological, and genetic factors to examine. That’s why data from 15 years ago are still being examined today.

There is one more thing we need to know. This was not a weight loss program; all the subjects were normal weight. They wanted to find the level of caloric restriction that would provide benefits but not cause problems with the immune system, such as the rodent studies found at 40% caloric restriction.

I think they succeeded; 25% caloric restriction was too much in free-living people, but 10% to 15% caloric restriction was doable with no issues in body composition, psychological factors, or several other variables they have reported on such as the decrease in an enzyme that sabotages the immune system as in Tuesday’s Memo.

It’s About the Calories

There were no special diet plans recommended. Subjects were provided support on how to reduce calories along with strategies to use if their interest started to wane over the entire two years. One of the researchers commented when interviewed that perhaps there will be a more effective diet between Mediterranean, keto, or some other way of eating.

No, there won’t.

I’m more convinced than ever: it’s all about the calories. I think people should choose to eat the healthiest foods they can afford so they get the optimal types of fat, phytonutrients, and other factors. But it was, it is, and it will always be about the calories—for weight loss if you’re overweight, for improved health if you’re normal weight, or both.

What are you prepared to do today?

        Dr. Chet

Reference: SCIENCE. Feb 2022. 375(6581):671-677

Reducing Calories Improves Immunity

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The two-year results from the Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) clinical trial—the first controlled study of calorie restriction in healthy humans—were released last week. The purpose of the study was to determine the benefits and hazards of calorie restriction. Animal studies have demonstrated that reducing calories up to 40% allows the animals to live longer, but at a cost: their immune systems become compromised and as a result they have more infections. On top of that, you can restrict that many calories from animals because you feed them, but it’s unrealistic in free-living humans.

After meticulously assessing each person’s basal caloric need, they asked half of the 200 subjects to restrict their calories by 14% and sustain it; if they required 2,100 calories per day, that’s a reduction of about 300 calories a day. That’s just two tablespoons of oil per day; skip the mayo on a burger and get a small order of fries instead of a medium, and that’s it. There are hundreds of little changes like that a person could make to reduce calories by 300 a day.

Under-eating just that little bit and maintaining it triggered an interesting effect: it stimulated the immune response to operate even better than before. I’ll talk about why (and a confirmation of what I’ve always said) on Saturday.

What are you prepared to do today?

        Dr. Chet

P.S. The Super Bowl Webinar is over, but you can still watch the replay. Just click if you want to learn more about Reclaiming Your Power!

Reference: SCIENCE. Feb 2022. 375(6581):671-677