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WSJ: "Not All Calories Equal, Study Shows"

Interesting article from the WSJ about how the types of calories affect weight loss (or gain) as well as our overall health.

Some money quotes:

"A diet based on healthy carbohydrates—rather than a low-fat or low-carbohydrate diet—offers the best chance of keeping weight off without bringing unwanted side effects, a study published Tuesday in the Journal of the American Medical Association suggests."

And this one:

"Dr. Ludwig said those on the low-carb diet had the biggest boost in total energy expenditure, burning about 300 calories more per day than those on the low-fat diet—about the same as an hour of moderate exercise. But that bump came at a cost: increases in cortisol, a stress hormone, and a measure of inflammation called CRP, which can raise the risk of developing heart disease and diabetes."

Read it for yourself here: http://online.wsj.com/article/SB10001...

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  1. I read it, the study (or the write-up) did not really seem to be a complete systematic test. If you eat something that is harder to digest, it is going to take more calories to digest is it not? So a calorie could be a calorie, just that the "system" has more exercise by the fact that you "exercise" more internally to digest it.

    1 Reply
    1. re: cacruden

      How fattening a calorie is depends upon what hormonal effects it has. Fat does not raise blood glucose nor insulin, so does not stimulate hunger nor fat storage. Carbs from sugars and starches (fruit is in the sugar group) stimulate sudden high insulin levels that lead to excess fat storage and insulin resistance. Protein causes a strong, and sustained insulin response but by only partially converting to glucose at a rate of about 58%, and doing it over hours, it provide a long period of energy without a glucose spike unless your type 1 diabetic. Many studies in children and adults have found what my personal results have been for 14 years; greatly reduced appetite, blood glucose and insulin levels, and weight maintenance on exactly 50% more calories (scrupulously documented for years in my case) than low fat, high carb which has all the opposite effects. The Schneider Hospital peds study found double the weight loss on 50% more calories in the low carb/high fat group. Calories matter, but they matter differently based upon what metabolic responses they provoke.

    2. Bittmann offered up the same basic review of the study so I'll just post it here: http://opinionator.blogs.nytimes.com/...

      It seems the fundamental lessons really boil down to a reduction in the amount of simple sugars:

      "Almost every diet, from the radical no-carb-at-all notions to the tame (and sane) “Healthy Eating Plate” from Harvard, agrees on at least this notion: reduce, or even come close to eliminating, the amount of hyper-processed carbohydrates in your diet, because, quite simply, they’re bad for you. And if you look at statistics, at least a quarter of our calories come from added sugars (seven percent from beverages alone), white flour, white rice, white pasta … are you seeing a pattern here? (Oh, and white potatoes. And beer.)"

      As always with threads on this subject, I hope the discussion can avoid simply devolving into anecdotal evidence and strict adherence to preconceived beliefs. Clearly there will be more studies to come, but it does seem that a balanced and common sense approach to diet is going to be continued to be endorsed. Significantly reducing or eliminating whole nutrient classes may result in weight loss, but the long term impacts, both psychologically and physiologically, are likely to be less than ideal.

      7 Replies
      1. re: MGZ

        "Significantly reducing or eliminating whole nutrient classes may result in weight loss, but the long term impacts, both psychologically and physiologically, are likely to be less than ideal."

        THANK YOU. I have been saying this for years while everyone around me has gone no carb, low carb, high protein, etc. I think it's nuts. While I'm not dropping 10 pounds in 1 week, I have maintained the same weight for several years now by eating a balanced diet of real foods. There is no "bad" food or "good" food, just eat what you want in moderation. When you go overboard, eat lighter the next day. Move around every day as much as you can. That's it.

          1. re: rockandroller1

            Poison is 'bad' food. That's why we don't eat it.

            The evidence on a lot of foods that have been demonized in the media has, admittedly, been mixed. But I've seen strong evidence that added simple sugars, and fructose in particular, does no one any good and many people a great deal of harm. Of course, there are some substances containing fructose that appear to be healthy in moderation for the average individual - dark chocolate, fruit - but these seem to be healthy in spite of their fructose content, not because of it (they are also problematic when over-ingested, whereas by comparison you can eat a great amount of, say, beans on a very regular basis for many years with no apparent ill effects).

            I'm often baffled at the tenacity of the 'everything in moderation' line of thought when both the wealth of scientific findings and even a simple and easy thought experiment that anyone can do prove it woefully inadequate.

            1. re: rockandroller1

              There is no diet I know of, short of the Johns Hopkins epilepsy diet, that removes an entire nutrient group. That's because glucose from carbs harms the brain and ketones actually are healing and the brain switches to them preferentially when they are present.

              Eating low carb increases nutrient density by carbohydrate immensely while reducing the caloric % of them. That's what happens when one replaces high calorie, nutrient impoverished starch and sugar with colorful, fibrous, leafy vegetables. No one's dying of starch defiicits, many are suffering horribly from carb excess.

              1. re: rockandroller1

                But carbs are not a 'nutrient class' . There is no such thing as an 'essential carbohydrate'. There are no nutrients in carbs that CANNOT be found in other foods, yet there are many detrimental things found only in certain carbs.

                And 'no grains' is not the same as 'no carbs'...not in the least.

                Moderation doesn't work for everyone. Some people (me) do much better and are much healthier cutting out certain foods completely.

                1. re: PAINTEDPEGGIES

                  There are many foods that are almost all, if not all, carbs that have nutrients that cannot be found in other foods. In most vegetables/fruits, there is a wide assortment of nutrients and phytochemicals that you cannot get elsewhere, eg. blueberries, spinach, broccoli, etc. Nuts also contain carbs. So, you can't lump those foods in w/ processed sugar or pasta or starches. If you're cutting out all carbs in your diet, you're cutting out more than just starches. Unless you're a carnivore, you're probably eating carbs, though not starches.

                  At the same time, there should be some carbs in meat, theoretically. I've never looked into it but what happens to muscle glycogen when an animal dies? It doesn't disappear. Just thinking out-loud, so to speak.

                  1. re: chowser

                    There's no such thing in human biology as an essential carbohydrate. That's because we can get everything they provide that's important from other sources or manufacture it in our bodies. In human biology, the only essentials without which you die are protein and fat.

                    No one here is discussing cutting all carbs.

            2. The Jama study seems to have attracted a lot of attention all over the web (just not here). Another read:

              http://www.theatlantic.com/health/arc...

                1. re: paulj

                  I was with him right until he completely failed to grasp the fallacy about the endocrine changes on the low carb diet as negatives... they are not. For one thing, cortisol is normalizing, not elevated; it's suppressed as is its transport protein in higher carb/insulinemia. Lower carb allows it to normalize to meet our requirements. This is true of other steroids, too, including testosterone and estrogen, etc.

                  Active thyroid hormone is lowered by all reducing diets, and identically in very low calorie and very low carb. Also, the terrible side effects he lists for long term low carb, I have never heard those complaints in a decade of extensive communication with other low carbers and I've experienced nothing but benefits in 14 years, though not at Atkins induction levels, which is a two week segment of a life time eating plan.

                  Finally, I'm so glad to see the pendulum swinging to recommendations for more fat, focusing on quality, not restriction, and less starch and sugar. I think if our public health authorities promoted a 40% non starchy carb diet with 40% fat and adequate protein (though this diet does not fit all, no diet does) we can afford universal health care. That's because so many fewer folks would be on dialysis, diabetes and lipids drugs, bypass surgeries and having amputations, losing their vision, etc. If we get a recommendation to restrict carbs, not fat, and if folks are taught to tailor their protein intake to their own individual lean body mass requirements, we will see huge benefits for individuals and as a country.

                  1. re: mcf

                    While I don't always agree with your more "low carb" diet pronouncements, I completely concur with the fact that some type of official endorsement of a 40-40-20 for otherwise healthy people would benefit society. (One other balance to the approach would be a reduction in how much of the fat and protein comes from beef. In that way we can also deal with the growing environmental impact of such overconsumption.)

                    Without devolving too much into personal, anecdotal evidence, I was first introduced to the idea of eliminating simple carbohydrates over 30 years ago. I was a chubby, allergy-addled 10 year old and an aging hippy chiropractor suggested the diet to my parents. Needless to say, avoiding bleached white flour, sugar, and corn syrup in 1970s New Jersey was rather difficult - but it worked. My allergies went away, my weight normalized, and my overall heath improved.

                    Since that time, I have basically followed that dietary practice. There were of course times when I deviated (30 some years is a long time to go without treats), but the weight gain was always there to remind me. In fact, in college, when my football coach worried about my girth, I resorted to pizza (lousy, Central PA stuff) and beer to balloon up to my largest size ever (then again, I also spent a few hours a day in the weight room instead of the ocean).

                    Nevertheless, for practically my entire adult life, I have maintained the same basic frame (I still have a sports coat I wore to a homecoming dance in High School - what can I say, Madras may make a comeback). This is true even though I have never avoided whole grains or all starches. Unbleached flour, potatoes, and rice are all acceptable foods for me, although not everyday fare - their "brown" cousins are certainly preferable. At bottom, however, balancing such starchy carbs with lean protein, fats, and regular exercise seems to be the key.

                    1. re: MGZ

                      That allergy reduction, I believe, is because of the removal of the impediment to steroid synthesis, the cortisol elevation being called a "risk" of low carb in this study. It's a benefit! Glad to know you've found what works for you.

                      Anecdotally, all the folks with IBS and asthma who came to a once very active forum were reporting complete resolution of asthma and IBS upon switching to low carb. Most of the asthmatics no longer needed inhalers, they said. So you can allow your body to make its own steroids and get out of its way, or...

                      I do not believe 40-40-20 is necessarily appropriate for most people, even healthy ones, but that cutting the carb recommendations by 33% would be a HUGE advancement, along with improving fat and protein intake.

                      I believe the best way to arrive at an *individualized* eating plan is to calculate protein requirements first, the way Protein Power addresses it, based upon lean body mass maintenance or desire to increase it plus individual metabolic status and activity levels. Then calculate carbs and fats from the balance, making sure to get no less than 40% fat, since lipids researchers say you cannot get optimal health and EFAs from even 30%. And really important to get the carb balance from nutrient dense sources, colorful, high fiber ones.

                      Madras make a comeback? It's never left the uber preppy, country club world... maybe you're looking for chances to wear it in all the wrong places. ;-)

                      1. re: mcf

                        In my "uber preppy, country club" days, the only plaid anyone wore were the flannel shirts the caddies wore to work over their Nirvana shirts. I split that world a decade ago - I'd rather spend my time in a wetsuit or boardshorts. I'll guess I'll have to save the Madras for just the right wedding, or to house my ashes for the trip offshore.

                        1. re: MGZ

                          Good plan. I think grown men look silly in the stuff they wear to preppy country clubs. Though any club with caddies in Nirvana shirts and plaid would not be working at any of the upscale prep clubs I know of and avoid like plague, too. Rather be kayaking somewhere open to the public. ALL of the public.

                          1. re: mcf

                            Hey, what can I say - it was the 90s and the club made them change before donning a bag. Hell, I only went to drink anyway . . . .

                            1. re: MGZ

                              Nothing *wrong* with Nirvana, mind you.

                      1. re: mcf

                        "see the pendulum swinging to recommendations for more fat, focusing on quality, not restriction, and less starch and sugar"

                        Exactly. The problem is people have oversimplified foods into carbs, fat, protein, without looking at each one individually. In the "low fat" 80's, people cut out all fats instead of the bad ones. And in the "low carb" 2000's, people eschewed carbs, and went no carbs instead of eating the good ones and reducing out starch and sugar. Snackwells will never be a healthful snack but that doesn't mean Brussels sprouts (or even better brussels sprout chips) are bad for you. I love my starches/sugars too much to cut them out completely but I believe in using them more as condiments than as a major part of the meal, for the most part; and I definitely think of them as splurge items. But, imo, my diet is far from "no" or "low" carb.

                        1. re: chowser

                          "And in the "low carb" 2000's, people eschewed carbs, and went no carbs instead of eating the good ones and reducing out starch and sugar."

                          This is myth. Even in the most restrictive plan outside of the JHU epilepsy diet, Atkins' two week induction period, dieters were to eat several servings of salad and veggies daily. What was cut drastically was % of calories from carbs, the "no carb" popular diet is distortion and myth. I suspect that has a lot to do with, as you point out, ignorance of the fact that vegetables are carbs, and folks (and media) mistook starches and sugars as synonymous with carbs.

                          1. re: mcf

                            That's what I meant: both were myths. It was also a myth that Snackwells are healthy. There's more to food than just "carbs" and "fat" and "protein" being good or bad and the danger has been in the broadbrushing.